Volume XXIV, Number 11


    December 1, 1991


    MORLEY SAFER: [voice-over] What you are watching is quite rare.  This man and his wife are smoking marijuana, but legal marijuana.  They are among only 14 people in the United States who have had it prescribed by their doctors.  Applications have to go through the DEA, the FDA, and the National Institute of Drug Abuse, and if all approve, the legal marijuana grown on a government farm in Mississippi is sent to the patient's pharmacist, a month's supply of cigarettes at a time.


    Smoking to Live


    SAFER:  Marijuana is not good for you. It's an axiom. But for some people, marijuana could be the difference between life and death.  That's what they and their doctors say.  The doctors prescribe it and the patients smoke it to live.
    What you are watching is quite rare.  This man and his wife are smoking marijuana, but legal marijuana.  They are among only 14 people in the United States who had it prescribed by their doctors.  For Ken and Barbara Jenks, marijuana is but one more of the myriad of prescription drugs they must take every day.
        [interviewing] How often do you smoke these?:
    BARBARA JENKS: We usually smoke - well, I usually smoke at least three to four a day.
    SAFER:  What would happen to you physically, both of you, if you went for a couple of days without these?
    KEN JENKS:  We'd throw up all the time.
    Mrs. JENKS:  I would get sick to my stomach.
    Mr. JENKS:  I mean, you couldn't - you get sick, and then you can't take your medicine, so
    Mrs. JENKS:  I wouldn't be able to eat.
    Mr. JENKS:  - and then you can't eat, so, I mean, the weight - and then you'd start losing weight, so, I mean -
    Mrs. JENKS:  Having AIDS is like a wasting syndrome, you know, with the virus and everything.  The smell of food, the - just even thinking about food just makes you nauseated.
    SAFER:  [voice-over] Ken and Barbara Jenks are dying.  He is a hemophiliac.  Eleven years ago, he was given blood contaminated by the AIDS virus.  He unknowingly infected his wife.  They are both too sick to work.  They live on disability, barely able to cope.  Without the marijuana, they would probably be dead, would have wasted away because of the nausea brought on by their chemotherapy.
    Before they got marijuana legally, they bought it on the street, or grew it, until last year, when police burst into their trailer in Panama City, Florida, and got the goods on them: two marijuana plants.
    Mr. JENKS:  And then they started, you know, going through my house, I mean, just dumping drawers and tearing the cabinets up.
    SAFER:  [voice-over] The police thought they were onto something big when they found a suitcase filled with syringes and other drug paraphernalia.
    Mr. JENKS:  I mean, they were going berserk.
    SAFER:  [voice-over] Ken tried to convince them that the syringes and the pills were prescribed by doctors.  He did not tell them that marijuana was the only medicine that enabled them to take the chemotherapy without being violently ill.
    Mrs. JENKS:  You're talking to somebody that never wanted to take an aspirin for a headache.  It's - it's a relief to know that there's something that you can smoke to relieve the nausea from taking all the medications that you're on.
    SAFER:  [voice-over] The Jenks were charged with growing marijuana and possession of drug paraphernalia.  In court, their lawyer, John Daniel, tried to prove that for the Jenks, marijuana was a medical necessity.
        [interviewing] Did the prosecution present any counterevidence?
    JOHN DANIEL:  None whatsoever, sir.  In fact, they even stipulated in Kenny and Barbara's case that it was beneficial for them and that they would die without it.
    SAFER:  The prosecution conceded that?
    Mr. DANIEL:  Yes, sir.
    SAFER:  But you lost the case because you couldn't prove medical necessity, so that doesn't jibe somehow.
    Mr. DANIEL:  Judge Foster said there is no such doctrine as medical necessity in Florida, that it's a matter for the legislature to promulgate a statute that says that it is or is not.
    SAFER:  But the judge was not an unsympathetic judge.
    Mr. DANIEL:  Super judge.  The sweetest sentence I've had in 20 years of criminal defense work.
    SAFER:  [voice-over] The judge found them guilty, but sentenced them to 500 hours of community service.  Their only task?  To look after each other.
    As decent as the sentence was, the Jenks were outraged that they were still considered criminals.  They decided to appeal.
    Mr. DANIEL:  Kenny and Barbara said, "Go for it.  We're going to be gone soon.  There's going to be people following in our footprints and in our pain and suffering, and there needs to be some law made one way or the other on it."  That's why they took it up on appeal, and I'm glad to do it for them.
    SAFER:  Why?  They're not exactly the wealthiest clients in the world.
    Mr. DANIEL:  No.  I'm not exactly charging them, sir.
