SETBACK ON MEDICAL MARIJUANA

The federal government won a major legal victory Monday in its
benighted efforts to prevent the use of marijuana to relieve the
symptoms of pain, nausea or loss of appetite in desperately ill
patients. But the Supreme Court's unanimous verdict against a
California cooperative set up to supply marijuana to qualified
patients need not terminate all efforts to help those who have no
reasonable alternative treatment. The verdict simply shifts the onus
to individual patients or to compassionate state governments to obtain
marijuana for medical purposes and test the limits of federal
intransigence.

Although marijuana is categorized as an illegal drug under federal
drug control laws, California and eight other states have passed laws
that give patients the right to obtain it for medical purposes.
Federal authorities, concerned that such state laws are a loophole
allowing people to secure illegal drugs, sued for an injunction
against the Oakland Cannabis Buyers' Cooperative to shut down its
operations as a violation of federal law. In its ruling against the
cooperative, the court, which has often championed states' rights,
found reason to ignore the wishes of Californians. The cooperative had
the backing of the Oakland city government and police and was clearly
consistent with the wishes of California voters, 56 percent of whom
approved medical use of marijuana in a 1996 referendum.

But the Supreme Court, in an 8-to-0 decision, ruled that Congress, by
classifying marijuana as a Schedule I drug under the Controlled
Substances Act, had determined that marijuana has "no currently
accepted medical use in treatment in the United States." Thus the
cooperative could not claim a medical defense for distributing it,
even though highly respected medical groups, ranging from the
Institute of Medicine to the California Medical Association, have seen
a valid if limited role for marijuana in relieving the symptoms of
patients who are not helped by pills containing an active ingredient
of marijuana or by other treatments. Smoking marijuana, for example,
can alleviate the nausea associated with cancer chemotherapy and the
wasting syndrome associated with AIDS.

The decision left some wiggle room for future efforts to allow medical
uses. Congress could make marijuana medically available through
legislation, but that is not considered likely with Republican control
of both houses. State governments could distribute the drug
themselves, as two states are now considering, and hope that a Supreme
Court that has favored states' rights in other contexts might rule for
the states in this context as well. Or patients can take matters into
their own hands and dare federal authorities to come after them for
activities their own state authorities deem legal.

Five of the Supreme Court justices left hints that they might read
federal law as prohibiting any medical use of marijuana in any setting
outside a research project. But the other three signed a concurring
opinion contending that this week's decision found only large-scale
manufacture and distribution of marijuana illegal and did not address
the issue of whether individual patients could obtain and use the drug
for medical purposes. Either way, sick patients may now be forced to
grow the plants themselves or buy marijuana from illegal dealers on
the street, increasing the very trafficking that federal authorities
say they want to shut down.

Federal agents could theoretically arrest patients who grow or use
marijuana for treatment recommended by a physician, but under
California law the state and local police could not. If any patients
should actually be arrested, juries would seem unlikely to convict in
a state where most people endorse the medical use of marijuana.
Congress should be as wise.