The Washington Blade; Friday, January 3, 1997
Sue Fox

Many people with AIDS smoke or ingest marijuana to combat loss of appetite associated with wasting syndrome and nausea from some AIDS medicines. Marijuana is also used by some glaucoma patients, and to combat the side effects of chemotherapy and radiation treatments in people with cancer. In November, voters in California and Arizona approved ballot initiatives that legalize marijuana for medical purposes.

On Monday, Clinton administration officials announced that they will send letters to doctors warning them about the federal laws prohibiting the possession and use of marijuana. At a news conference with Attorney General Janet Reno and Secretary of Health and Human Services Donna Shalala, retired Gen. Barry McCaffrey, director of the office of National Drug Control Policy, said: "These propositions are not about compassion, they are about legalizing dangerous drugs." McCaffrey also said that voters in California and Arizona "were asleep at the switch" in approving "hoax referendums."

At a U.S. Senate hearing in early December, drug control officials warned that the California and Arizona measures undermine national efforts to eradicate the use of illegal drugs, including marijuana. This week administration officials rejected a more assertive approach to the new initiatives, such as sending federal agents to California and Arizona. The administration also decided against challenging the new laws in court. Reno said federal prosecutors would determine charges on a case-by-case basis.

In late 1992, the U.S. Food and Drug Administration (FDA) approved the use of Marinol (dronabinol) as a marijuana substitute. Ingested in capsules, Marinol is a synthetic version of THC, the active ingredient in marijuana. Some AIDS activists, however, have maintained that the drug does not adequately replace marijuana as an anti-nausea treatment, takes longer than marijuana to work, and has side effects such as dizziness and muddled thinking.

Also in 1992, the federal government closed a "compassionate access" program that provided medical marijuana to patients who completed a rigorous screening process and could verify their medical need for the drug. There are currently eight patients still in the program, according to FDA spokesperson Don McLearn. Public health and drug enforcement officials in the Bush administration asserted that anecdotal proof of marijuana's medical benefits is "irrelevant" and that there is no evidence that smoking marijuana helps people with AIDS.

At this week's news conference, Shalala said, "All available research has concluded that marijuana is dangerous to our health." She also said the National Institutes of Health will continue to review claims about the drug's medical benefits for a limited number of uses, such as combating HIV-related wasting syndrome.

AIDS Action Council, which represents more than 1,400 community-based AIDS service organizations, supports the elimination of federal restrictions that bar doctors from prescribing marijuana for medical use by people with HIV/AIDS. AIDS Action also supports reopening the government's compassionate access program to qualified patients.

"We don't support the federal government interfering in the rights of doctors and patients to have whatever means are necessary to relieve the pain and suffering of AIDS ... especially if [legalizing medical marijuana] is what local communities want to do," said Jeff Bloom, who works as the FDA Fellow at AIDS Action Council.

D.C. ballot measures filed

The national debate over the state laws is heating up in the District of Columbia, where a local AIDS activist has proposed a similar ballot initiative. Steve Michael, an AIDS activist with the Washington, D.C., chapter of ACT UP, filed a proposal with the D.C. Board of Elections and Ethics on Dec. 5 for a ballot initiative legalizing medical marijuana.

U.S. Attorney Eric Holder Jr. announced Dec. 4 that he wants to toughen marijuana laws in the District, making it a felony to distribute the drug. The offense is currently a misdemeanor.

"That doesn't make any sense at all," said Michael, who said his proposal was crafted in response to Holder's announcement. "We had to do something to counteract that."

The response by federal officials to the Arizona and California laws prompted Michael to file a revised proposal, "The Use of Marijuana for Medical Purposes by Seriously Ill Washingtonians Act," with the D.C. Board of Elections and Ethics on Monday. The new proposal includes language that protects seriously ill people who use medical marijuana, as well as their doctors and caregivers, from criminal prosecution or sanction. Michael's proposal also requires the D.C. Commissioner of Public Health to devise a plan to provide for the "safe and affordable" distribution of marijuana to Medicaid patients and people in AIDS programs funded by the Ryan White CARE Act.

"We haven't really discussed medical use as far as marijuana goes," said Philippa Lawson, executive director of the HIV Community Coalition in D.C. "Individuals have given me their opinions ... but [as a coalition] we haven't taken a formal position. Some people, especially some recovering substance abusers, are opposed to it, but then there are other individuals who swear by it, who are growing marijuana and feel it should be legalized."

The Board of Elections and Ethics has not yet put Michael's proposal on its agenda, according to board spokesperson Bill O'Field. If the board approves the measure, Michael will have 180 days to gather signatures on a petition to put the measure onto the ballot. Michael would need to obtain signatures of 5 percent of D.C. registered voters in five of the city's eight wards, according to O'Field. Citywide, there were 361,419 registered voters when the last count was taken, during the Nov. 5 election.

Michael also filed a ballot initiative proposal with the board last month to legalize the distribution of hypodermic needles in D.C. As part of ACT UP, Michael bid unsuccessfully this year for a District needle exchange contract, which would allow a community-based group to hand out clean needles to drug users. City officials recently canceled the AIDS prevention contract because of technical flaws and said it would be rebid. Michael has said ACT UP plans to apply for the contract again.

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