REEFER REFERENDUM
Is Marijuana Good Medicine? And Is The Ballot Box The Best Place To
Decide That Question?

It was 1990. A house on Sherman Street in Portland's Parkside
neighborhood. A drug deal was about to go down. "Betty" (the real
names of those involved have been changed at their request) waited in
the car while her husband, "Rick," went inside.

"Were the cops watching the house?" Betty remembered thinking. "Would
we get busted? We were buying it through the friend of a friend, but
we were worried about how safe it was. Was it laced with something?

"Everybody involved knew it was illegal. But it's like a starving
person stealing an apple. We loved [Virginia] and we wanted to give
her a shot."

"Virginia" is Betty's sister-in-law. She was 27 years old and
suffering from ovarian cancer. Chemotherapy had left her with intense
nausea and no desire to eat. She was losing weight as the chemo and
the cancer ravaged her body. One day, in her doctor's office, while
hooked to several IVs, Virginia discussed her deteriorating condition
with another patient, an older woman. The woman listened
sympathetically, and then asked, "Have you tried pot?"

Virginia was "totally surprised," according to Betty, but she began
seriously considering the idea. After researching the matter, she
decided she had nothing to lose. Rick and Betty volunteered to make
the buy, even though neither smoked pot. "Once you stop eating, it
starts a downward spiral," Betty said. "We were worried she was going
to die. So we made the big score."

Before she smoked marijuana, Virginia had "no interest in food," Betty
said. "After smoking, she was interested enough to eat whatever she
wanted." The nausea vanished, her appetite returned and the weight
loss stopped. Today, Virginia is alive and healthy. She doesn't smoke
pot or use other illegal drugs. But she doesn't dare to speak out
about the medical benefits she believes she received from marijuana
because some family members hold jobs that could be jeopardized if it
became known she had once smoked dope.

It might not be that way much longer.

On Nov. 2, voters will be asked to legalize the use of small amounts
of pot to treat a handful of illnesses, including cancer, AIDS,
epilepsy, multiple sclerosis and glaucoma. The proposed law was
drafted by a well-funded group called Mainers for Medical Rights,
which is closely affiliated with Americans for Medical Rights, the
California organization that spearheaded similar successful
referendums in that state, Alaska, Arizona, Colorado, Nevada, Oregon
and Washington. If approved, the bill would allow doctors to recommend
- -- but not prescribe -- the use of pot for treating medical problems
such as severe nausea, strong seizures and debilitating muscle spasms.
Patients would be allowed to possess up to 1.25 ounces of marijuana.
Or they could grow up to six plants, no more than three of which could
be mature at any one time.

The proposal on the ballot has some serious blind spots. It does not
specify how patients would obtain the drug or the seeds to grow it.
That means Betty and Rick would still have to engage in illegal
activity to obtain pot for Virginia. Nor does the measure alter
federal law, which would continue to classify marijuana as illegal.
Although the wording of the ballot measure attempts to shield
physicians who advise their patients to use the drug from federal
sanctions, such as the loss of their authority to prescribe medicine
and the revoking of their Medicare and Medicaid eligibility, many
doctors and law enforcement officials say such punishments would
remain a serious legal threat.

In spite of those shortcomings, lots of people see the referendum as a
chance to make a real difference in the lives of those suffering from
serious illnesses. But the patients themselves are often reluctant --
for obvious reasons -- to speak out in their own behalf.

Poster Children

Although it's not hard to find folks who've used pot
to treat the side effects of chemo, wasting syndrome from AIDS and
other illnesses, the campaign to legalize medical marijuana in Maine
is sadly lacking in spokespeople with firsthand knowledge of the
issue. With one exception, those who say they've been helped by the
drug refuse to allow their names or photos to be used for fear of the
backlash.

"People are afraid to come out in support," said "Bob," a former
Portland resident who now lives in another state and who asked that
his identity be kept secret. "You're afraid you'll be branded."

In 1986, Bob's wife, "Mary," was diagnosed with multiple sclerosis.
The disease caused severe spasms that rendered her helpless to feed
herself or meet her other basic needs. Her doctors prescribed drugs to
control the spasms, but those medications proved ineffective. Bob
heard from an acquaintance that marijuana might help, but Mary was
"really opposed to it." Finally, in desperation, she tried a joint.
"Suddenly her hand wasn't shaking anymore," said Bob. "The first time
I saw it, it was almost like a miracle."

