Source: New York Times Magazine, 7/20/97
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Just Say 'Sometimes'

By serving up legalized medical marijuana, 

California is transforming the war on drugs into a muchmorenuanced
dialogue between prosecutors and the public.

The police sergeant offers the dealer some tips about hydroponic growing.
The ailing county prosecutor takes a few hits before dinner. the grower
is willing to give up thousands in profit to get peace of mind. With
California's Proposition 215 in place, Washington fears that its drug war
may be going up in smoke.

By Michael Pollan

One morning in May, Sgt. Scott, 
Savage of the San Jose Police Department’s narcotics unit paid a visit to
the newest tenant in the modest onestory professional building at the
corner of Meridian and San Carlos: the Santa Clara County Medical
Cannabis Center. Sergeant Savage, who has the upbeat demeanor of a young
suburban cop (think 'Adam12) and wears polo shirts to work, has one of
the more unusual jobs in American law enforcement. He is responsible for
developing a set of regulations and procedures to govern the distribution
of medical marijuana in San Jose, work he likes to describe as "very
creative" and "a thinking man's game.

	Since November, when voters in California overwhelmingly approved
Proposition 215, the Compassionate Use Act of 1996, it has been legal
under state law for any "seriously ill" Californian to obtain marijuana
upon the recommendation of a physician. Ballot initiatives are a famously
messy way to make law however, and the language of Prop 215, which took
shape in the marijuanasmokefilled rooms of San Francisco's notorious
Cannabis Buyers Club, is even wispier than most. It doesn't explain
exactly how the marijuana is supposed to find its way from the field to
the patient without breaking state laws not addressed by Prop 215. During
the campaign, California's Attorney General, Dan Lungren, had predicted
"legal anarchy" if Prop 215 were to pass.

	Sergeant Savage's job is to make sure that doesn't happen, at least not
within the San Jose city limits. Which is what took him to Suite 9 of
this professional building, crouched amid the lowslung sprawl of
bungalows on the north side of town. He came to present the Police
Department's new "Medical Marijuana Dispensary Regulations" to Peter
Baez and Jesse Garcia, the proprietors of what will soon be the nation's
first municipally licensed medicalmarijuana dispensary (Clubs like the
one in San Francisco operate with the tacit approval of local
authorities.)

	Unlike many of the other cannabis dispensaries that have sprung up since
the passage of 215, San Jose's has nothing clublike or countercultural
about it: no Grateful Dead tunes on the sound system, and not even a
whiff of marijuana smoke in the air. "This is a nosmoking building,"
Peter Baez explains, and Baez, a slender 33yearold colon cancer patient
who smokes marijuana to relieve the effects of chemotherapy, is dead
earnest about playing by the rules  both the old ones, and the new
ones.

	San Jose's District Attorney has called Baez and Garcia "the Eagle
Scouts" of medical marijuana. As Baez tells it, this is not a
particularly easy role to play. "I've got growers calling every day
offering me free bud"; in exchange, they want a piece of paper
designating them as "medicalmarijuana growers," which may or may not
afford them some legal protection  no one really knows. The center,
which is notforprofit and operates on a shoestring, could surely use
the free pot, but Baez is reluctant to do business with what he calls
"the criminal element." When it's not growers looking to make a deal, or
the occasional forged prescription (which Baez dutifully reports to
Sergeant Savage), it's all the Vinnies from New York" phoning in their
extravagant offers of startup capital  for what could make a better
organizedcrime front than a licensed marijuana dispensary?

	And then there are the new rules that Sergeant Savage came to discuss.
Most of the Police Department's regulations seem straight forward enough,
if somewhat cognitively dissonant in the midst of a drug war that has
made marijuana a prime target. (Six hundred thousand Americans were
arrested for marijuana crimes in 1995, an alltime record.) The new rules
cover such things as the approved way to inventory marijuana plants; the
maximum amount of marijuana a client can buy in a week (one ounce) and
the provision of childproof containers. There is only one regulation that
troubles Baez: the city has decreed that all marijuana dispensed by the
center must be grown on the premises.

