Doctors are facing a dilemma: risk breaking the law or withhold a potential treatment.
You might say it was like a bad trip. One morning in 1997, family physician
Robert Mastroianni arrived early at his office in tiny Pollock Pines,
California, to find two agents from the federal Drug Enforcement Administration
waiting for him. After a brief introduction, they began firing questions: Where
had Mastroianni gone to school? Where had he done his medical training? One of
the agents then handed the doctor a copy of a letter he had written
recommending marijuana for a patient. Had Mastroianni actually prescribed pot,
the agent asked, or had he only suggested it? Did he sell marijuana to his
patients? Was he aware that marijuana was a deadly drug for which there was
absolutely no medical use?
Mastroianni was stunned, then angered. He refused to answer further
questions without a lawyer present. "Many of the agents' questions were
professionally insulting," he wrote later. Worse, they revealed "a
primitive and largely inaccurate understanding of medical practice." The
agents requested Mastroianni's DEA number, a code that doctors must use when
they prescribe any controlled substance. He complied, and the agents left --
but not before sending a chilling message to Mastroianni, and, when news
reports about the drug agents' visit got out, to thousands of doctors
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What had Mastroianni done? Nothing that California's Proposition 215 -- the
medical marijuana initiative -- said he couldn't do. Passed by the state's
voters as the Compassionate Use Act of 1996, the law allows physicians to
recommend cannabis, though not to prescribe it, for a wide range of medical
ills without being "punished or denied any right or privilege." It also
exempts from prosecution seriously ill patients who possess or cultivate the
drug for medical treatment on the recommendation of a physician. (Arizona
voters passed a similar law, later overturned by state lawmakers; neither law
authorized the transportation or selling of marijuana as medicine.) In 20 years
of practice Mastroianni had seen about 50 patients use marijuana to combat
muscle spasms and chronic pain as well as the nausea caused by chemotherapy.
"Patients report no other medications work as well," he wrote in an
affidavit filed in a class-action suit.
Mastroianni's views hardly put him on the medical fringe. Physicians who
treat cancer patients have long been aware that smoking marijuana can relieve
the terrible nausea of chemotherapy, allowing patients to maintain the weight
crucial for survival. In fact, a survey conducted by Harvard Medical School in
1991 revealed that 44 percent of oncologists had proposed marijuana use to
Even some drug enforcement officials have broken ranks to back the medical
use of marijuana. In 1988 a DEA administrative law judge wrote that marijuana
should be classified as a Schedule II drug -- one that's safe for limited uses.
"Marijuana, in its natural form, is one of the safest therapeutically
active substances known to man," he said. "[It] has a currently
accepted medical use in treatment in the United States for nausea and vomiting
resulting from chemotherapy." The DEA rejected his opinion, though, and
recent attempts to have the courts reclassify marijuana have failed.