PATIENTS WHO USE MARIJUANA FEAR WORST IF FORCED TO STOP

Their Dilemma: Break Law or Be in Pain

Erin Hildebrandt moved her family from Maryland to Oregon last June for one
reason: She wanted to live in a state where she could use marijuana legally.

Hildebrandt has Crohn's disease, a chronic inflammation of the digestive
tract that gives her nausea. The 34-year-old mother of five underwent
surgeries and tried various treatments, but nothing worked until she tried
marijuana.

Now, she's a registered marijuana user in Oregon, one of 10 states that has
allowed patients who suffer from debilitating illnesses to use the drug as
a pain reliever. "Medical marijuana gave me back my life," she said. "I
don't do drugs. ... I'm just a mom."

But the Supreme Court's ruling Monday that state medical-marijuana laws do
not protect Hildebrandt and thousands of other medical-marijuana users from
federal prosecution has her fearing the worst. "I moved here to be a
law-abiding citizen, and I'm not sure that I am anymore," said Hildebrandt,
who lives in Lafayette, about 30 miles southwest of Portland. "I'm afraid
I'll have the DEA (Drug Enforcement Administration) at my door. Yesterday,
I would have told so much more (about the treatment). Now, I'm afraid."

Her remarks reflected the concern Monday of medical-marijuana users who
said the court's 6-3 decision had left them with a difficult choice: Break
the law in order to take a drug that makes life tolerable, or give up
marijuana and be miserable.

The California patients behind the dispute that was decided by the court,
Diane Monson and Angel Raich, were defiant Monday but hopeful that somehow
a Republican-led Congress would approve a federal medical-marijuana law --
even though it has shown no inclination of doing so.

"I'm going to have to be prepared to be arrested," said Monson, 48, of
Oroville, Calif., suggesting that she would continue to smoke marijuana to
ease back pain caused by a degenerative disease of the spine.

Raich, 39, of Oakland, called on Congress to show compassion for those who
have found marijuana uniquely effective in relieving their pain. "Now is
the time for Congress to step in to help us sick, disabled and dying
patients," said Raich, who has an inoperable brain tumor and a seizure
disorder. "Something will be done if it takes every last breath in my body."

In Washington, the message was: Don't look for action anytime soon.

U.S. Rep. Barney Frank, D-Mass., a co-sponsor of a bill that would give
Congress' blessing for states to make their own medical-marijuana laws,
said the Supreme Court has "now made it clear that this is up to Congress.
If Congress wants to do this, it can."

But Frank and other members of Congress suggested that even in a generation
of lawmakers who came of age as marijuana became popular among youths, few
are willing to go on record as voting for a bill to allow pot smoking.

"I think support is strong" for a federal medical-marijuana bill, said U.S.
Rep. Ron Paul, R-Texas. "But people are still frightened a little bit by
the politics of it. If you had a secret vote in Congress, I'll bet 80%
would vote for it."

After taking several hours to digest the ruling, officials in California
and other states with similar medical-marijuana laws -- Alaska, Colorado,
Hawaii, Maine, Montana, Nevada, Oregon, Vermont and Washington state --
said they doubted that the decision would lead the U.S. Justice Department
to significantly crack down on individual users of medical marijuana,
including those who grow the leaf for their own use.

"People shouldn't panic. There aren't going to be many changes," California
Attorney General Bill Lockyer said. "Nothing is different today than it was
two days ago, in terms of real-world impact."

In Oregon, officials said they would temporarily stop issuing medical
marijuana cards to sick people. The cards allow patients with prescriptions
to possess the drug. "We want to proceed cautiously until we understand the
ramifications of this ruling," said Grant Higginson, a public health
officer who oversees Oregon's medical marijuana program.

The Drug Policy Alliance, a group in Oakland that supports more lenient
drug laws, estimated that there are more than 113,000 registered users of
marijuana in the 10 medical-marijuana states, with more than 100,000 in
California alone.

Marijuana is the most commonly used illicit drug in the USA. About 95
million Americans age 12 and older have used marijuana or hashish in their
lifetime, according to the 2002 National Survey on Drug Use and Health.
About 15 million people use marijuana regularly, the survey found.

The Bush administration has made marijuana a priority in its war on drugs,
casting it as an entry-level drug with no scientifically proven benefits
that leads many users to try more dangerous ones such as cocaine and
heroin. But DEA Administrator Karen Tandy said after the ruling that the
administration's focus would remain on major growers and traffickers.

