A History of Medical Marijuana

George McMahon knows he hasn't got much time to live. On this recent day, he sits in his car beside a crowded beach and opens a shiny metal canister filled with marijuana cigarettes. McMahon casually presses a large joint between his wrinkled lips, then lights it.

He's not in Amsterdam, or even Music City, but in rural Texas, home to Bible thumpers, Bush whackers, and a prison system renowned for zero-tolerance sentences and assembly-line executions. Even so, he's not concerned about legal repercussions. He can smoke pot in any state of the union without being arrested or prosecuted.

Afflicted with a rare neurological disease, George McMahon, 50, is the fifth U.S. citizen to receive legal medical marijuana from the federal government. He gets 300 joints a month, courtesy of the little-known Compassionate Investigational New Drug Program (IND), run since 1978 by the Food and Drug Administration.

The U.S. has a long history of allowing the use of experimental pharmaceuticals, but progress toward legitimizing the palliative power of pot stopped cold last month, when the Supreme Court ruled unanimously that "marijuana has no medical benefits worthy of an exception" from the Controlled Substances Act. In their ruling, the justices made no mention of Uncle Sam's own pot farm at the University of Mississippi, nor of the machine-rolled joints sent free of charge to sick people like George.

For now, the program continues because, officially at least, it's considered a research project. In theory, the feds are supposed to be collecting data on the therapeutic effectiveness of marijuana, but McMahon says the agencies supplying him have never sought much information on that. "I am just so pleased to be able to use what they send me legally," McMahon says. "To be relieved of some of the pain and still be within the law means so much."

The FDA's "compassionate" approach hasn't been available to many. The agency implemented the program under Jimmy Carter, following a lawsuit by Robert Randall, a glaucoma patient who demanded that the government acknowledge the medical necessity of his marijuana use. He was soon joined by cancer patients and people with multiple sclerosis or spinal cord injuries, who smoked federal pot for relief from nausea, pain, and muscle spasms.

But as the AIDS epidemic swelled, so did the number of applicants. Overwhelmed officials in the Bush administration stopped accepting applications in 1992, throwing hundreds of requests in the garbage and forcing the chronically or terminally ill to break the law by seeking their medicine on the black market.

The government agreed, however, to continue supplying the 34 patients, like McMahon, who already had been accepted. Today, only a half dozen remain.

His pain momentarily quieted, McMahon steps onto the green grass and limps toward the rickety wooden dock that reaches into glistening water. He suffers from an obscure disease known as Nail Patella Syndrome, a poorly understood genetic condition. NPS can attack major organs, including the kidneys and liver, disrupt the immune system in ways that are difficult to comprehend, and cause bones to be deformed, become brittle, and easily break. It affects the joints, limits mobility, and causes chronic pain, muscle cramps, and spasms. Some NPS patients also have serious immune system complications from the incurable disease.

George winces slightly as a cool breeze carries a cloud of marijuana smoke toward the lake. Although he's well acquainted with pain, he lived without a concrete diagnosis for many years. As a child, McMahon contracted colds and the flu frequently. Muscles in his arms didn't develop normally, and lifting weights did not help. He was constantly breaking bones, especially in his hands and wrists, and he lost all of his teeth by the time he was 21. He felt exhausted and could stand for only a few minutes without experiencing unbearable pain. Spells of nausea, fever, chills, and night sweats were common for him. He suffered from hepatitis A and B and tuberculosis, and there were times when his pain was just constant--whether he was walking, lying down, or sitting up.