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.

The herb has brought McMahon the relief he couldn't find in traditional pills, and with fewer side effects. "Most people don't know that I'm sick unless I tell them," he says. "The marijuana has really been that effective in controlling my symptoms. I don't need statistics and research. I am living proof that marijuana works as medicine."

Efforts to get data gathered in the "investigational" pot project proved fruitless. Various FDA representatives have promised to answer questions and look up reports, but none did.

For people like McMahon, the true goal--to relieve suffering--seems obvious, as does the need to grant the relief to all who need it. His own medical history includes 19 major surgeries, seven of them performed in one week. Throughout his life, he has been prescribed morphine, Demerol, Codeine, Valium, and other sedating medications. He has been rushed to hospital emergency rooms on at least six occasions with severe drug-induced conditions, including respiratory and renal failure and hallucinations. The medications did little for his chronic pain and spasms, and he was both mentally and physically incapacitated.

Convinced that using small amounts of pot daily helped ease his discomfort better and without life-threatening side effects, McMahon smoked marijuana illegally for 20 years. Finally, he found a doctor in Iowa, where he lived at the time, who took a special interest in helping him get marijuana legally. He put McMahon through an investigation protocol and a spastic-pain evaluation. Then McMahon contacted Iowa Sen. Charles Grassley's office and was pleased to find a sincere willingness to help.

After yet more tests and stacks of legal paperwork, McMahon received his first shipment of marijuana from the National Institute on Drug Abuse in March 1990. These days, he goes to a designated pharmacy, where he picks up the medicine in the form of joints, stored in a silver tin with a prescription tag.

McMahon keeps his monthly supply with him at all times. As a general rule, he tries to be discreet, in hopes of not offending people or appearing to kids as a recreational pothead. "I cope with the pain," he says. "Some days are better than others, but if I go more than a few hours without my medicine, I can get myself in trouble."

Sometimes, though, he lands in a jam by taking it. McMahon says few cops seem to be aware of the program. On one occasion he and Margaret, his wife of 30 years, were attending a Virginia conference sponsored by the National Institute on Drug Abuse, where he intended to contradict the agency's specious claim that marijuana was addictive. George had meandered away from the main crowd to smoke his medicine, when he was approached by two police officers, one of whom began hitting his fingers, trying to knock the joint out of his hand, yelling at him to put it out.

"He called me a ïàmotherfucker,' called my wife a ïàfucking bitch,' and told me to ïàshut my fucking mouth,' " he says. "They tried to get us to leave by intimidating us. They treated me like a criminal. I am not a criminal. It was one of the worst feelings I've ever had."

Despite the intensity of his daily struggles, McMahon describes himself as a "regular family man who has had to make wide adjustments." His voice and appearance are rugged, the heavy toll of years spent at manual labor, for mining companies and large farming operations. Today, he lives quietly on disability insurance at his modest home in an East Texas gated community, and enjoys spending time with his three adult children and seven grandchildren.

He has a certificate of heroism for participating in the President's Drug Awareness Program in 1990, signed by former first lady and prohibition advocate Nancy Reagan.

McMahon is a reluctant hero. He expresses gratitude to his family, especially his mother and stepfather, June and Robert Baker, who have given a $500,000 annuity to the University of Tennessee at Knoxville to educate aspiring nurses. His wife has also been a tremendous support to McMahon, and she has seen the difference cannabis makes. "If he did not receive the marijuana," Margaret says, "George would probably be dead by now from all the other narcotics he would be taking for pain."

In addition to struggling for survival, McMahon is fighting for the decriminalization of medical marijuana. Since government weed contains only a moderate level of the intoxicant THC, McMahon remains lucid and eloquent. He has traveled the country, speaking with university students and faculty, legislators, physicians, and law enforcement officials--all while smoking 10 joints a day.

The recent Supreme Court decision to ban the Oakland, Calif., Cannabis Buyers' Cooperative from distributing medical pot set the campaign back, even as it exposed the government's hypocrisy. According to legal documents, the compassionate program that helps McMahon was a cornerstone of the cooperative's cause.

Few expect the federal government to start zealously enforcing the law. Consider the ramifications if officials began arresting and incarcerating tens of thousands of patients, breaking apart the families of sick and dying people, and using tax dollars to prosecute, imprison, and provide medical services to these patients. Politicians want to avoid front-page photos of MS patients with spasmodic arms handcuffed to wheelchairs while relatives sob in the background. "Federal agents generally aren't prosecuting marijuana possession crimes," says Knoxville criminal defense attorney James Bell, "unless someone has more than 100 plants."

