The Bay Area Reporter - January 6, 1998
Phillip Alden, ACT UP/Golden Gate Writers Pool

Marijuana as medicine has a long and controversial history. Between 1840 and 1900, American and European medical journals published over 100 articles on the therapeutic value of cannabis. Use of marijuana declined in the early 20th century with the rise of opiate-based drugs, and the invention of aspirin and synthetic barbiturates. The Marijuana Tax Act of 1937 moved cannabis under the umbrella of what would become known as the Drug Enforcement Agency. The DEA moved the drug to the Schedule I under the Controlled Substances Act, where it virtually perished from the pharmacopoeia.

Recreational use of marijuana is well-documented, but the anecdotal evidence derived from casual use of cannabis is in contention. Proponents of the use of marijuana claim that it is less harmful than alcohol, while opponents state that marijuana is the "gateway" drug, opening the door to use and abuse of harder and more dangerous drugs.

Ron (not his real name) is a PWA living in Berkeley, and a user of medicinal marijuana to combat the effects of wasting syndrome and the toxicity of antiretroviral therapy. He used marijuana recreationally as a young man, but stopped in 1982. On the advice of his doctor, he started using Marinol, the pill form of marijuana, but switched to the plant form when the buyers clubs opened. "Marinol doesn't work as well as the smoke, it takes effect at odd times, and hits you differently each time," he says, referring to the fact that Marinol can take anywhere from a half-hour to three hours before it starts working. Ron has been going to both the San Francisco Cannabis Buyers Club and the Berkeley Buyers Club since they opened. "I'd hate to go to drug dealers," Ron said. "There's no reason for [State Attorney General] Dan Lungren to go after us."

But Lungren and opponents of medical marijuana feel that there's good reason to go after people like Dennis Peron, the founder of the first buyers club in Northern California. They cite a November 1997 Time magazine article chronicling the "party" atmosphere at the San Francisco club, and charge that Peron has been distributing marijuana to children and people who don't need the drug. Those charges are little more than empty rhetoric, although if Peron was distributing the drug to children, there'd be more criminal indictments against him, and the club would most likely be shut down.

Many people wonder what goes on inside these clubs. Recently, this writer followed a PWA to the San Francisco club - now called the Cannabis Cultivators Club - to see exactly what does happen when a person initially seeks out medical marijuana. At the door, the PWA (whom we'll call Bill) requested an intake, and was shown into a long bar on the first floor of the club. The club is painted in a tropical motif, and hundreds of Origami cranes hang from the ceiling. A stairway leads up to the other three floors of the club, but upstairs access was denied until Bill's application was finalized.

Bill had to produce a letter of diagnosis from his doctor. The SF club calls medical care providers to ensure that the letter of diagnosis is genuine. If a person falsifies medical cure documentation, they will be blackballed from the SF club. Bill had to produce a valid California driver's license or ID card. It took about 30-45 minutes for the club to process his information. His picture was taken with a digital camera, and he was handed a laminated ID card.

The second floor of the club is little more than a landing with a walled-off office on one side. On the other side is a small counter, where three young men encouraged Bill to voluntarily sign a "Dennis Peron for Governor" petition. They also sold T-shirts with the Club's logo on the front and the "Service - Justice - Compassion" catch-phrase underneath the art.

The cannabis is distributed behind another large bar on the third floor. Bill showed his new membership card and was offered a number of choices regarding the quality and quantity of cannabis he needed. After purchasing an 1/8 ounce bag of high quality cannabis, he explored the rest of the club.

There are marijuana smoking lounges on the third and fourth floors. Every floor of the club is painted in the same tropical jungle motif as the lobby and first floor. There was 1970s disco music playing, and members were offered fresh juices and fruit in a couple of areas of the club. A number of people, some looking ill, some not, sat together and talked. The atmosphere seemed warm and comfortable, and the club offered food and drink (for a price), and marijuana-laced baked goods for those who are too sick to smoke.

A doctor's opinion

Is marijuana truly beneficial to people with AIDS? A recent e-mail from Dr. Donald Abrams, Professor of Clinical Medicine and Assistant Director of the UCSF AIDS Program, stated the following:

"We just got $1 million from the NIH to study marijuana in people with HIV. There are certainly a lot of unknowns. Does marijuana interact with protease inhibitors, as they are metabolized by the same liver system? Does THC suppress the immune system in people with HIV?"

Dr. Abrams was also concerned about what happens to viral load in marijuana smoking. He noted that marijuana was a licensed and approved drug in the United States until 1942, and some reports from the past have suggested marijuana can lower testosterone levels in men. "That would certainly not be useful in people with wasting, where low testosterone levels appear to exacerbate wasting," he said.

"We clearly see patients with HIV wasting, nausea, vomiting, anxiety, and pain who obtain benefit from smoking marijuana. It is all anecdotal, of course, but even the New England Journal of Medicine editor last year questioned whether clinical trials are actually needed to prove benefit in patients with terminal illness."

A 1995 article in the Journal of the American Medical Association had the following to say about the therapeutic use of marijuana:

"One of marijuana's greatest advantages as a medicine is its remarkable safety. It has little effect on major physiological functions. There is no known case of a lethal overdose; on the basis of animal models, the ratio of lethal to effective dose is estimated as 40,000 to 1. By comparison, the ratio is between 3 and 50 to 1 for secoburbital, and between 4 and 10 to 1 for ethunol. Marijuana is also far less addictive and far less subject to abuse than many drugs now used as muscle relaxants, hypnotics, and analgesics."

The long-term future of marijuana is still up in the air, both legally and scientifically. Until these issues are decided, though, we can look at the anecdotal evidence. Medicinal marijuana seems to help people by calming the side effects of chemotherapy and antiretroviral therapy. Until the courts and the medicos have issued their final stance on the use of medical marijuana, it might be best to let the people who need it continue to obtain it in a legal, safe, and supportive environment.
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