Failed experiment

In 1971, a young Florida fellow named Robert Randall moved to Washington, D.C., hoping to make his way as a political speechwriter. He would end up making more history than most of the politicians in D.C.

Troubled by difficulty focusing his eyes in 1972—he was not yet 25—he went to an ophthalmologist who told him he had advanced open angle glaucoma—pressure inside the eyeball that pinches the optic nerve. The doctor told him he had “three to five years of remaining sight” and would be blind at age 30.

Randall began taking prescribed medications. They did not stave off haloes around light sources, milky vision, and periods of temporary blindness.

Then suddenly Randall’s condition improved dramatically. His doctor could not explain it. Randall did not tell him that he had, on a friend’s recommendation, begun smoking pot. The friend gave him a joint and Randall smoked it one night. Walking from living room to kitchen a few minutes later, he glanced out a window. “What I saw stopped me in my tracks,” he later wrote. “Actually, it was what I didn’t see that stopped me. The haloes around the nearby streetlight were gone.”

He resisted the idea that marijuana is medicine. It went against everything he had heard from government all his life. He stopped using marijuana. The symptoms returned. He started smoking it again. The symptoms dwindled. By 1974 trial and error convinced him. (Randall always continued legal medication along with the marijuana therapy.)

Obtaining marijuana was a problem, with a return of pain and near sightlessness accompanying lack of supply. He began growing four plants at home and was prosecuted. Randall could have paid a fine and moved on but decided to fight, pleading innocent on grounds of medical necessity. His lawyer told him to prove it.

Randall’s quest for proof determined the trajectory of the rest of his life and made the federal government very sorry. An acquaintance gave him the names of several federal officials in the health field. When he contacted them, most knew of the health benefits of marijuana, including reduction of pressure within the eye. Some even congratulated him on finding out the truth. One gave him an annual report to Congress, Marijuana and Health Report, for 1974, that spelled it all out. Randall was infuriated. “Without marijuana I would go blind,” he later wrote of this experience. “Hell, the entire drug control bureaucracy knew that.” Repeatedly over the years, that bureaucracy by its actions, and members of Congress by their votes, told Randall and other sufferers: Go blind.

“It was understandable that a pro-pot lobby would make whatever claims possible,” he wrote. “But to find that federal agencies knew, had known for five years, was staggering.”

At times Randall went off marijuana, relying solely on legal medication as part of research for which he was recruited at the University of North Carolina and University of California, Los Angeles. The result of new drugs was always negative. Sometimes a drug’s effect was exactly what it was intended to prevent—periods of total blindness. The findings of the scientists became a part of the court record.

Randall won his case. The judge, who had gone deeply into marijuana research, ruled, “The evil he sought to prevent, blindness, is greater than that he performed to accomplish it, growing marijuana in his residence in violation of D.C. Code.”

Randall petitioned for marijuana from the federal farm in Mississippi. After jumping through all the hoops, he was grudgingly approved to receive legal marijuana and became the only legal pot smoker in the United States.

Prohibition of marijuana is a relatively recent development. It was enacted by Congress in 1937 over the objections of the American Medical Association. The bill contained an exception for medical use, but gradually the feds leaned on the medical community—which yielded—to stop using it as medicine, mainly then an analgesic. Subsequently, research demonstrated additional uses for marijuana in treating maladies from glaucoma to cholera, though the United States—given its prohibition—was not until recently on the cutting edge of that kind of research. Just this year, Science Direct published a paper by Chinese and New York scientists that found cannabis “can prevent acute alcohol-induced liver steatosis” in laboratory animals.

The climate of the 1970s was congenial to Randall’s activism. Richard Nixon, who launched his own drug war, was gone, though his legacy—increased drug use as a result of accelerated enforcement of prohibition—lingered on. President Gerald Ford adopted a saner approach to drugs, leaving a White House drug “czar” office created by Congress vacant. He deemphasized enforcement in favor of treatment. He was followed into the White House by Jimmy Carter, who followed a similar softer policy until he needed some political cover, whereupon Carter staffed the drug office and got tough.

Randall set about helping fellow glaucoma patients, then victims of other maladies as he learned more about marijuana’s wider value as a virtual wonder drug. He immersed himself in the issue of medical marijuana, becoming something of a lay expert, producing half a dozen books like Muscle Spasm, Pain, and Marijuana Therapy (Galen Press, 1991).

Randall joined a petition to the Drug Enforcement Administration for reclassification of marijuana. As in the case of his criminal trial, he found that if someone could be coaxed into examining the research with an open mind, the verdict was assured. DEA administrative law judge Francis Young spent two years holding hearings and studying the research, then ruled in 1988, “Marijuana in its natural form is one of the safest therapeutically active substances known to man. … Uncontroverted evidence in this record indicates that marijuana was being used therapeutically by mankind 2000 years before the Birth of Christ. … [T]he marijuana plant … has a currently accepted medical use in the United States.” The DEA ignored it.

