BALANCING MEDICINE WITH THE LAW

California Voters Ignored Politicians When They Chose To Decriminalize
Possession And Cultivation Of Medicinal Marijuana In A 1996 Referendum. But
The Referendum Failed To Address Who Can Supply The Drug

SAN FRANCISCO - In a nondescript suite above an auto-parts shop in West
Hollywood, Scott Imler cultivates several hundred marijuana plants and buys
more than 20 kilograms of the drug off the street each year to supply clients.

The rules at the Los Angeles Cannabis Research Center are simple: Don't
smoke in public, don't share the joint, don't take more than 27 grams a
week -- and bring a note from your doctor.

His organization charges its 630 or so customers whatever they can afford
for the weed. About 30% pay nothing at all.

The centre is the primary distributor of medicinal marijuana in the city --
and in a unique position in the U.S. legal system.

California voters ignored politicians when they chose to decriminalize
possession and cultivation of medicinal marijuana in a 1996 referendum. (A
few other states, including Alaska, Washington, Oregon and Colorado, have
followed suit.)

But the referendum did not address important related issues, such as who
can supply the drug.

Last week, the state assembly approved a measure to introduce a registry of
users, which would shield patients from $450 (US) fines for possession.

However, governor Gray Davis has already let it be known he won't support
the bill.

"The governor is against the use of drugs," a spokesman from his office
said flatly.

Meanwhile, federal officials resist making distribution of marijuana to
patients legal as the U.S. continues to wage an all-out war on drugs of all
kinds. This is even though research commissioned by the White House shows
the positive medicinal effects of pot.

In the past year, federal and state authorities have closed the handful of
well-known distribution sites in northern California, forcing patients and
distributors to set up surreptitious dispensaries. Only about four are now
operating, health officials say.

"Patients are not discussing this above board because the feds will just
shut them down," said Jeff Jones, 24, whose Oakland Cannabis Buyers
Co-operative was closed by U.S. marshals last October.

In southern California, the L.A. centre has had its share of difficulties,
but has managed to stay open by walking a fine line between openness and
discretion.

"We don't want to rub it in anyone's face," said Mr. Imler, founder and
president of the centre, which does not advertise.

Undercover agents from the federal Drug Enforcement Agency have visited his
operation, posing as patients and bringing bogus doctors' letters. Mr.
Imler said they were sent away when their documentation didn't check out.

The organization maintains good relations with the nearby sheriff's office,
and belongs to the local chamber of commerce and better business bureau. It
also claims charitable status each year when it files a tax return.

"We have a serious drug problem in this country," Mr. Imler said. "But it's
wrong to put it on the backs of sick people."

The 41-year-old has suffered from seizures all his life. Unable to tolerate
the heavy side effects from medicine traditionally prescribed for epilepsy,
he smokes two to three joints a day instead.

He says he hasn't had a seizure in more than two years, but he does get
very hungry and likes to take a nap in the afternoon.

"I don't think I'd want to go and fly an airplane or anything," he admitted.

A scientific study into the medicinal uses of marijuana commissioned by the
White House concluded earlier this year that cannabinoids in the drug offer
a "modest" way to treat pain, chemotherapy-induced nausea and vomiting, and
poor appetite and wasting caused by AIDS.

"We believe that cannabinoids are an underutilized source of new drugs,"
Dr. John Benson, a principal investigator for the Institute of Medicine,
said in March when he released the study's results.

Dr. Herminia Palacio, a policy advisor to San Francisco's director of
health and a physician who has treated AIDS patients for the past decade,
wants the government to fund further research.

"The federal government's battle cry is that there's not enough scientific
proof, but it won't support the research," she said.

In Canada, Ottawa has announced it will fund clinical trials for medicinal
marijuana. Two AIDS research groups in Toronto are in the preliminary
stages of protocol development. In the meantime, Health Canada is taking
applications for legal exemptions allowing patients to grow and possess --
but not purchase or supply -- medicinal marijuana.

To date, only two people have won such exemptions in Canada, said
spokeswoman Reva Berman.

Besides finding the money to fund their work, researchers in the U.S. and
Canada face an additional hurdle -- how do they get their marijuana? The
only legal supplier in North America is the U.S. National Institute of Drug
Abuse.

Scientists and physicians are also nervous about their own legal position
when it comes to marijuana, said Dr. Palacio, who is a firm believer in
what the drug can do for her patients.

She chooses her words very carefully when discussing her role in the
distribution of the drug.

"We're not allowed to prescribe," she explained. "I discuss with my
patients the possible benefits to them as well as the possible risks of
marijuana. I do have patients that I know are smoking marijuana, and I
manage them and their marijuana as providing part of their clinical care."

Mr. Jones started the Oakland co-operative in 1997. Although his business
lasted only a year, it was serving about 2,000 patients by the time it was
closed down.

He said he became an advocate of the medicinal use of pot after watching
his father suffer an agonizing death from cancer, which he believes the
drug could have eased.

These days, he is concerned by the legal situation, and restricts his work
to selling hemp products and sponsoring seminars on medicinal marijuana.

"I don't want to be locked up," he explained.

For the moment, there is a delicate balance between patients and the law.

Federal drug agents are too busy to pay much attention to the medicinal
shops and California's new attorney-general, Bill Lockyer, is more
supportive of the voters' 1996 proposition than his predecessor.

"The police chief has assured me that the last thing they want to do is
bust sick people," said Tom Ammiano, president of San Francisco's Board of
Supervisors and an advocate of medicinal pot.

He blames some of the early clubs that have been closed for being too loose
in their practices -- courting too much media attention and not policing
themselves strictly enough.

But more than anything, he blames Bill Clinton, the U.S. president, and the
federal government for their hypocrisy.

"Clinton has been a tremendous disappointment -- Mr. I Didn't Inhale. Where
is he for the people who really need it?"

Bill Zimmerman, executive director of the special interest group Americans
for Medical Rights, is under no illusions. Despite his support of medicinal
marijuana, he admits all aspects of the matter violate federal law.

To make real progress the first step must be to depoliticize the issue, he
explained.

As a member of a state-appointed task force established to try to resolve
the contradictions in laws, Mr. Zimmerman helped draft the user registry
proposal now before the California Assembly.

But without strong leadership from the governor, the present system will
continue to limp along with all its inconsistencies.

"Unfortunately, anything that has to do with drugs is seen as a criminal
justice matter. The governor sees this not in terms of compassion for the
sick, but rather as a simplistic law and order matter on which he has to
look tough to the public," he said.

Mr. Imler agrees it is a huge mistake to mix the issue of decriminalizing
medicinal marijuana with wholesale decriminalization -- something he
doesn't support.

"We've never tried to be anything but a group of patients growing their own
marijuana," he said.