Mary kept her illicit drug use a secret from everyone except her
husband and a family friend who grew the pot she used. "She was so
embarrassed, she never told anyone," Bob said. Nevertheless, she
continued smoking pot for about two years, until the MS became so
advanced that she had to enter a nursing home, where she died in 1993.
"It really changed my view about how ridiculous the laws are," said
Bob. "There's so much hypocrisy about that."

Mike Lindey isn't afraid to admit he used marijuana.

Between 1995 and 1996, the 67-year-old retired veterinarian from
Freeport underwent four operations for bladder and prostate cancer,
followed by intensive chemotherapy. He lost more than 40 pounds and
was suffering from anemia. "I got myself in a sorry state after three
months," he said. "I was so down in weight and weak, I wasn't
functioning well. I was essentially toxic."

Lindey's doctor prescribed Marinol, a synthetic form of THC that is
the active ingredient in marijuana. Marinol comes in the form of a
pill. For many patients suffering from nausea, the medication never
gets absorbed before it's vomited up. For others, its effects are felt
only after an extended period of time. For Lindey, it simply didn't
work.

Friends suggested he try the real stuff. After just "two long puffs,"
he felt better. His nausea soon abated and his appetite returned. For
the remainder of his treatment, Lindey medicated himself twice a day
with small amounts of pot supplied by friends. Today, he's fully
recovered from cancer and no longer uses marijuana.

"There were no side effects, no addiction afterwards," he said. "None
at all. That never was an issue.

"It seemed to be almost the perfect drug."

Not according to the state's medical establishment.

No Inhaling

On Sept. 17, the Maine Medical Association's (MMA)
governing body met in Bar Harbor to consider a resolution opposing the
marijuana referendum. The original draft of that resolution was
unrelenting in its reefer-madness-style criticism of the ballot
question. It said there was "no scientific basis" for using pot to
treat some diseases, even though the National Academy of Science's
Institute of Medicine released a study in March stating there was
strong evidence the active ingredient in pot was helpful in treating
ailments associated with AIDS and cancer. The resolution claimed
marijuana is "addictive and a gateway drug leading users to frequently
use stronger illicit and harmful drugs ...." That statement also
contradicted the findings in the Institute's study. The resolution
charged the proposed law would require doctors to recommend pot, a
claim that even a cursory reading of the document reveals to be false.

After hearing from local and national experts on medical marijuana and
engaging in an extensive debate, the MMA finally approved an amended
statement opposing the referendum for just two reasons: 1) Not enough
research had been done on the subject, and 2) there was no way under
the proposed law to be sure of the purity or strength of the drug
patients would receive.

"We did try to focus on what we felt were the most important aspects
and leave out the distracting issues," said Dr. Katherine Stoddard
Pope, the chair of the committee that drafted the revised resolution.
"We're not opposing [medical marijuana] if it's studied appropriately
.... The lack of scientific data was really the central issue for the
MMA."

Dr. John Garofalo was one of the authors of the original resolution,
and he still supports many of its rejected arguments. Garofalo cited
two patients of his with MS who he suspected were using marijuana.
Over time, he said, what "started out as treatment became recreational
.... It is a gateway drug in terms of leading to other types of
substance abuse."

Overall, the state's doctors seem unimpressed with the Institute of
Medicine study and unmoved by its call to allow patients with serious
illnesses to smoke marijuana now. "There's not enough significant
research," said Dr. Larry Harcourt, a medical ethicist. "At this
point, it may be premature."

As for the suffering their hard-line stand may cause for current
patients who might benefit from the drug, the physicians are uneasy
but unmoved. "Clearly, that's the most difficult issue," said Dr.
Ronald Blum, a member of the MMA committee that revised the
resolution. "If a patient is close to terminal, there might not be
unreasonable [medical] concern [about smoking marijuana], but the
doctor is still liable."

Marijuana Maverick

As for doctors who worry more about their patients'
health and comfort than their insurance premiums and legal bills,
they're rarer than pot plants in public gardens [see "Politics and
Other Mistakes,"]. One of the few physicians who openly favors using
the drug to treat some diseases is Dr. Owen Pickus, a Portland
oncologist. "I'm not happy with patients taking a drug that's not
properly monitored," Pickus said. "I have no idea what they're
getting. But there's no question I've seen patients with cancer, HIV,
glaucoma that say the only thing that works for them is marijuana.
There's not much I can say about that."