John Walters, the White House's anti-drug czar, said that those who
flagrantly flout federal law will be punished, but he agreed with Tandy's
emphasis on major traffickers.

"I don't think anybody makes a career out of arresting and punishing
low-level users," he said.

The high court's ruling Monday came four years after it ruled that federal
anti-drug laws could be used to shut down cannabis cooperatives that sell
marijuana for medical purposes. The cooperative at issue in the case was
set up in California after the voters there in 1996 passed the nation's
first medical-marijuana law.

Federal enforcement of that ruling has been sporadic, however, and dozens
of clubs continue to dispense marijuana to patients.

Several California cities, including San Francisco, Oakland, Huntington
Beach and Modesto, have cracked down on marijuana co-ops and dispensaries
recently. Oakland limited the number of clubs last year, and San Francisco
in April put a moratorium on new clubs while the city's Board of
Supervisors decides how to regulate the more than 40 facilities in the city.

Monday's case dealt with whether federal law could be used against those
who possess or grow marijuana in small amounts, for their personal use.
Such prosecutions are rare but are not unheard of: In August 2002, federal
agents seized six plants from Monson's home and destroyed them in an
incident that led to her involvement in Monday's case.

Writing for the court's majority Monday, Justice John Paul Stevens called
the California dispute a "troubling" case because of the legal and ethical
dilemmas faced by Monson, Raich and other medical-marijuana users.

"The case is made difficult by strong arguments that (Raich and Monson)
will suffer irreparable harm because ... marijuana does have valid
therapeutic purposes," Stevens wrote. "The question before us, however, is
.. whether Congress' power to regulate interstate markets ... (covers)
drugs produced and consumed locally."

Stevens also cited the government's argument that medical marijuana laws
could inspire abuses such as unwarranted prescriptions that could lead to
interstate drug trafficking violations.

"One need not have a degree in economics," Stevens wrote, "to understand
why a nationwide exemption for the vast quantity of marijuana (or other
drugs) locally cultivated for personal use (which presumably would include
use by friends, neighbors and family members) may have a substantial impact
on the interstate market for this extraordinarily popular substance."

Relying on a 1942 ruling that permitted government restrictions on local
wheat farming, the majority said Congress may regulate purely intrastate
activities -- such as the personal growing of marijuana -- if it finds that
failing to regulate them would harm the U.S. government's ability to
regulate the commodity.

Stevens was joined in the majority by Justices Antonin Scalia, Anthony
Kennedy, David Souter, Ruth Bader Ginsburg and Stephen Breyer.

Dissenting were two conservatives, Chief Justice William Rehnquist and
Clarence Thomas, and Sandra Day O'Connor, who is usually at the political
center of the divided court. The dissenters said states should have the
right to set their own course in dealing with medical marijuana.

O'Connor said the majority was giving the federal government far too much
authority. "The government has made no showing in fact that the possession
and use of homegrown marijuana for medical purposes, in California or
elsewhere, has a substantial effect on interstate commerce," she said.

Despite predictions by California's Lockyer and others that the ruling's
impact on the vast majority of marijuana-using patients would be minimal,
advocates for medical marijuana called the ruling a huge disappointment.

"In the war on drugs, we have had a war on patients," said Sandra Johnson,
a lawyer and ethicist at Saint Louis University. "This is a tremendous
setback. ... Untreated pain is a public health issue."

Randi Webster, a co-founder of the San Francisco Patients Co-op on the edge
of the city's Haight-Ashbury district, said she wasn't surprised by the
ruling. "The first thing I thought was, what a crying shame that once again
politics is taking the place of compassion," she said.

"We're very disappointed," said Sandee Burbank, director of the non-profit
Mothers Against Misuse and Abuse, known as MAMA, in Oregon. "It's going to
make it harder for doctors and patients to have access (to medical
marijuana) because of the fear."

She says her group, which provides information about the benefits and risks
of medical marijuana, will work harder to push Congress to resolve the issue.

"My phone's been ringing off the hook," she says, describing patients who
are afraid that U.S. officials will take their plants away. In Oregon, she
said, many medical marijuana users grow their own plants. More than 10,000
residents have had permission from the state to do so.

In Washington, Walters, the anti-drug czar, saw the ruling as a rejection
of the idea that marijuana is a proven pain reliever.

"The medical marijuana farce is done," he said. "I don't doubt that some
people feel better when they use marijuana, but that's not modern science.
That's snake oil."