	Savage explained to Baez and Garcia that "we can't have you driving down
from San Francisco with your tiunk filled with marijuana. Prop 215 didn't
address the issue of transportation, so that's still a felony which means
you're going to have to grow it all here." Baez and Garcia had been
driving their marijuana down from San Francisco, where they bought it
wholesale ($3,200 a pound) from Dennis Peron, the controversial pioneer
of California's medicalmarijuana movement and the proprietor of the San
Francisco Buyers Club. Peron's club is exactly the sort of operation  a
loosely run, roundtheclock pot party that sells 20 to 30 pounds of
marijuana each week  that gives the city fathers of San Jose nightmares.
Savage and his superiors seem genuinely committed to making Proposition
215 succeed, but they insist on going by the book, such as it is.

	"I told Scott gardening wasn't my forte," Baez recalls, "and that we
don't have the space to grow on site." Savage wasn't about to yield, but
he did want to be helpful. So he mentioned that as part of his recent
research into marijuana he had toured NASA's Ames Research Center in
nearby Mountain View where engineers are developing "some very
sophisticated hydroponic growing systems for the space program. They
showed us how you can now go from seed to head of lettuce in 17 days."
Savage, who is almost boyishly enthusiastic on the subject of marijuana
cultivation, mentioned that the NASA engineers were willing to help Baez
and Garcia design a stateoftheart marijuana grow and had estimated it
could be built for about $50 a square foot. He gave Baez a number to
call.

	But Baez had other worries besides horticultural know how. "What about
Flower Therapy?"

	Flower Therapy is a new cannabis club in San Francisco that operates
with the approval of the city's District Attorney and Department of
Public Health. The club also grows marijuana on site  or at least it did
until early one morning in April, when Federal agents of the Drug
Enforcement Administration kicked down the door, confiscating more than
300 plants and the equipment used to grow them. Baez said to Savage:
"You're telling me I have to grow marijuana on site, when the D.E.A. is
raiding clubs for doing exactly that Flower Therapy had 331 plants
chopped up  I can't afford to lose all my medicine like that." Today;
playing by the book in San Jose means breaking the law in Washington
under Federal law which is undisturbed by Proposition 215 the crime of
cultivating 100 marijuana plants carries a five year mandatory minimum
sentence. (Provided, of course, a Federal prosecutor could win a
conviction from a California jury. Which may explain why the U.S.
attorney has so far declined to bring any charges against the proprietors
of Flower Therapy; two of whom are AIDS patients.)

	Sergeant Savage acknowledged that he couldn't do any thing about the
D.E.A., but he wouldn't budge on the issue of onsite cultivation: "This
is going to be the rule in San Jose." He did offer to fax a letter to the
D.E.A. saying that the Santa Clara club was in full compliance with
zoning and police regulations, but couldn't make any promises it would
work.

	Like characters in an improbable Hollywood Buddy move, Peter Baez and
Sergeant Savage, the pot dealer and the cop, have been thrown together by
Prop 215, as they both struggle to chart a course through the peculiar
new landscape created by legalized medical marijuana. The path these two
have chosen is notable for its almost punctilious legalism, and many
communities in California are looking to San Jose as a model. But there
are others   most notably San Francisco's Dennis Peron  who are heading
off in a different direction, and who regard San Jose's attempt at
legitimacy as quixotic. "Some people are trying to forget that, even with
215, dispensing medical marijuana is still an act of civil disobedience,"
Peron told me. "Isn't that the message of Flower Therapy?"