Ironically, Pickus is opposed to the referendum, because it leaves
physicians caught in a legal and moral tug-of-war between the needs of
their patients and the requirements of federal law. Instead, he
supports efforts to convince Congress to approve national legislation
legalizing the use of medical marijuana. Pickus also wants increased
advocacy to educate his peers about pot. "Doctors are terrified of
drug use," he said. "We need to change people's thoughts about the way
they think about drugs. Nothing we've done so far has stopped the
[illegal] use of drugs. We need to rethink. We need to stop lumping
all drugs in one giant category."

Many experts predict that within five years there'll be new methods
for administering marijuana to patients, methods, such as inhalers and
patches, that will allow doctors to control the dosage. Once those
products are developed and approved, Pickus said many of the
"repetitively stupid arguments" against prescribing pot will vanish,
and the drug will become no more controversial in the medical
community than morphine or tranquilizers.

But even if the initiative passes and medical research advances,
little is likely to change in the state as long as most doctors fear
the repercussions of recommending that their patients smoke dope.
"It's unlikely the vast majority of physicians will be affected by [a
state law legalizing medical marijuana]," said Dr. Pope of the MMA,
"because the vast majority will not advise its use. There may be some
who'll advise it, but it's doubtful the majority will
participate."

About the best most people with serious illnesses can expect from
their physicians is a don't-ask-don't-tell attitude. "On two occasions
in the Legislature, we have testified that we have great compassion
[for] patients undergoing chemotherapy and those with wasting syndrome
from AIDS," said Gordon Smith, executive vice president of the MMA.
"It's not going to bother the doctors of Maine if patients use marijuana."

As long as the doctors of Maine don't have to help
them.

The Politics Of Pot

Polls show most Maine people are far ahead of
their physicians and elected leaders on the issue of medical
marijuana. Two statewide surveys conducted in September indicated
strong support for the referendum, with over two-thirds of those
questioned favoring the measure.

But those numbers aren't reflected in the positions of the state's
congressional delegation. Only Rep. Tom Allen dares to admit he
supports such a modest step as allocating money for additional
research into pot's potential benefits in treating illnesses.
Congressman John Baldacci and Sens. Susan Collins and Olympia Snowe
all say they oppose such spending because pot is dangerous, a
difficult argument to refute without the scientific investigation they
refuse to fund.

The state Legislature has been more receptive to the needs of those
who could benefit from medical marijuana. In 1979, lawmakers approved
a measure allowing chemotherapy patients to obtain pot from the
National Institute on Drug Abuse. The law was renewed in 1983, but the
federal agency never supplied the needed medication. The statute has
since expired.

In 1991, a medical marijuana bill similar to the one on the November
ballot actually passed the state House and Senate, but was vetoed by
then Gov. John McKernan. In 1994, the measure was withdrawn because
McKernan again promised to veto it. In 1997, the bill won overwhelming
support in the Legislature's health and human services committee, but
died on the House floor.

The bill's defeat convinced supporters of medical marijuana there was
little likelihood the Legislature would change the law. They promptly
decided to launch the current referendum drive, prompting opponents to
new extremes in their attacks on the proposal. "This is nothing more
than [an attempt] to soften people's attitudes toward drugs -- to make
children smoke marijuana," said state Rep. Glenys Lovett of
Scarborough. "It's a hidden agenda."

"It was brought before the voters because other people chose not to
deal with it," said state Rep. Michael Quint of Portland, who
co-sponsored an earlier medical marijuana bill. Quint admitted the
bill is "flawed" in its failure to deal with a distribution system for
the drug and a lack of clear legal protections for doctors. But, he
said, "This is the only avenue they have to require people to take a
look at it."

"Ideally, Congress would pass a law saying stop this foolishness,"
said state Sen. Anne Rand of Portland, the sponsor of the 1997 bill.
"But it's not politically wise, because you'll be labeled soft on drugs."

That fear of being branded as someone who condones smoking pot extends
well beyond the political spectrum. Many organizations with a stake in
the outcome of the medical marijuana debate have kept a low profile in
the debate. When pressed, they've issued halfhearted statements that
are heavy on ambiguity.

The Maine Hospice Council, for instance, has called for more research
into "the medical effectiveness of crude marijuana." If there's
sufficient scientific data to merit using the drug to treat dying
people, the council favors making pot available by prescription, a
move that would require a change in federal law.

Where does that leave people who are suffering right
now?

"It's up to an individual," said Kandyce Powell, the council's
executive director. "People can acquire [marijuana] if they see fit."

At Peabody House in Portland, a lodging facility for people with AIDS,
the organization's official position on the referendum is equally
murky. "While not specifically endorsing The Maine Medical Marijuana
Initiative," reads a written statement from the agency's board,
"Peabody House supports 'prescriptive access' to marijuana, and
encourages individuals to exercise their right to vote as they see
fit."

