December 30, 1996

Voter initiatives in California and Arizona approving the use of marijuana for medical purposes are spreading alarm among many families and confronting law enforcement officials with a tough dilemma. Although the voters in those two states have clearly spoken, it is impossible for either measure to be carried out without someone violating Federal law. The Clinton Administration thus has little choice but to insist that Federal drug statutes be enforced. That response is not enough, however. Federal authorities need to address concerns that a legitimate treatment for seriously ill patients is being blocked because of broader fears of marijuana abuse.

The Federal Drug Enforcement Administration maintains there is no medical evidence that smoking marijuana has ever helped anyone. But it is difficult to dismiss the testimony from many seriously ill patients and their doctors that marijuana can ease pain, reduce the nausea associated with cancer chemotherapy, stimulate the appetites of AIDS patients who are wasting away, and glower the pressure within the eyes of glaucoma victims. The Food and Drug Administration has approved a synthetic version of THC, a main ingredient of marijuana, that can help in such cases, but many patients complain that it is a poor substitute and is much more expensive.

What is needed now is a more thorough effort to test the claims from reputable sources that marijuana may be a compassionate means of relieving suffering. Many critics charge that drug enforcement authorities have instead cut back on research out of fear that it would become impossible to limit marijuana use to those who need it medically. The fears are understandable, especially given the rising use of marijuana, especially among teenagers today. But it ought to be possible to regulate marijuana as a prescription drug if it is found to be of legitimate benefit for sick people.

State initiatives are a clumsy way to set policy. The California proposition, for example, is so vaguely written that it could lead to wholesale distribution of marijuana well beyond the medical scope intended by those who voted for it. It says nothing about withholding marijuana from young people or from those operating dangerous equipment. It also suggests that a simple oral recommendation from any doctor would suffice. That loose provision, designed to get around federal laws that bar doctors from prescribing an illegal substance, makes abuse of the new law inevitable. The Arizona law, by contrast, requires that marijuana be prescribed in writing by two doctors. But that measure is also written too broadly. It says that many other drugs, not simply marijuana, may be prescribed if permission from two doctors is obtained.

Supporters of the California measure did their cause no good by immediately lighting up marijuana cigarettes after it passed last month and proclaiming that a legitimate medicinal use would include smoking a joint to relieve stress. Dennis Peron, originator of the California initiative, said afterward, "I believe all marijuana use is medical - except for kids." These actions made it obvious that the goal of at least some supporters is to get marijuana legalized outright, a proposition that opinion polls indicate most Americans reject.

Parents have legitimate concerns about the increase in marijuana use amongst teen-agers. Many who used marijuana a generation ago are struggling over what to tell their children, but they need to realize that today's marijuana is more potent than the version they smoked and that research has shown the drug to be far more dangerous to young people than was known in the 1960's and 1970's. It can be particularly harmful to the growth and development of teen-agers.

California's Attorney General, Daniel Lungren, has ordered state law enforcement officials to interpret the law's language narrowly and require proof from those arrested that marijuana is being used medically. The Clinton Administration is expected to announce today an aggressive campaign to combat the state initiatives, including criminal prosecution of doctors who prescribe marijuana. That hard line makes sense for now. But if the Government refuses to investigate carefully claims about medical use of marijuana, it will only spur voters in other states to take the issue into their own hands.