Along the way, Randall was tireless. Early on, in the late 1970s and early ’80s, a number of states made medical use of marijuana legal. New Mexico was the first, in 1978, and Randall was deeply involved, as he was in other states, either in person or on paper. He was like the Johnny Appleseed of medical marijuana.

Then the effort moved to Nevada.

The measure was Senate Bill 470 of the 1979 Nevada Legislature. No one was brave enough to sponsor it, so it was given a committee introduction. To provide further political protection, patients would be using marijuana under the guise of research—most states used a similar subterfuge—along with all kinds of regulation and bureaucracy that, as it turned out, kept the program from working well. The bill established “a program to research the therapeutic effects of marihuana on certain patients; establishing a board of review for the program; requiring … regulations for the program; establishing requirements for admission in the program; authorizing the health division to contract to receive marihuana.” (Until the Reagan administration, the federal government perversely spelled marijuana's name with an H, and state legislatures had to follow suit.) Research in marijuana had been stymied by the federal government for decades. Soon more than 25 states put on their scientist caps and got in the business—though few scholarly papers resulted.

In something of a mockery of the serious needs of patients, approval of the Nevada measure was fueled not just by the science and the efficacy of the drug but by two politicians who opposed marijuana until their own personal interests became engaged. Conservative Democrat and state court judge Keith Hayes and conservative Republican and former state senator James Slattery had little use for the drug until Hayes contracted cancer and Slattery’s wife developed glaucoma.

“However, if it appeared to [be] medically appropriate, I would consider smoking it, but it would be a cultural departure for me,” Hayes told reporter Tricia White. He said his changed view was driven by the agony of chemotherapy.

The two men became lobbyists for medical marijuana. Unfortunately, they were unsophisticated about it. At an April 27 hearing, asked if the bill would allow pot smoking, Hayes told the legislators that the medicine used would ideally be in tablet form, if such was available.

This was a notion federal drug warriors—desperate to block the spread of medical marijuana—had been pushing, that THC (an active ingredient in marijuana) could be made into a pill. Drug companies had no interest in distributing it for the feds and approval through the Food and Drug Administration moved slowly, but the big problem was that it didn’t work effectively.

It was eventually approved for several uses, including nausea and vomiting of patients undergoing chemotherapy. But its effect hit the body with a jolt compared to the gradual absorption of smoked marijuana that patients could control, a critical problem for an anti-nausea drug. Randall was fond of saying, “Who, but a bureaucrat, would be dumb enough to give a vomiting patient a pill?” This was an anti-nausea medication that could cause nausea, a neat match for that anti-glaucoma medicine that had temporarily blinded Randall. Hayes was not speaking for informed patients but lawmakers were responsive to him (he had previously chaired Assembly Judiciary).

As it happened, at that same hearing where Hayes spoke, a letter from Randall—who could not attend in person—was presented to the committee, and it warned against exactly the technique Hayes promoted.

“The only flaw in the [Nevada bill’s] approach is, I think, in the proposed legislation’s neglect of organic cannabis preparations in favor of synthetic marijuana-like substances,” Randall wrote.

“I cannot emphasize enough the dangers which reliance on synthetic cannabis poses. … Delta-9-THC, the preparation of synthetic marijuana now available … is not marijuana’s most therapeutically active substance, but merely its most psycho-active. …Evidence suggests Delta-9-THC is effective in some cases. This is also true for both glaucoma control and as an anti-emetic. Yet the evidence also indicates that the oral preparations of Delta-9-THC are inferior to marijuana in smoked form. In a recent study conducted by the National Cancer Institute, 15 cancer chemotherapy patients were tested. Initially, all were placed on oral Delta-9-THC. At the conclusion of the study, however, all patients had been transferred to smoked marijuana. In effect, Delta-9-THC became ineffective while the federally-developed, dose controlled cigarettes continued to offer relief.”

Randall enclosed a Cancer Institute memo on the issue and also urged the lawmakers to protect patients from “the Hobson’s choice between medical relief and criminality.”

The Nevada Medical Association, a Clark County prosecutor, and others endorsed the legislation. It was approved by both houses—both had Democratic majorities—and signed by Republican Gov. Robert List. The final legislation was silent on how the treatment was to be applied, by pill or joint, and it allowed the Nevada Board of Health to extend the program beyond cancer and glaucoma if it chose.

The program went into effect with a budget of less than $32,000, most of it for start-up costs like new office furniture and travel to states with similar programs for planning purposes. No state workers were added and the program was housed in the already existing state Health Division.

The program was swaddled in bureaucracy designed to further protect the legislators, with the result that patients were discouraged from using it. The process of qualifying for the program was complicated, so using traditional access to marijuana was simpler and faster—and pain or blindness doesn’t wait.

Just as detrimental was the election of Ronald Reagan as president the year after the Nevada program was created.