A source said the board was uneasy about supporting the measure
because it required people to obtain the drug illegally. "We're
government funded," said the source. "Our hands are tied on this."

One of the few organizations that doesn't seem afraid to publicly back
the referendum is the Maine Civil Liberties Union. While acknowledging
the initiative doesn't address the problem of how patients will get
the drug, Sally Sutton, the MCLU's executive director, said, "It's a
step in the right direction .... Even this change in the law goes a
long way toward giving people permission they wouldn't otherwise have."

The Weeds Of Crime

If there's any group that's unified in its opinion
on the pot referendum, it's the law enforcement community. From local
cops to county district attorneys to the federal prosecutor's office,
they're uniformly against it. But few are as rabidly opposed as Jay
McCloskey, the U.S. attorney in Maine.

"The referendum is a ruse to promote the legalization of marijuana,"
McCloskey said. "It will promote the widespread use of marijuana. It
will make it de facto legalized by making it impossible to prosecute."

McCloskey also believes medical marijuana will send "mixed messages"
to teenagers about drug use and will increase drug abuse by adults. As
for pot's value in treating some diseases, he doesn't buy the claims.
"Smoked marijuana is unlikely to have any medical value," he said.

Geoffrey Rushlau, the district attorney in Sagadahoc County and the
president of the Maine Prosecutors Association, said it's his opinion
that if the referendum passes, it will cause legal confusion, because
many pot smokers will claim they are using the drug for medical
reasons, even though they haven't been diagnosed with any of the
diseases mentioned in the ballot measure. He said even those with
legitimate medical problems may use marijuana for recreational
purposes on occasion, making it difficult to decide when to prosecute.

Police officers say a medical marijuana law will make it tougher for
them to make drug busts. "It doesn't give me a lot of guidelines as to
who can have [pot]," said Joseph Rogers, the chief of police in
Hampden and the president of the Maine Chiefs of Police Association.
"If they say, 'I've got glaucoma,' now what's an officer going to do?"

David Pickering, the police chief in Cape Elizabeth, said busting
someone for possession of marijuana will become more difficult and
time-consuming if the initiative is approved. "There'll be more
follow-up," Pickering said. "It'll take a detective off the street and
have him checking to see if some doctor recommended this. Maybe what
we'll need is a state registry."

Attempts to establish such a registry of medical marijuana users in
California have so far gone nowhere because many patients claim such a
listing would violate their right to privacy.

As a practical matter, though, there probably won't be many cases in
which people with serious illnesses get hassled by police for smoking
dope. One big reason is that local cops already often overlook such
violations. "Even in small towns, where police knew the person had a
terrible illness, they just let it go," said Sen. Rand. "Technically,
that's not legal either, but there's widespread tolerance for the
medical use of marijuana."

Most cops won't admit that on the record, but they do say cases
involving relatively small amounts of pot are rarely prosecuted by
DAs. If the referendum is approved, the likelihood of prosecution
would become even more remote. "It would probably be difficult to get
a complaint in district court on that," said Pickering. "The courts
are overburdened with offenses that are more important than that."

Pushing Pot's Potential

The groups spearheading the referendum drive
for medical marijuana choose their words carefully in order to avoid
being tagged as pro-dope. They cite medical evidence. They discuss
legal safeguards. They tailor their message to appeal to the strong
libertarian streak in Maine voters.

"We're trying to take the government out of the process between
doctors and patients," said Craig Brown, campaign manager for Mainers
for Medical Rights. "It's really putting medical decision-making where
it belongs, and out of the realm of reefer madness."

"It should be left up to the voters," said Gina Pesulima, spokesperson
for Americans for Medical Rights in Santa Monica, Calif. "Let's see
who voters trust in making this decision."

What Brown and Pesulima are less comfortable talking about are the
legal and medical problems inherent in the initiative. Both shrug off
questions about how marijuana will be distributed. "We are working
toward changing federal policy," said Brown, "but until that happens,
we think people with AIDS, people on chemotherapy for cancer shouldn't
be denied the use of the drug."

"We hope the federal government changes its own law as more states
change their laws," said Pesulima.

It's also significant that advocates for the measure are careful to
mention AIDS and cancer as often as possible, but rarely say anything
about glaucoma and other diseases mentioned in the proposal. That may
be because most studies, including the recent findings of the
Institute of Medicine, show marijuana is most effective in treating
the side effects of chemotherapy in cancer patients and wasting
syndrome associated with AIDS, but far less useful for medical
problems associated with other illnesses.

