POT: The Cannabis Buyers' Club says it helps the sick and dying. But the underground movement has met with resistance from those who question the drug's safety and effectiveness.
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.
In 1975, he was arrested on suspicion of possessing marijuana. At first, his lawyers laughed when he explained why he was smoking pot, but eventually they agreed to mount the first marijuana defense based on medical necessity.
After a battery of tests, independent researchers concluded that Randall would go blind without the drug.
He was acquitted when the court concluded that any sane person would break the law to save one's sight.
The government provided him pot through the Compassionate Use Investigational New Drug program, in which the FDA gives certain patients drugs that are not fully tested and gathers data on the effects.
Randall smokes eight to 12 joints a day--without the unpleasant side effects associated with conventional glaucoma drugs.
"I still have my eyesight," Randall, 48, said as he puffed on a marijuana cigarette.
Gradually, a few other people were admitted to the program and given marijuana to smoke legally. But the government did not make it easy: One doctor estimated that it took 50 hours of paperwork to enroll a patient.
With the AIDS epidemic, interest in medicinal marijuana blossomed in the late 1980s, and Randall developed a streamlined way of applying for legal marijuana. The number of applicants soared, prompting the George Bush Administration to close the program to new patients in 1992.
"In a sane society, the prospect of an easy to grow plant that could ease suffering and prolong life would be a cause for celebration," Randall said.
The use of marijuana is even more restricted than narcotics such as morphine, codeine and cocaine, which can be prescribed or administered by physicians for specific purposes.
DEA spokesman Mike Heald said marijuana is strictly controlled because the public does not believe that smoking it is proper behavior.
He said marijuana, like alcohol and tobacco, is a "gateway" substance that leads to the use of hard drugs such as heroin, cocaine and LSD--a contention disputed by marijuana advocates.
Attacking the medicinal marijuana movement, the DEA spokesman also contended that efforts to make hemp available to patients are a smoke screen for the campaign to legalize cannabis.
Heald said the DEA is not stalling medicinal marijuana research but rather is insisting on a high standard of research and limited access to the drug.
Rayford Kytle, a spokesman for the Public Health Service, which oversees the FDA, said his agency is aware of the strong interest in using marijuana legally among some sick people. But, he said, "we have to work with the DEA, and there are just a lot of problems that need to be worked out."
Before clinical trials could be approved, he said, researchers must ensure that delivery of government marijuana is secure and that only test participants get the drug.
"I think in general we are supportive," Kytle said. "It may take a while to get it straightened out, but we are trying to do it."
Despite claims of beneficial effects, Kytle said, federal health officials doubt that its value exceeds its dangers, including potential damage from inhaling the smoke.
"If there is a benefit for some people, we want to make that available," Kytle said. "We also are concerned that we send out a consistent message on drugs, that they are not healthy and they are not good, especially for young people."
* * *
Once a common remedy, marijuana declined in use medicinally after 1900 with the advent of aspirin and barbiturates.
When the federal government imposed a heavy tax on marijuana in 1937, doctors abandoned it. By 1941, it disappeared from the nation's pharmacopoeia.
Now, marijuana must meet new drug standards to be accepted as a legitimate medicine. That means its effectiveness for specific ailments must be proved through controlled studies--a difficult proposition when test subjects can easily tell whether they are smoking a placebo.
No one knows how cannabis acts on the body, how it eases pain or produces a high.
Even research may not tell them--just as science cannot explain how long-used drugs such as digitalis and aspirin work.
Federal health experts maintain that a variety of drugs can provide the same relief attributed to marijuana, including the synthetic form of pot's main active ingredient, THC, which is sold under the trade name Marinol.
But many patients who have tried both say Marinol does not work as well.
Swallowing a pill, they argue, is not an effective way to treat nausea. And, they say, smoking marijuana gives them immediate relief and they can better control consumption.
Some advocates believe that the plant has not been approved as a medicine because no firm is likely to make much money on it.
Typically, pharmaceutical companies spend $200 million or more to develop a drug and win FDA approval, then receive 17-year patent rights that allow them to recoup their investment and make a profit, said Lester Grinspoon, a Harvard professor of psychiatry and co- author of the 1993 book "Marihuana, the Forbidden Medicine."
But because marijuana is a plant, Grinspoon said, there can be no patent--and no big profit.
Moreover, legal medicinal marijuana would be very cheap to produce, costing pennies per dose, and could cut into revenues from competing drugs.
