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http://www.mapinc.org/drugnews/v99.n315.a03.html
Newshawk: Paul Wolf
(paulwolf@voicenet.com)
Pubdate: Fri, 19 Mar 1999
Source: New York Times (NY)
Copyright: 1999 The New York Times Company
Contact: letters@nytimes.com
Website: http://www.nytimes.com/
Forum:
http://forums.nytimes.com/comment/
Author: Sheryl Gay Stolberg
FOR A VERY FEW PATIENTS,
U.S. PROVIDES FREE MARIJUANA
WASHINGTON - Every weekday morning around 11 o'clock, a
middle-aged stockbroker named Irvin Rosenfeld gets up from his
desk and walks to a breezeway outside his office in Boca Raton, Fla.
There, alongside the potted palms and smokers taking their
breaks, he lights up a cigarette of his own -- not tobacco, but
marijuana, sent to him by the Federal Government.
The arrangement is 16 years old and perfectly legal. Rosenfeld,
who suffers from a rare bone disorder and smokes to relieve his
pain, is part of an exclusive club of Americans who receive a free
can of marijuana cigarettes each month under a "compassionate
use" program sanctioned by the Food and Drug Administration
and the National Institute on Drug Abuse.
There are only eight participants in the program. "I'm one of the
fortunate people," Rosenfeld said.
Or at least, blessed with good timing. Since 1992 the door has
been shut on the little-known program, which began in 1978 and
at its height had no more than about 20 patients. Now, however,
the question of whether the Government should be providing an
illegal drug to a chosen few has been thrust into the spotlight by a
new study showing that marijuana is beneficial for certain
conditions, including pain, nausea and the severe weight loss
associated with AIDS.
The study, the most comprehensive review of the literature about
medical marijuana to date, was commissioned by the White House
and conducted by a committee of 11 scientists appointed by the
Institute of Medicine, a branch of the National Academy of
Sciences. A report on the study concluded that the benefits of
smoking marijuana were limited by the toxic effects of the smoke,
but nonetheless recommended that the drug be given under close
supervision to patients who do not respond to other therapies.
Yet, it does not appear likely that the list of Government-approved
marijuana smokers will grow any time soon. Indeed, that the
program continues to exist at all is testimony to the Government's
schizophrenic approach to one of the thorniest questions in law
and medicine: whether doctors should be able to write
prescriptions for marijuana.
On the one hand, the Institute on Drug Abuse pays the University
of Mississippi to grow what a spokeswoman called a "consistent,
reliable source of research-grade cannabis" for Rosenfeld and the
others.
A North Carolina manufacturer receives $62,000 a year from the
Government to roll the cigarettes and ship them Federal Express,
in sealed tins of 300 each, to the patients' doctors and pharmacists.
Rosenfeld, who is 46, carries a folded letter in his wallet, dated
March 17, 1983, from the Food and Drug Administration,
authorizing him to use a substance that might otherwise bring a
Federal prison term of up to five years. Most days, he smokes in
his car while driving to work; "I get no euphoric effect," he said.
The F.D.A. letter, he added, has been helpful on those rare
occasions that the police have pulled him over.
On the other hand, Congress has prevented the District of
Columbia from releasing the results of a recent ballot question that
asked voters to decide if marijuana should be made legal for
medical purposes. And the Clinton Administration has moved to
shut down marijuana buyers' clubs in California and has
threatened to prosecute doctors who write prescriptions for the
drug.
"Why allow eight patients to have legal access to marijuana but
criminalize thousands of other patients in very similar
circumstances who have the same conditions, virtually identical
medical histories?" asked Chuck Thomas, spokesman for the
Marijuana Policy Project, a nonprofit group in Washington that
lobbies to make the drug legal for medical use. "Why deny them
legal access?"
That question is now before a Federal judge in Philadelphia, where
165 patients have filed a lawsuit seeking to force the F.D.A. to
grant wider access to the drug. The the case is scheduled for trial
in June.
"The compassionate access program is an acknowledgment by the
Government of the United States that marijuana has medicinal
value," said Lawrence Hirsch, the lawyer for the patients. "It is
fundamentally unfair for the Government to supply marijuana
for medical necessity to eight people in the United States, when the
rest of the potential candidates for therapeutic cannabis are
excluded."
In response, a spokesman for the Department of Justice argues
that Congress has made the possession and distribution of
marijuana illegal and that the F.D.A. has no obligation to make
further exceptions.
The Government hopes the program will eventually become
extinct through attrition; some of the patients who were enrolled
have died.
Those who remain owe their precious exceptions to a 51-year-old
glaucoma patient, Robert Randall of Sarasota, Fla. While the
Institute of Medicine has found marijuana is not particularly
useful for glaucoma, Randall begs to differ. In 1973, when he was
a college student in Washington, Randall said, he found that
smoking marijuana helped ease the pressure on his eyes.
"So I grew four little marijuana plants on my sun deck on Capitol
Hill, to make up for those times that I couldn't afford to buy it," he
said. "Then I got arrested."
As his case worked its way through the legal system, Randall sued
the Federal Government, contending that his smoking was a
"medical necessity." In 1976 a judge agreed, he said, and he began
receiving marijuana under the supervision of a doctor at Howard
University.
But that arrangement unraveled in 1978, and he sued again.
The Government settled the case through the compassionate use
program, under which the F.D.A. gives patients access to
unapproved drugs if no other therapies will help them.
"The marijuana is mediocre," said Randall, who was the first
enrollee. "It's what you would expect from a
Government-controlled monopoly. But it works."
Randall later helped others apply, among them Rosenfeld and two
Iowa patients, Barbara Douglass and Ladd Huffman.
Both have multiple sclerosis, a condition for which the Institute of
Medicine found marijuana beneficial. They met in 1990 after a
local newspaper published an article about Huffman, who had been
arrested for growing the drug in a shed behind his home. In
1991 they applied for Federal marijuana together.
Both received F.D.A. approval. Ms. Douglass began receiving the
drug shortly therafter.
"It relaxes the muscle spasms," she said.
But the program was shut down before the final paperwork was
finished for Huffman.
A spokesman for the Department of Health and Human Services
said today that the department determined that the marijuana
was no longer necessary because of the advent of the drug
Marinol, a capsule containing marijuana's active ingredient that
was approved by the F.D.A. in 1985.
Huffman says Marinol does not work. "With these capsules, you
take them and about an hour later you get so stoned you can
hardly function," he said. But, having been sentenced to two years'
probation for his marijuana offense, he is afraid to smoke the
drug again.
As for Rosenfeld, he has pangs of conscience, knowing that people
like Huffman have been prosecuted for buying a drug he gets
courtesy of the taxpayers. And he worries that his supply could
be cut off at any time, particularly if the Government loses the
lawsuit in Philadelphia.
"I'm not against the Government," he said. "I appreciate what
they do for me."
New York Times (NY)
19 Mar 1999
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