US: For A Very Few Patients, U.S. Provides Free Marijuana



Pubdate: Fri, 19 Mar 1999 



Source: New York Times (NY) 



Author: Sheryl Gay Stolberg 	



ubject: 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."