This lack of emphasis on marijuana prosecution also holds true at the state level. Bell claims that "most police officers in Tennessee have better things to do than go after marijuana smokers, medical or otherwise."

H. Wallace Maroney, a Memphis attorney who believes that patients should be able to use marijuana if it helps them, concurs with Bell. "Tennessee law enforcement officials don't typically arrest those who are ill. They target kids and young adults, racial minorities, people who remind them of the 1960s, guys with long hair or an earring."

In 1999, Tennessee marijuana policy made national headlines when former Vice President Al Gore told reporters that his sister was supplied medical marijuana through a state program while she was undergoing chemotherapy in 1984. "It came in a prescription container with a label on it," he told reporters in 1999. "She was treated at Vanderbilt Hospital, and it's my understanding it has not been unknown for some patients undergoing chemotherapy to be prescribed, in the past, marijuana as a means of dealing with the side effects of chemotherapy." Gore pointed out that his sister's physician was the former head of the American Lung Association. "Her doctor was one of the very best in the entire world, and his view of the prevailing science then was that it might be efficacious."

Former Tennessee Gov. Lamar Alexander, a Republican who endorsed Bush, had signed a law making medical marijuana, provided by the federal government for state research programs, legal in Tennessee. The Tennessee law was repealed in 1992 but similar laws remain effective in 13 states. Since the mid-1980s, these state programs have not been operating, due to the inherent difficulty of getting access to federal marijuana.

Although seven state public health departments actually implemented programs, they all quit after having to cope with a prohibitive federal bureaucracy. "It is essentially impossible for state governments to obtain federal marijuana for their research protocols," says Mary Lynn Mathre, the clinical addictions consultant to the University of Virginia Health System and president of Patients Out of Time, a nonprofit organization dedicated to educating health care professionals and the general public about therapeutic cannabis.

These days, medical cannabis users in Tennessee risk the same penalties as any other person prosecuted for violation of state marijuana laws. While most acknowledge that patients generally aren't the target of law enforcement, patients nevertheless found guilty of possessing even one medical marijuana cigarette face up to a year in jail and a minimum $250 fine. Those growing medical marijuana can face up to a 12-year sentence for cultivation.

Not all Tennessee officials support this harsh policy, however. State Sen. Steve Cohen, a Memphis Democrat, takes a compassionate stand on the issue. "If people are in a critical state, if they are dying, then I think they should have anything that God has provided on earth to eliminate their pain and suffering," he says. "Even for people who are not dying, but are in serious pain, marijuana should be permitted by prescription from a qualified physician. I have had several friends over the past 20 years who have died from cancer, and they found that marijuana positively benefited them, reducing their pain and allowing them to eat. There but for the grace of God go I, and if I were ever in that situation, I would hope that my last days could be relatively pain-free and comfortable. I don't think that politicians should interfere with that process."

Recent polls indicate 70 to 80 percent of the public approves of medical marijuana being used by the general population. Yet when decriminalization advocates push for reform, the government counters that there simply isn't enough research to warrant the reclassification of a potentially dangerous drug. Dr. Randolph Smoak (no pun intended), president of the American Medical Association (AMA), spoke to Tennessee Rotary Club members in April, claiming that the government should examine the medical effects of marijuana before making any changes in policy. "We don't know if it has medical value," he told the Chattanooga Times Free Press. "We've told the FDA that [it] ought to go and find out."

McMahon finds it hard to believe that the president of the AMA is unaware that the FDA has been using marijuana to treat patients for over 20 years.

This call for evidence operates in a circular fashion, as the drug laws themselves have prevented the accumulation of much data. Legitimate scientists who seek to perform controlled studies on cannabis face a daunting bureaucratic gauntlet. Additionally, officials have repeatedly ignored the findings of their own commissioned research panels, which argue that marijuana is a relatively safe substance and has medical applications.

Meanwhile, as attorneys and pharmaceutical executives play politics and debate where to draw the line, sick and dying people like George McMahon continue to be arrested.

George extinguishes his government roach as a blazing sun descends behind him on the lake. It seems unreasonable to him that our nation can lock patients in prison, strip them of their voting rights, confiscate their property, and destroy their families, all because it seeks to eradicate a natural herb that has no fatal side effects, was used medically for thousands of years, and is less harmful and addictive than tobacco or alcohol. "I want people to know that I am just a normal guy," he says. "I'm not an activist, but I do believe that every sick patient in America should be able to make these personal choices without going to jail."


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