	All three would agree, however, that they're standing together on a kind
of frontier, a decidedly gray area where the old rules of engagement in
the drug war have been suspended (sort of), but where the new rules are
still being worked out, sometimes painfully. That's mainly because the
process is playing itself out under a cloud of Federal disapproval: the
Clinton Administration  contending that medical issues should not be
decided by referenda, and concerned about pot smoking by teenagers  is
working hard to insure the failure of California's experiment with legal
marijuana. Washington is worried that California will serve, as it often
has, as a bellwether for the rest of the nation. Already Proposition 215
has forced the issue of medical marijuana onto the national agenda. A
halfdozen states are likely to cast votes on similar initiatives in
1998, and another halfdozen State Legislatures are currently debating
medicalmarijuana bills. Moreover, as the Administration recognizes (and
as medicalmarijuana advocates will acknowledge, though mostly off the
record), much more is at stake here than the provision of an herbal
remedy to a handful of sick Californians. California's experiment with
medical marijuana could well turn out to be a turning point in the drug
war, if for no other reason than it is rapidly transforming what has long
been a simplistic monologue about drugs  Just say no  into a complex
conversation between the people and their Government.

	So far, the most compelling voices in that conversation belong to the
patients, the doctors, the growers and the cops who together are
struggling to carve out a place for legal marijuana in the face of fierce
opposition from Wash ingrown. I recently traveled to Northern California
the seedbed of the medicalmarijuana movement, to hear what they were
saying, and learn what their experiment might mean for the rest of us.

The Patients

	The stories of sick people have propelled the cause of
medical marijuana. Proposition 215 was framed by its supporters as a
question of patients' rights, and their most effective television ads
told the stories of cancer patients for whom smoking marijuana brought
dramatic relief. "I've been a registered nurse for over 40 years," began
one spot, shot at a grave site, "but when my husband, J. J., was dying of
cancer, I felt helpless.

	"The nausea from his chemotherapy was so awful it broke my heart. So I
broke the law and got him marijuana. It worked  he could eat. He had an
extra year of life. Prop 215 will allow patients like J. J. to use the
marijuana without becoming criminals. Vote yes on 215. God forbid,
someone you love may need it."

	How do you argue with such a story without seeming heartless? The
opponents of Prop 215, including the Clinton Administration's drug czar,
Gen. Barry McCaffrey, decided they couldn't. They attacked the hidden
agenda of the medicalmarijuana movement ("a stalking horse for
legalization," McCaffrey called it), the deep pockets of their
outofstate backers (including George Soros and Laurance Rockefeller)
and, above all, the "wrong message" that legalizing medical marijuana
would send to children. But they consistently refused to appear with or
debate medicalmarijuana patients. Thus the patients framed the political
narrative.

	Before the Prop 215 campaign, Americans had focused exclusively on the
victims of drugs; now they were meeting victims of the war against drugs,
and these people looked a lot like people they knew. The old stories of
children with drug problems were suddenly displaced by stories of dying
parents in need of pain relief. And these stories resonated with the
experience of voters, a third of whom told pollsters
they personally knew someone who used marijuana for medical reasons.

[Emphasis added]

	In California I met scores of patients who credit marijuana with dimming
their pain, quelling their nausea, firing their appetites and quieting
their seizures; I also met a handful of people who believe marijuana is
keeping them alive. Keith Vines is one patient who has no doubt on that
score; nor does his doctor. Vines told me his story over a 16 ounce
ribeye steak at Harris' Restaurant in Pacific Heights. I mention the
detail because Vines is an AIDS patient afflicted with wasting syndrome;
for someone in his situation, polishing off a big steak (along with a
Caesar salad, scalloped potatoes, sugar snap peas and a slab of pastry)
counts as an accomplishment.

	Keith Vines has had to "come out" three separate times in his 46 years.
The first time was 16 years ago, when he told his wife the mother of his
2yearold son  that he was gay; a fact he realized he'd been repressing
since high school. At the time, he was an Air Force captain, working for
the military as a malpractice lawyer at Scott Airbase Medical Center in
Belleville, Ill. Soon after coming out he moved to San Francisco, where
he went to work for the city as an assistant district attorney. For two
years he served on the Federal Narcotics Strike Force, successfully
prosecuting what at the time had been the secondbiggest drug case in the
city's history.