    SAFER:  [voice-over] The DEA classifies marijuana as a highly dangerous drug, in the same class as heroin and LSD.  And the only way to get it legally is to face a bureaucratic jungle, three of them.  Applications have to go through the DEA, the FDA and the National Institute of Drug Abuse, and if all approve, the legal marijuana, grown on a government farm in Mississippi, is sent to the patient's pharmacist, a month's supply of cigarettes at a time.
    Robert Randall was the first American to gain legal access to marijuana for medical use.  He was diagnosed with glaucoma in 1972. Doctors told him he had three to five years before he would go blind. One evening, he tried a marijuana cigarette.
    ROBERT RANDALL:  It was a bit like a "Eureka!" experience.  I mean, I had known in college that if I smoked marijuana, what the doctors then called "eyestrain" seemed to diminish, but I had never put all the pieces together, and suddenly they came together.  The next morning I woke up and thought that I was crazy.  It's crazy to believe that an illegal drug is going to prolong your sight, when all the modern pharmaceuticals have failed to do so.
    SAFER:  [voice-over] Randall is still on prescription drugs, but his doctors found that the essential drug in relieving the intense eye pressure of glaucoma was marijuana, which he's been smoking for 15 years. But getting it legally was not easy.
    Mr. RANDALL:  It took 14 months from the time of my arrest.  I had to go through -
    SAFER:  You were arrested for possession?
    Mr. RANDALL:  I was arrested for growing four marijuana plants.  I had to go through two controlled medical studies that were really unnecessary.  They simply demonstrated to others what I already knew to be the case.  And then I had to wait around for many months while a bunch of bureaucrats, who were really not very excited about this idea, decided whether or not I would go blind.  It's a very uncomfortable, frightening situation to be in.
    SAFER:  [voice-over] Only 14 people are now able to get marijuana legally from the government.  It took the Jenks almost nine months to get their first prescription.  Many doctors are reluctant to make the effort, fearing that the ramifications of even applying for marijuana will affect their reputations.
        [interviewing] The Jenks' own doctor, who prescribes marijuana for them, won't come on and talk about it.
    Mr. DANIEL:  A junkie doctor.  He doesn't want to be called that.  I understand that.  He could - it could also be, "I'm afraid I'll have all of these people coming out of the woodwork saying, 'Oh, I've got a back pain, Doctor, how about giving me 400 joints?'"  I can understand that.
    SAFER:  [voice-over] But many doctors say their reluctance to apply for a prescription has nothing to do with bureaucracy.  Dr. Richard Gralla, who heads the Department of Oncology at the Ochsner Clinic in New Orleans, told us that the scientific studies do not show marijuana as effective as other drugs, despite the claims of Randall and other patients.
    Dr. RICHARD GRALLA:  There are testimonials for almost any medicine, and in fact, sometimes testimonials are the germ of a good idea, the beginning of a good idea.  Unfortunately, more often than not, they're just that, they're just testimonials.
    SAFER:  [voice-over] But Dr. Lester Grinspoon, who practices psychiatry at Harvard University, disagrees.  He's one of the first physicians to take a stand on using marijuana as medical treatment.
    Dr. LESTER GRINSPOON:  It is very useful for the treatment of the nausea and vomiting which accompanies the use of some chemotherapeutic substances for the treatment of some cancers.
    SAFER:  [voice-over] Dr. Grinspoon knows it from the most personal kind of experience.  His son had leukemia and died, but during the chemothernpy Grinspoon feels it was the marijuana that was keeping young Danny alive.
    Dr. GRINSPOON:  He would be so tense before he took the medicine, because he knew what was going to follow, and what followed was eight hours of first vomiting, and then retching.  It's very, very, difficult.  He got to the point where he said, "I'm not going to take the medicine anymore."
    SAFER:  How old was he?
    Dr. GRINSPOON:  He was 15.
    SAFER:  [voice-over] His wife bought some marijuana near a local high school.  At Danny's next treatment, Grinspoon was amazed.
    Dr. GRINSPOON:  It was absolutely stunning, the difference that this made.  He was relaxed, he had the treatment, he not only did not have nausea and vomiting, but he asked if he could get a submarine sandwich on the way home.  I was really dumbfounded.  I then called the doctor, Dr. Jaffe, who was taking care of him, and told him what had happened, and so the next time he smoked cannabis right in the treatment room at the Children's Hospital.  Same thing, not a bit of discomfort, ate afterwards, and it was then that Dr. Jaffe and I went to the head of the Children's Hospital, Dr. Frye, and suggested that maybe this bore some kind of systematic looking into.  And that, in fact, led to the Salan study, which first established that this is useful in the treatment of the nausea and vomiting of cancer chemotherapy.
