Federal Rx: Marijuana

George McMahon knows he hasn't got much time to live. On this fall day he sits in his truck beside an empty windswept beach and opens a shiny metal canister filled with tightly rolled marijuana cigarettes. McMahon presses a large joint between his wrinkled lips, then lights it. He inhales deeply, holds his breath for a few moments, and then exhales. He grins and mutters, "Seize the day."

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

Afflicted with a rare neurological condition, George McMahon, age 51, is the fifth United States citizen to receive legal medical marijuana from the United States Government. He receives 300 joints a month, courtesy of the little-known Compassionate Investigational New Drug Program, run since 1978 by the Food and Drug Administration.

The U.S. has a long history of allowing the use of experimental pharmaceuticals, whether an unproven root bought in a health food store or the once-shunned thalidomide recently given to blood cancer patients like former vice-presidential candidate Geraldine Ferraro. Medical marijuana patients suffered a major legal setback in 2001, however, when the US Supreme Court ruled unanimously that "marijuana has no medical benefits worthy of an exception" from the Controlled Substances Act of 1970. The nine 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.

Despite last year's ruling, ballot-mandated cooperatives continue to provide marijuana to sick and dying citizens in nine states including California, where DEA agents have recently focused efforts to seize records, close clinics, and destroy medical cannabis plants, violating the express will of the citizenry. Public outrage over these intrusive enforcement tactics has been so overwhelming that Santa Cruz officials recently joined local activists to pass out medical marijuana in front of city hall, in direct defiance of federal law. This is the first time in nearly forty years (since the civil rights movement in the 1960s) that federal and state laws are in direct conflict.

George McMahon has strong emotions about the recent headlines from California. "It's like some absurd cosmic joke. I have safe, legal access to my medicine, but my fellow patients are being threatened and jailed. Where's the justice in that?"

For now, George continues to receive marijuana from the federal program because, officially at least, it's considered a research project. In theory, officials are supposed to be collecting data on the therapeutic effectiveness of marijuana, but George says the government agencies have never conducted longitudinal case studies on the legal patients. "I'm 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 originally 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. Randall 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 chronically and terminally ill patients to break the law by seeking their medicine on the black market.