	Not long after arriving in San Francisco, in 1983, Vines was infected
with H.I.V By 1993, he had developed wasting syndrome, a
littleunderstood metabolic change that causes patients to lose rapidly
not only fat but also muscle tissue. It is often a death sentence. "In a
matter of months I dropped from 195 pounds to 150," Vines said. "You
wouldn't have recognized me; it wasn't the death camps, quite, but
close." This was hard to believe: the man before me looked as robust and
thickly muscled as a football player. "People at work started asking me
about my health. So that was my second outing  as someone with AIDS."

	Like many AIDS patients, Vines takes 10 to 15 medications a day. Many of
these medicines cause debilitating nausea and suppress appetite; and yet
many of these drugs must be taken on a full stomach  and missing even a
single dose can be disastrous. Vines was dying a slow death by emaciation
when he managed to get into a experimental trial that was treating
wasting syndrome with human growth hormone, a treatment that has recently
been approved by the F.D.A. His doctors explained that for the new drug
to have any chance of working, it was essential that he eat three meals a
day  something he found impossible to do.

	Dr. Lisa Capaldini, Vmes's primary physician, suggested he try Marinol
to stimulate his appetite. Marinol is a synthetic form of THC the
principal active ingredient in marijuana. It was approved by the F.D.A.
initially as an antiemetic for chemotherapy patients and then, in 1993,
as an appetite stimulant for AIDS patients. But like many people who take
it, Vines found that Marinol took a long time to kick in and that, when
it did, the effects were far too powerful and long lasting. "One capsule
would make me feel stoned for hours," he said. "Sometimes I'd be too
stoned to eat, or I'd just fall asleep."

	Opponents of medical marijuana often point to Marinol as an superior
alternative; indeed, it appears that the Government speeded the
development and approval of the drug as a way to relieve the political
pressure to legalize medical marijuana, which was building in the wake of
the MDS epidemic. (Before AIDS, the F.D.A. actually administered a small,
quiet medicalmarijuana program in which a dozen or so patients received
pot grown on a Federally run farm in Mississippi. But during the late
80's the AIDS epidemic flooded the ED.A. with applications that it would
have been politically awkward to approve in the midst of the war against
drugs. The program has since been closed down, though eight original
patients still receive their monthly allotment of marijuana 
cigarettes.)

	But many AIDS patients find, as Vines did, that the pills don't do the
job. When it became clear Marinol wasn't working for Vines, Lisa
Capaldini mentioned to him that many of her patients were getting better
results from inhaled marijuana. They found they could more easily
tolerate, or control, the dose, simply by adjusting the number of puffs.
This conversation took place two years before Prop 215; didn't she feel
funny recommending marijuana to a district attorney?

	"Not really;" Capaldini told me. "Because when I looked at Keith I
didn't see a district attorney. I saw a patient who was dying."

	Vines didn't find the decision to try marijuana particularly difficult,
either. "I'm hanging off a cliff, staring at death, and my doctor's
telling me this might help," he recalled. "It's against the law yes, but
I'm not thinking of myself as a prosecutor. I'm a man fighting for his
life."

	So Keith Vines came out for a third time, telling his colleagues in the
D.A.'s office that he felt compelled to break the same drug laws he'd
been working to uphold. San Francisco being San Francisco, everyone 
including, eventually, his boss, District Attorney Terrence Hallinan 
was supportive.

	For Vines, the hard part was obtaining a supply of marijuana without
finding his face in the paper. It's difficult to imagine Vines, who
probably would not object to my describing him as something of a square,
riding up in the Jerry Garcia Memorial Elevator to the third floor of the
San Francisco Buyers Club  a smoky loft done in High Crash Pad, circa
1969. This is where the club's patrons place their orders from the
marijuana menu board (Humboldt Green: $65 an eighth; marijuana lemon
squares: $5 each) and, if they choose, light up and pass out. Keith Vines
got his eighth to go, and went.

	Vines had tried pot once or twice in college and R.O.T.C. ("I tried it
and, yes, I inhaled," a quip I must have endured three dozen times in
California; the relation of the President's past to his policy shadows
every conversation about marijuana here.) But marijuana had never been a
part of his life until now. He began taking a puff or two from a pipe
right before dinner  just enough to make him hungry without getting
stoned. It worked, and very quickly Vines began gaining weight. "I saw
myself in the mirror literally coming back to life," he said. "It was the
growth hormone that put on the weight, but it would never have worked if
the marijuana hadn't given me back my appetite."