"The medical evidence is that it does provide some benefit," said
Brown, "but other alternatives are equal or better. It calls for more
study."

"We're not saying it's the best medicine all the time," said Pesulima.
"But doctors have a similar difference of opinion about morphine. It
should be an option."

For all the rhetoric about health care, it's obvious the Maine
referendum is aimed less at providing pot to patients than at taking
political potshots at Congress and the federal Food and Drug
Administration. The November vote is simply one step in a carefully
orchestrated campaign by Americans for Medical Rights to increase the
pressure on Washington to add marijuana to the list of drugs that are
available by prescription. Until that happens, no state law is likely
to make a significant difference to the Virginias, Marys and Mikes
who'll still have to break the law to deal with their diseases.

Waiting For The End

It was 1992. A house in the Portland suburbs. Illegal drug use was about to
occur.

Betty and her father, "Don," were sitting in his kitchen. Don, 51, had
been diagnosed with terminal lung cancer. He'd stopped his chemo
treatments, but the nausea and weight loss persisted. He had become
depressed, often talking about how he would miss seeing his future
grandchildren. He knew what marijuana had done for his
daughter-in-law, Virginia. He decided to try it.

Once again, Betty volunteered to obtain the pot, although this time,
she knew of a friend who grew his own. No fear-filled trips to
Parkside. No worries the crop might be laced with other drugs.

"It's ironic," she said. "He had raised me not to do illegal things,
but also to take responsibility. It was honorable. I look back on the
time we were doing it with a lot of fondness. It gave us a last chance
to bond.

"It allowed him to have a few good meals in between the bad bouts. It
got his hopes up, too. I can't imagine where he would have been if he
hadn't had the chance to try it.

"To make judgment calls, to just say there are other chemicals out
there, to say you can't try it, I don't understand. Everyone should be
given a chance."

Don died in 1993.
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Al Diamon is CBW's political columnist.
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SIDEBAR

On The Fringe

Mainers for Medical Rights (MMR) isn't the only group in the state
seeking to legalize the use of marijuana to treat illnesses. There's
also Maine Vocals, a loose-knit organization dedicated to promoting
pot for personal use.

The two campaigns have little in common -- and little good to say
about each other. MMR is a well-funded machine that gets its marching
orders from Craig Brown, a former top aide to ex-Congressman Tom
Andrews. Maine Vocals is a ragtag outfit, best known for staging the
annual Hempstock festival in Starks. Its frontman is Don Christen of
Madison, whose claim to fame is his 1993 arrest and conviction for
handing out marijuana-laced brownies at a public rally.

From the beginning of its push to legalize medicinal pot, MMR has made
it clear it wanted nothing to do with Christen's crowd. "We were told
to stay as far away from them as we could," said one of MMR's
organizers in 1997. "They're political death."

Christen is equally complimentary, labeling MMR's initiative "a piece
of garbage. It won't work. It can't conceivably work. People won't do
it.

"They just want to send a message to the feds, and that's
bullshit."

For the past several years, Maine Vocals has tried, without success,
to get its own marijuana referendum on the ballot. That measure
differs from MMR's proposal in several ways. MMR's plan limits doctors
to advising their patients about using pot to treat a few specific
illnesses, such as AIDS and cancer. The Vocals' bill ignores federal
law by allowing physicians to prescribe the drug "for any illness for
which marijuana can provide relief." MMR limits the amount of pot a
patient can possess to 1.25 ounces or six plants. The Vocals would
allow an unlimited supply. MMR is conspicuously silent on the subject
of where the marijuana would come from. Maine Vocals would permit
people to grow their own and would set up a state board to develop a
distribution plan for those who couldn't do so.

In short, MMR is the mainstream, limiting its efforts to legalizing
marijuana for medical uses. Maine Vocals is on the fringe, more
interested in making pot widely available for almost any purpose. For
this group, medical marijuana appears to be almost an afterthought.
When Vocals member Harry Brown, on whose farm Hempstock is held, was
busted recently for possession of pot, he told the Lewiston Sun
Journal he used the drug medicinally to treat allergies, sleeplessness
and lack of energy. But Brown said he did not support MMR's referendum
because "Medication should be a point between people and their doctor."

While Christen usually steers his discussions of pot to the economic
benefits of hemp production, he admitted in a 1992 radio interview
that his primary reason for becoming an advocate for the legalization
of medical marijuana was "because I like to smoke it."