LIFE WITH AIDS AND MEDICAL MARIJUANA

A Drug Prosecutor's Pot Conversion

When two doctors told Keith Vines three years ago that he should consider
smoking marijuana for his health, the 46-year-old San Francisco assistant
district attorney was thrown into a quandary.

He had always been a strong advocate of the nation's anti-drug policies.
And as a self-styled "foot soldier" in the war on drugs, he had prosecuted
one of the biggest pot busts in San Francisco history, sending a man to
prison in 1993 for possessing more than 400 pounds of marijuana.

Yet Vines was faced with a potentially life-and-death decision.
AIDS-related wasting syndrome had lopped 45 pounds off his 195-pound frame,
and doctors thought pot might revive his long-lost appetite. To him, it
simply came down to a choice between smoking or dying.

"When you're in a situation like I am, and you're desperate, and you're
watching your body evaporate and disappear around you," he says, his voice
trailing off. "I mean, I started seeing my ribs and my chest (bones). It
was very scary. I was losing the battle."

Vines has no doubt that he's alive today only because he followed his
doctor's advice, and he's glad they had the nerve to tell him--a narcotics
prosecutor--to use marijuana.

Last month he repaid them, in a way. Vines joined a group of doctors and
patients in a San Francisco lawsuit that accuses the U.S. government of
violating free speech rights by threatening to prosecute or suspend the
prescription powers of doctors who recommend pot.

The government's fighting words were provoked when California voters in
November approved Proposition 215, which permits doctors to recommend
marijuana to patients.

The Clinton administration promptly announced it would send letters to
every physician in California--as well as Arizona, which approved a similar
initiative--warning that marijuana remains an illegal drug under federal
law and threatening to take action against any doctor who recommends or
prescribes it. An outcry did prompt the officials to back down somewhat,
educing them to simply stressing that they are not convinced pot can be
therapeutic.

Vines insists that if doctors are muzzled about marijuana or any other
substance, patients will suffer. "In my case," he says, it was clear that
nothing else was working."

The Perfect Plaintiff

Vines is the perfect plaintiff for Conant v. McCaffrey.

A former Air Force captain with the Judge Advocate General Corps, he's led
the kind of life that shreds the derelict pothead image of Prop 215 backers
that drug czar McCaffrey--a former general himself--has tried to project.

San Francisco D.A. Terence Hallinan, who approved Vines' participation in
the case, calls Vines a "straight-arrow guy" who at one time was known in
the office as the "king of DUI prosecutors."

Vines, who is gay, no longer prosecutes drug cases, to avoid any conflict
over his role in Conant, but he was on the D.A.'s federally funded Drug
Strike Force for two years. He now heads the office's psychiatric unit,
handling conservatorships and competency hearings, among other things.

"General McCaffrey must have a lot of chagrin when he hears a former
military officer and foot soldier in the war on drugs--basically someone
with McCaffrey's own resume--make a compelling case for the use of
marijuana," plaintiffs lawyer Graham Boyd says.

If so, McCaffrey isn't saying. His spokespeople in the Office of National
Drug Control Policy refuse to comment on the case. So does defense counsel
Kathleen Moriarty Mueller, a Justice Department lawyer who will represent
McCaffrey and the other defendants--Attorney General Janet Reno, Drug
Enforcement Administration chief Thomas Constantine and Health and Human
Services Secretary Donna Shalala.

In Conant, Vines joins a distinguished troop of plaintiffs that includes
Marcus Conant, one of the best-known AIDS doctors in the country; Stephen
Follansbee, chief of staff at Davies Medical Center; Milton Estes, medical
director of San Francisco's Forensic AIDS Project; and former Police
Commissioner Jo Daly, who uses marijuana to combat cancer. It's essentially
a dream team of plaintiffs.

"[Federal officials have] tried to portray patients who use medical
marijuana as criminal outcasts from society," says Boyd, an associate at
San Francisco's Altshuler, Berzon, Nussbaum, Berzon & Rubin. "We want to
demonstrate that extremely respected and responsible people rely on
marijuana as a legitimate medicine necessary to survive serious illnesses
like AIDS or cancer."

Being out front on such a sensitive issue isn't particularly to Vines'
liking. It goes against his nature to be fighting for a cause publicly, and
he's still getting used to the idea of using a substance banned by the
federal government.

"It's an awkward situation," he says. Vines started toking only after
considering several factors--his rapidly failing health, his doctors'
advice, San Francisco's tacit approval of marijuana buyers' clubs and the
Board of Supervisors on-record backing of medicinal marijuana.

"I weighed all of that and looked at the big picture, that it wasn't
something I was going to abuse," Vines says. "I discussed it with friends
in the D.A.'s office and they were supportive. My reasons were not
recreational. It was to save my life."

But he still would not have joined Conant without the OK of his boss. And
Hallinan gave it happily.

"He has AIDS, and he has been helped by [marijuana]. He's clearly within
the definition Of 215, and I thought some of the statements made by General
McCaffrey were out of line," Hallinan says. "I did not think it was
inappropriate that [Vines] send a message that the medicinal use of
marijuana has been accepted in the state of California."

Both Hallinan and Vines say they know of no one who objects to Vines' role
as a prosecutor challenging government policy.

Vines has handled some prominent cases during his 12 years in the D.A.'s
office. He successfully prosecuted a Castro District gay-bashing case that
led to a 1995 California Supreme Court ruling upholding the
constitutionality of the state's hate crimes statutes.

He also handled what at the time was one of the city's biggest drug busts.
The case involved the March 1992 confiscation of 400 pounds of marijuana
and S1.3 million in cash from the Turk Street residence of Soloman Mohamed
and Paula Polite. Polite got three years' probation and Mohamed was sent to
State prison for four years. Each was ordered to pay $12,500 in restitution.

In recent years, Vines has pulled out the nerve-wracking world of criminal
prosecutions because of AIDS-related health problems. His robust appearance
is deceiving, he says.

"I might look good, but I don't have the same capacities [as before]," he
explains.

Vines was one of the first people in San Francisco to use growth hormone to
help bolster his weight and he has begun taking the new AIDS wonder drugs,
protease inhibitors, in the last year. Both help immensely, but he says he
still finds it necessary to smoke pot to stomach food.

"A lot of it is forced eating habits, because I know I don't want to get
back to where I was before," he says.

Vines says he tried Marinol, the government-approved prescription drug that
contains THC, the essential element found in marijuana. But he says it was
unpredictable and caused an uncomfortably long-lasting "buzz" that does not
occur with just a few puffs of marijuana. He won't say how much he uses per
week, but says he does not toke during work hours.

Vines, whose partner Michael died of AIDS in 1990, says his participation
in Conant is one way he can make a difference. He took his first step in
that direction on Dec. 1, when he spoke at Glide Memorial United Methodist
Church on World AIDS Day about being gay with AIDS. It was a special
moment, he says, because members of his family were in the audience,
including his 17-year-old son, who lives in Alabama.

Vines admits to being a bit hesitant to step out of his "quiet little
corner of the world," but he figures that fighting for doctors' rights to
provide their best advice to patients is a worthy cause.

"If General McCaffrey and those other people in Washington would look
beyond the ideological and political issue, and look at the individuals,
they might understand," Vines says. "I would love to have some of those
people step into my shoes...and see what they would do."