	"I understand the drug laws, I know why marijuana is illegal," Vines
went on to say "I certainly don't want my 17yearold son smoking it  we
have a serious drug problem with our youth in this country." He pointed
out that legal opiates like morphine have done nothing to undermine the
war against heroin, and suggested the same would be true for medical
marijuana. "They can still have their war on drugs," he said. "Just take
this out of it. This is medicine."

	If the FDA ever does approve marijuana it will probably be as an
antiemetic and appetite stimulant for people like Keith Vines. But of
course Proposition 215 opened the way not only for them but also for
anyone suffering from "any other illness for which marijuana provides
relief," and a whole assortment of Californians are squeezing through
that door.

	My notebooks are stuffed not only with the testimonies of cancer and
AIDS patients who vouched for marijuana's efficacy; but also with those
of people suffering from paraplegia; multiple sclerosis; msomnia;
posttraumatic stress disorder; anorexia; anxiety; psoriasis, and even
drug addiction. The place to interview these less conventional patients
is the San Francisco Buyers Club. I spent a couple of hours there one
morning, observing the "patient intake" procedure at the club; it was
risible. [ ris·i·ble (r¹z“…b…l) adj. 1. Relating to laughter or used in
eliciting laughter. 2. Eliciting laughter; ludicrous. 3. Capable of
laughing or inclined to laugh. {defination provided by GMS}]

	The staff was eager to show off the new "safeguards" put in place to
weed out illegitimate patients  nifty things like photo ID's with bar
codes on them. But if you believe, as Dennis Peron, the club's
proprietor, famously does, that all marijuana use is medical (except by
children), the process of evaluating "patients" is bound to lose some of
its precision. Even a faded, yearsold letter of diagnosis, its type
rendered chubby by generations of photocopying, will get you in here. I
watched an M.S. patient secure a membership card on the strength of a
letter not even from a doctor but a social worker. When I pointed this
out to the intake staffer, he gave the letter a closer look. "Good point.
Not an M.D. But would you please just look at this man?" The man was
pretzeled into his wheelchair, his arms and hands too badly bent to sign
his name to the application form. "I'm sorry; but we're just too
compassionate here to turn a man like this away just because he lacks the
proper paperwork."

	What I was witnessing here was something other than medicine  it was,
in fact, a lot closer to religion. Peron is California's evangelist of
marijuana, and he has drawn around him a following  people sick in body
or soul who come to his church, many of them daily; to be healed by the
laying on of smoke.

	I spoke to one 31 yearold regular, Robert Boe, who will never be a
poster boy for medical marijuana. He is a moisteyed man who introduced
himself to me as a "masseusepainterpoetartist"; he comes to the club
every day; and evidently finds some form of relief from his torments. He
told me he has had "intractable pain" since 1995, when he was stabbed in
the chest during a mugging and suffered "permanent nerve damage"; the pot
helps, Boe said, "but I come here for the community too." Today he has
brought a poem he wrote in honor of Peron's birthday.

Dennis Peron may well be the world's biggest pot dealer, but he is also,
I think, perfectly sincere in his conviction that "all marijuana is
medicinal," the logic of which seems a shade less absurd the longer you
spend in his smoky tabernacle. (The smoke could have something to do with
it.) It all depends on how you define medicine, what you mean by healing.
When I ask Dennis Peron about all those people I've known who smoke
marijuana strictly for fun, he asks me to consider: "But what is fun? Why
do they need it? It's obvious: something is missing from their lives."

	Peron's practice of medicine may be a joke, not to mention an insult to
people like Keith Vines, who is not smoking marijuana to compensate for
"something missing" in his life. But if he's a charlatan, to many in
California he's a heroic one. It was Peron, after all, who was willing to
sell Keith Vines the marijuana his doctor said he needed when doing so
was still a crime.