"Here, there is no money to be made," Grinspoon said. "Even worse, the drug companies have something to lose."
Grinspoon said he began researching marijuana in 1967 in the hope of convincing young people that they were using a dangerous drug.
In 1971, his 12-year-old son, Danny, was diagnosed as having leukemia and began chemotherapy that caused debilitating nausea.
During his research, Grinspoon learned of a Texas youth with leukemia who smoked marijuana to prevent nausea from chemotherapy. The professor, however, opposed letting his son try the drug because it was illegal.
But on the way to chemotherapy one day, Grinspoon's wife, Betsy, stopped by Danny's school and asked one of his friends to get some marijuana.
Betsy and Danny smoked it in the hospital parking lot before his treatment and the effect was remarkable. Instead of throwing up for hours after receiving chemotherapy, Danny asked for something to eat.
The professor said he realized that he had been "brainwashed" about marijuana.
"When this country comes to its senses, it will see it as a 'miracle medicine,' a remarkably versatile substance with very limited toxicity," said Grinspoon, whose son later died. "If you scour the medical literature, you cannot find a death due to cannabis."
Even advocates acknowledge that some patients find that conventional drugs work better for them. Some are disturbed by pot's psychoactive effect--the high sought by recreational users.
But Grinspoon argues that marijuana should be legally available to any patient who can benefit from it.
In his book, Grinspoon cites the case of Harvard geology professor Stephen Jay Gould, who underwent chemotherapy for cancer. Gould disliked the marijuana high but found that the herb prevented nausea and improved his attitude.
"It is beyond my comprehension," Gould wrote, "that any humane person would withhold such a beneficial substance from people in such great need simply because others use it for different purposes."
In San Francisco, the Cannabis Buyers' Club--just a mile up Market Street from City Hall--has become an oasis for medicinal users.
* * *
Since it opened in 1991, more than 3,000 people bearing notes from their doctors have flocked to the second-story speak-easy and joined the club. The charismatic Peron said he founded it after his lover--who had been arrested for using medicinal marijuana--died of AIDS.
Hidden behind an unmarked door on the edge of the Castro district, the club is reminiscent of the 1960s, with its muted psychedelic decor and eclectic furnishings.
A menu board lists each day's specials: an eighth of an ounce of AA California Green is a pricey $75; an eighth of an ounce of Grade B Mexican goes for $15.
Peron said the club goes through eight pounds of marijuana a week--about $45,000 worth. He uses the proceeds to pay a stipend to patients and supporters who work behind the sales counter and as doormen.
Customers range in age from 18 to 75 and represent all races. Most are gay men with AIDS, but there also are people suffering from other ailments. Peron, a 48-year-old Vietnam vet, calls the club "the U.N. of diseases."
A longtime marijuana dealer, Peron once was shot by police in a drug raid. He served six months in jail in 1978 for selling pot and knows that he risks incarceration again.
"I'm willing to go to prison for what I am doing," he said.
Like many supporters of medicinal marijuana, Peron hopes that its approval as a legal drug would be the first step in legalizing the plant for all uses.
In 1991, he sponsored an advisory measure on the San Francisco ballot calling for its legalization as a medicine. The proposition passed with 80% of the vote. This year, he has begun pushing a statewide initiative for the 1996 ballot that would legalize it for medical purposes.
At the Buyers' Club, members swear by its beneficial effects.
"It allowed me to gain 30 pounds in the past six months," said AIDS patient Jon Bush. "It's also an antidepressant. It's certainly helped my mood."
Hazel Rodgers, who began searching for marijuana when she was diagnosed with glaucoma, volunteers at the club. The 75-year-old said she was referred there by county Supervisor Angela Alioto, whose late husband smoked marijuana when he was dying of cancer.
"I am an extremely strong advocate of medicinal marijuana," Alioto said. "I saw it work."
Another volunteer is "Brownie Mary" Rathbun, who became a Bay Area celebrity after she was arrested on suspicion of making marijuana brownies for AIDS patients. The charges were later dropped.
"It relieves the wasting syndrome and makes them want to eat," said the grandmotherly Rathbun, 71. "It gives them some form of dignity."
At the height of her baking operation, Rathbun said, there were so many sick people asking for brownies she had to pull names from a cookie jar.
"My kids are dying, some of them in the streets," she said, starting to cry. "Why marijuana is not allowed is something I will never, never understand."
Copyright Los Angeles Times