SAN FRANCISCO — This is a different kind of drugstore. A haze of marijuana smoke hangs in the air, and in the background Mick Jagger sings, "You can't always get what you want . . ."
Dozens of people sit on rummage sale couches and folding chairs, smoking high-grade marijuana. A dozen more line up at the counter, fingering the day's sample buds and buying their ration of weed. The pungent smoke thickens, and a sense of euphoria settles over the room.
It is business as usual at the Cannabis Buyers' Club, a flourishing illegal marijuana market rooted in civil disobedience. But this is a club no rational person would aspire to join: Doing your shopping here means you are sick or dying.
"These people are struggling to live, and marijuana is helping them live," said Dennis Peron, the club's founder and a longtime gay activist. "We lose members every week, and it breaks my heart. But I'll always know that in their final days I gave them a little solace."
The underground pharmacy is part of a growing movement aimed at gaining sick people the right to use marijuana. Across the country, thousands of patients with AIDS, cancer, glaucoma, epilepsy, multiple sclerosis and other illnesses defy the law daily to treat their ailments or ease their pain.
In San Francisco, long known for its tolerance, authorities have chosen to ignore the law, saying that sick people who can benefit from the plant should be able to buy it.
"I have no problem whatsoever with the use of marijuana for medical purposes," said Mayor Frank Jordan, a former police chief. "I am sensitive and compassionate to people who have legitimate needs. We should bend the law and do what's right."
But elsewhere, medical hemp users often are casualties in the war on drugs. Some have paid a high price, enduring repeated police raids, the seizure of their drugs or time in jail.
"We have many problems with what the government is doing to us poor people who need this stuff," said Byron Stamate, 75, who spent four months in the El Dorado County Jail a year ago for growing pot for his ailing girlfriend. "We've got to change the laws."
Cannabis has been used to treat pain and other ailments for at least 5,000 years, from ancient China to Victorian England. In this country, it was a battlefield painkiller during the Civil War and was added to patent medicines until the turn of the century.
But whether marijuana is a safe and effective drug by modern American standards is the subject of growing debate in the medical community.
Advocates cite anecdotal evidence that the plant can reduce nausea from chemotherapy, reverse the wasting syndrome associated with AIDS and ease muscle spasms in paralyzed people, among other things. In one survey by Harvard University researchers, more than 40% of cancer specialists questioned said they have advised chemotherapy patients to smoke marijuana.
But other doctors and federal health officials say there is insufficient evidence to prove that hemp is beneficial; some suggest that smoking it could be harmful, particularly for AIDS patients vulnerable to lung ailments.
Because of the controversy, the government has been slow to permit studies of its effects.
"They can't approve medical use of marijuana because there isn't enough research, but then they aren't permitting the research," complained Rick Doblin, executive director of the Multidisciplinary Assn. for Psychedelic Studies in North Carolina.
For nearly three years, respected AIDS researcher Donald Abrams of UC San Francisco has sought federal approval to conduct a rigorous clinical trial to determine whether smoking marijuana can help patients overcome the deadly AIDS wasting syndrome.
But amid opposition from the federal Drug Enforcement Administration and fears that approval of the study would undermine anti-drug efforts, the Food and Drug Administration has refused to authorize the research.
"People in Washington are putting up barriers," Abrams said. "In my opinion, it's becoming very ridiculous. This trial will go on if the science survives the politics."
Despite the government's reluctance, it has been forced over the years to acknowledge that some individuals have a legitimate medical need for the drug.
Bob Randall, a onetime cabdriver who lives in Washington, D.C., is one of eight people in the country who can legally smoke marijuana. In fact, the government has been supplying him with it for nearly 20 years.
In the early 1970s, Randall was diagnosed with glaucoma and was told that his eyesight was deteriorating so rapidly he would be blind in a few years. None of the conventional glaucoma drugs reduced the disease's elevated pressure within his eyes.
Then, by accident, he discovered that smoking marijuana reduced the pressure and halted the deterioration of his sight. He began smoking every day.