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Pall of Turmoil and Concern Over Medical Marijuana Law

Good judgment of doctors is the only real protection for now

November 10, 1996

Now that Proposition 215 has passed into law by a 56%-to-44% margin, one might think that Californians, with the appropriate doctor's note, can grow and smoke marijuana for medical use. That's not the case. Federal law supersedes state law, and according to federal law, possession of marijuana is a felony. State prosecutors charged with resolving this state-federal conflict are flummoxed, to say the least. "This thing is a disaster," said Atty. Gen. Dan Lungren. "We're going to have an unprecedented mess."

The mess could have been avoided. Gov. Pete Wilson twice vetoed a bill that would have provided marijuana to seriously ill patients suffering from AIDS, cancer and multiple sclerosis--a much more strictly defined category than that in Proposition 215. The California Medical Assn. and the California Academy of Family Physicians gave their qualified endorsement of the drug for these uses. But the governor disagreed, curtly explaining that the medical use of marijuana would "serve no useful purpose."

Much of the blame for the failure to seize this earlier, uncomplicated opportunity falls on the federal Drug Enforcement Administration. For years the DEA has had substantiated reports of marijuana's efficacy in relieving the effects of some ailments. In 1988, for example, a study published in the New York State Journal of Medicine found that 78% of the cancer patients who had not responded to other anti-nausea drugs benefited from smoking marijuana.

The objective of many of the doctors and scientists who lobbied the DEA was to persuade it to make marijuana a Schedule 2 drug rather than a Schedule 1 drug under federal regulations. The move makes sense, for Schedule 1 drugs--ranging from heroin to LSD--are illegal substances that lack "any accepted medical use" and are not considered safe. Schedule 2 drugs, in contrast, are also potentially dangerous (the category includes pure cocaine and opium), but because they are considered medically useful in some circumstances they can be prescribed by doctors under the close supervision of a state medical board.

Wilson's vetoes and the DEA's stonewalling, however, have left us, after the passage of Proposition 215, with marijuana virtually unregulated. The wording of the proposition allows your doctor to prescribe the drug for not only cancer and AIDS but "any other illness for which marijuana provides relief."

The danger here is that while the "Reefer Madness" film some of us saw in school, linking marijuana to insanity, was wrong, so too is the notion that pot is harmless. Solid research shows that for some HIV-positive patients, smoking pot can significantly worsen bacterial pneumonia. Even in a healthy person, short-term use can impair anti-bacterial defenses, while long-term use has been shown to cause neurological impairment.

President Clinton's anti-drug czar, Barry McCaffrey, has been meeting with Atty. Gen. Janet Reno on how the passage of 215 will affect federal drug law enforcement efforts. One thing McCaffrey is sure of: Passage of the loosely worded Proposition 215 sends a "terrible message."

So legislators and health advocates should promptly craft and pass "clean-up bills" that fix Proposition 215's wording. At the very least, these bills should specify that its reference to "physicians" means "licensed California physicians and surgeons" and require these physicians to consider legal drugs before prescribing marijuana. The DEA, moreover, should review the logic behind its drug schedules.

In the meantime, California's only bulwark against marijuana abuse will be the good judgment of its citizens and their physicians.

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