    SAFER:  But the DEA has maintained for years that marijuana has no therapeutic value, that it's a dangerous drug that must remain illegal.  However, no one from the DEA would come on this broadcast and respond to the scientific evidence of those who say otherwise.
    Three years ago, the DEA's administrative law judge, Francis Young, wrote of marijuana, "In light of the evidence, it would be unreasonable, arbitrary and capricious for the DEA to stand between those sufferers and the benefits of this substance."  But the DEA rejected its own judge's opinion and stands firm that doctors shall not prescribe marijuana.
   [voice-over] Except, of course, for those few who are willing to go through the agonizingly long process of applying.  Desperate patients say they would rather live by buying marijuana illegally than die by playing by the rules.  Dr. Ivan Silverberg hears that all the time from his cancer patients in San Francisco.
    Dr. IVAN SILVERBERG:  I have yet to hear of a patient who can't find it.  I have heard loud and clear from patients who resent having to go on the street when they're feeling sick, when they're nauseated, when they've lost 40 and 50, 60 pounds, to try and buy a drug from somebody without knowing whether that drug is adulterated because it comes off the street, of having to face the possibility that the person they're buying it from is an undercover policeman.  I think all these things are wrong.
    SAFER:  [voice-over] But Silverberg says if he had to fill out that mountain of paperwork every time a patient needed marijuana, he wouldn't have time to treat his patients.
        [interviewing] Why has the DEA dug its heels in on this and will not allow the general prescribing of marijuana by physicians when you can prescribe much more dangerous, much more habit-forming drugs?
    Dr. SILVERBERG:  You're absolutely correct.  I think morphine, for example, Demerol, are far more hazardous drugs, in my opinion, than marijuana.  I think part of it is an entrenched bureaucracy that doesn't want to admit it's wrong.
    Dr. GRALLA:  Even if it were available in 10 minutes down in the pharmacy, I'd be reluctant to write it.  It has nothing to do with it - the political issues that we have in drugs and the drug problem in the United States.  It's the fact that in my own experience in using cannabinoids - in my patients' experience, who have smoked marijuana, neither marijuana nor the cannabinoids measure up to those drugs that I have.
    SAFER:  [voice-over] Among those drugs is Zofran, which has been on the market only for the past few months.  By all accounts, it works wonderfully.
    Dr. SILVERBERG:  Zofran is a most effective drug which is said to have an 80 percent response rate, by their definition.  It costs $600 a day.
    SAFER:  And the patient has to have it administered in the hospital?
    Dr. SILVERBERG:  Or in a full - in an ambulatory care center where he's there, essentially, the whole day.
    SAFER:  [voice-over] If marijuana is as effective as Doctors Silverberg and Grinspoon say it is, why haven't the drug companies tried to get government approval for it?
    Dr. GRINSPOON:  You can't patent marijuana, it's a plant.  They can't make any money.  No way.  You see, in our country, the way drugs come into being, a drug company gets hold of a chemical, somebody discovered it has some sort of effect, they review it, they decide is it worth trying to do it.  They have to invest between $80 and $100 million to get it from chemical to drug on the shelf.  But then they get an exclusive patent for 17 years, and they can earn a lot of money.  How could they possibly do this with cannabis?
    SAFER:  [voice-over] For the Jenks, marijuana has made their troubled lives tolerable, and to the doubters they say -
    Mrs. JENKS:  Do I look like a junkie?
    Mr. JENKS:  Do I?  I mean -
    Mrs. JENKS:  I wish I didn't have to take the medication that I - I wish I didn't even have to smoke marijuana.
    Mr. JENKS:  Yeah.  It'd be nice to be to be free of drugs and disease, but we're not.  I mean, we need drugs.  I can't help that.  I mean, I've been taking drugs my whole life, and it hasn't made a junkie out of me.
    SAFER:  Do you ever agonize over, "Why me?  Why us?"
    Mr. JENKS:  At first.
    Mrs. JENKS:  At first we did.
    Mr. JENKS:  But then, I mean, for me it was easier.  I mean, I've been dealing with disease since I was six months old, so it was just like fuel to the fire.  I mean, you know, it was just one more thing.
    Mrs. JENKS:  He blamed himself because I had gotten it, and I don't blame him, because he - you know, I love him, he's my husband.
    Mr. JENKS:  You know, these are the cards you got dealt.  You've just got to play 'em or fold, kind of.
    SAFER:  The Jenks eventually won their appeal and their criminal convictions were overturned.  The Public Health Service is not accepting any new applications into the program for marijuana prescriptions and it's considering closing it down entirely, regardless of what patients say.