Pubdate: March 21, 1999 Source: Orange County Register (CA) Copyright: 1999 The Orange County Register Contact: http://www.ocregister.com/ Section: News page 39 Author: Sheryl Gay Stolberg-The New York Times ONLY 8 PEOPLE CAN LEGALLY USE POT AS MEDICINE Drugs: The federal 'compassionate use' program won't expand soon despite a study showing marijuana can be therapeutic. Every weekday around 11 a.m., a middle-aged stockbroker named his desk and walks to a breezeway outside his office in Boca Raton, Fla. There, alongside the potted palms and smokers taking their breaks, he lights up a cigarette of his own - not tobacco, but marijuana, sent to him by the federal government. The arrangement is 16 years old and perfectly legal. Rosenfeld, who suffers from a rare bone disorder and smokes to relieve his pain, is part of an exclusive club of Americans who receive a free can of marijuana cigarettes each month under a "compassionate use" program sanctioned by the Food and Drug Administration and the National Institute on Drug Abuse. There are only eight participants in the program. "I'm one of the fortunate people," Rosenfeld said. Or at least, blessed with good timing. Since 1992 the door has been shut on the little-know program, which began in 1978 and at its height had no more than about 20 patients. Now, however, the question of whether the government should be providing an illegal drug to a chosen few has been thrust into the spotlight by a new study showing that marijuana is beneficial for certain conditions, including pain, nausea and the severe weight loss associated with AIDS. The study, the most comprehensive review of the literature about medical marijuana to date, was commissioned by the White House and conducted by a committee of 11 scientists appointed by the Institute of Medicine, a branch of the National Academy of Sciences. A report on the study concluded that the benefits of smoking marijuana were limited by the toxic effects of the smoke, but nonetheless recommended that the drug be given under close supervision to patients who do not respond to other therapies. Yet, it does not appear likely that the list of government-approved marijuana smokers will grow any time soon. Indeed, that the program continues to exist at all is testimony to the government's schizophrenic approach to one of the thorniest questions in law and medicine: whether doctors should be able to write prescriptions for marijuana. On the one hand, the National Institute on Drug Abuse pays the University of Mississippi to grow what a spokeswoman called a "consistent, reliable source of research-grade cannabis" for Rosenfeld and the seven other patients. A North Carolina manufacturing plant receives $62,000 a year from the government to roll the cigarettes and ship them in sealed tins of 300 each, to the patients' doctors and pharmacists. Rosenfeld, 46, carries a folded-up letter in his wallet, dated March 17, 1983, from the Food and Drug Administration, authorizing him to use a substance that might otherwise bring a federal prison term of up to five years. Most days, he smokes in his car while driving to work; "I get no euphoric effect," he said. The FDA letter, he added, has been helpful on those rare occasions that the police have pulled him over. On the other hand, Congress has prevented the District of Columbia from releasing the results of a recent ballot question that asked voters to decide if marijuana should be made legal for medical purposes. And the Clinton administration has moved to shut down marijuana buyers' clubs in California and has threatened to prosecute doctors who write prescriptions for the drug. "Why allow eight patients to have legal access to marijuana but criminalize thousands of other patients in very similar circumstances who have the same conditions, virtually identical medical histories?" asked Chuck Thomas, spokesman for the Marijuana Policy Project, a nonprofit group in Washington, D.C., that lobbies to make the drug legal for medical use. "Why deny them legal access?" That question is now before a federal judge in Philadelphia, where 165 patients have filed a lawsuit seeking to force the FDA to grant wider access to the drug. The case is scheduled for trial in June. "The compassionate access program is an acknowledgment by the government of the United States that marijuana has medicinal value," said Lawrence Hirsch, the lawyer for the patients. "It is fundamentally unfair for the government to supply marijuana for medical necessity to eight people in the United States, when the rest of the potential candidates for therapeutic cannabis are excluded." In response, the Department of Justice argues that the government is simply upholding the law. Congress has made the possession and distribution of marijuana illegal, a spokesman for the department said, and the FDA has no obligation to make exceptions to the law for anyone other than those who had legal access to marijuana before the legislation was enacted. - --- MAP posted-by: Derek Rea