Since Virginia City enacted the nation’s first anti-drug law in 1876 as a result of racism, bad journalism, and political exclusion of health professionals, manufacturing anti-drug hysterias had become a United States tradition, and in the 20th century evolving public relations techniques took those panics national. The Hearst press and federal official Harry Anslinger—the J. Edgar Hoover of drug prohibition—had been the biggest ringmasters, but in the second half of the century, presidents launched scares—first Lyndon Johnson, who had moderate success; then Richard Nixon, who popularized the term “war on drugs”; then Reagan; and finally the first George Bush.

The result was that each time drug scares died down and more sensible policies came to the fore, another hysteria was launched, and the real experts were driven into the background.

Initially, after Reagan took office, the spread of medical marijuana continued—more than 30 states were on board. But the notion that Reagan was as benign on drugs as Ford and Carter ended on Oct. 2, 1982. The skills of his handlers in manipulating public opinion created the most damaging hysteria to date. A month before the midterm elections, with his poll numbers sagging and Republicans speculating he might not run for a second term, Reagan revived the drug war in a radio address:

“We’re making no excuses for drugs—hard, soft or otherwise. Drugs are bad, and we’re going after them. As I’ve said before, we’ve taken down the surrender flag and run up the battle flag. And we’re going to win the war on drugs.”

The power of a president to influence public opinion was never more apparent. What followed was an orgy of attacks on rights. Democrats cowered, the press offered no scrutiny, and the courts winked as Congress passed and the president signed measures that weakened private property rights and allowed the military to be employed inside the nation in combating drugs. Hoary and discredited fables about drugs like the marijuana gateway theory came roaring back. Legislatures stopped approving medical marijuana programs. Surveys showed parents willing to turn in their children for drug offenses. Employers drug-tested workers.

In this punitive environment, few people wanted to sign up for state marijuana programs and state governments had no interest in publicizing them. Few people knew Nevada had one. It’s not clear whether even Slattery or Hayes used it.

In 1987 the Nevada Legislature repealed the program as part of a larger bill dealing with pharmacies and drugs. The repeal received little attention. State pharmacy board lobbyist Joe Midmore told an Assembly committee, “There is a new drug on the market which is a synthetic form of marihuana, so statutes dealing with legal use of it are no longer required. … [T]he doctor had to present a case to a special board, which either approved or denied the request. After discussing this with [the] state health officer and others, it was decided to request repeal of this law.” (This is a characterization of Midmore’s remarks in the minutes, not a direct quote.) He did not identify who made that decision or who engaged in the discussion. Nor did he or anyone else tell the lawmakers of the problems with THC pills.

Before a Senate committee, Midmore called the bill merely a “housekeeping bill.” No legislator in either house asked any questions. Gov. Robert Miller signed it on June 11.

When Reagan left office, his successor George H.W. Bush stepped up. The Reagan hysteria was child’s play compared to the madness unleashed by the new president, and Democrats and journalists were even more culpable this time. The White House advanced an approaching nationally televised speech by telling journalists its topic, and the television industry took over from there. In the two and a half weeks before the speech, the networks ran about three drug stories a night, with four stories a night the week before the speech. None of these scrutinized the value of punitive policies. By the time Bush spoke, the public was primed.

“This is crack cocaine,” Bush said in his Sept. 5 speech. “[It was] seized a few days ago in a park across the street from the White House. … It could easily have been heroin or PCP.” (It was later learned that the seller actually operated elsewhere but was lured by agents to Lafayette Park to make the buy more dramatic.)

A new attack on rights began. The military’s role was expanded. Political candidates urinated in bathrooms and emerged to display their samples for cameras, a ritual known as “jar wars.” If under Reagan parents were willing to turn in their children, under Bush children turned in their parents. Extreme and racist sentencing was made mandatory. Democrats as an opposition simply melted, with Sen. Joe Biden calling Bush soft on drugs—“not tough enough, bold enough, or imaginative enough.”

The drug war went on, under Clinton and the second George Bush, neither of whom offered alternatives to punitive enforcement. Juries began refusing to convict and voters began asserting themselves.

In 2000, Nevadans voted to create a medical marijuana program. The new program, too, posed as a research effort. For several years, state legislators dragged their feet at implementing the law by making the substance difficult to obtain. When the legislature finally got on board, local officials became the problem. Whether voters will prevail is still to be decided.

Over the course of the Reagan-Bush/Republican-Democratic efforts against drugs, illicit drugs became a major industry. Rights that were hard won over the centuries from Runnymede (Magna Carta) to Federal Hall in New York (Bill of Rights) were damaged. Only when, as in the case of alcohol prohibition, the public began reasserting itself did the drug war slow.

The hysterias set off by presidents with the support of the press and the acquiescence of the opposition made it clear that more sensible drug policies can be reversed at any time by another manipulative president, a collaborationist Congress, and weak journalism and judges. This is one of those periods of relative sanity and prohibition opponents should not assume it will continue. They need to be ready to provide the opposition the political system does not.

There are now 20 states with voter-created medical marijuana programs, though some had have to pass them twice to overcome the resistance of politicians.

Randall died June 2, 2001, in Florida. He is now sometimes called the founding father of the medical marijuana movement. But many politicians are still telling such patients: Go blind. Suffer. Drop dead.