THE CASE FOR PRESCRIPTION POT

While the lawyers were arguing their way through one of the longest, strangest regulatory proceedings Washington has ever seen, Robert Randall used to slip out of the courtroom and over to Lafayette Park, in front of the White House, to smoke a joint of Uncle Sam's marijuana.

Randall learned long ago that even when you have a prescription for pot, smoking it in a federal office building is asking for hassles.

Since he won a landmark court case 12 years ago that gave him the legal right to smoke marijuana to treat his glaucoma, Randall has been getting 300 marijuana cigarettes a month from a government pot plantation in Mississippi. By now, he says, marijuana's effect is strictly therapeutic; it alleviates the excessive eye pressure that can blind glaucoma victims.

The idea that marijuana might be used as a prescription drug was dismissed as a pot smokers' fantasy when it was proposed 16 years ago by the National Organization for Reform of Marijuana Laws (NORML).

Last Friday the issue of prescriptions for pot reached the penultimate stage when administrative law judge Francis L. Young heard final arguments in the Drug Enforcement Administration proceedings that began in 1972.

The legal case involves only medical uses of marijuana and would do nothing to change marijuana's status as an illegal drug in every state but Alaska, where possession of small amounts for personal use is legal.

At present marijuana is classified by the DEA as a Schedule I Drug -- a substance with extremely high potential for abuse, no accepted medical use and no proven record of safety. Schedule I drugs -- which include heroin and LSD -- cannot be sold commercially and can be used for research only under the tightest controls.

The marijuana reformers have asked to "reschedule" pot, moving it down a notch to Schedule II, where it could be available by prescription under the same controls that apply to widely abused prescription drugs like cocaine.

In the past few years 33 states, including Virginia, have made marijuana legal for medical purposes or research, but the drug's Schedule I listing makes using it virtually impossible.

The DEA has repeatedly refused to change the drug's status, but again and again the medical marijuana advocates have taken the agency to court and won, keeping the case alive. Now Judge Young is expected to issue a ruling by fall. The case has produced hundreds of hours of testimony, 500 pages of it published in a book edited by Randall called Marijuana, Medicine & The Law.

The DEA proceedings turn largely on the question of whether marijuana has any accepted medical use. A parade of doctors, nurses and patients testified that smoking pot controls nausea and vomiting in cancer patients undergoing chemotherapy, can reduce intraocular pressure in glaucoma victims and can control muscle spasms in patients with multiple sclerosis, central nervous system injuries and amputations. The hearing record tells of Veterans Administrations hospitals where amputees smoke marijuana daily to control spasms, of a Harvard professor who scored pot at a high school for his son in chemotherapy, of Michigan's "grandma marijuana" who got gifts of pot in her mail box and passed it out to cancer victims.

But the vast majority of the nation's health establishment freaks out at the thought of prescribing marijuana. The American Medical Association, the American Cancer Society, the American Academy of Ophthalmology, the Food and Drug Administration and the Department of Health and Human Services all are opposed. The hearings suggested their opposition is based more on politics than medicine and raised the issue of whether "accepted medical use" means accepted by the doctors or their political organizations.

The DEA has led the fight, with two tough lawyers, Charlotte Mapes and Madeleine Shirley, marshaling medical and legal arguments against making pot available by prescription.

The DEA's opposition is a bit awkward, because the agency has permitted medical use of delta-9 tetrahyrocannabinol (THC), the chief psychoactive ingredient in marijuana, but says the plant itself is another matter.

Two companies are in the THC business. Unimed Pharmaceuticals, a small New Jersey firm, makes a synthetic version, and Cannabis Corp. of America in Massachusetts has a patent for extracting it from pot plants. Pure THC gets patients so high that many won't take it, while smoking marijuana allows patients to control their dosage, NORML's medical witnesses testified.

"To pretend marijuana has no medical value, while arguing that a chemical in marijuana, THC, has medical use is nonsensical," argued Dr. John Morgan, director of pharmacology at City College of New York.

The government's response is that the plant itself contains other untested chemicals and smoking it creates health hazards associated with no other drug.

But the real reasons THC is available by prescription but marijuana is not may be economic and political rather than medical.

Nobody can get a patent on pot, pointed out attorney Kevin Zeese, who represents NORML. The system for getting new drugs approved depends on private drug makers to conduct the costly tests to prove their safety and efficacy. No pharmaceutical company has been willing to invest the necessary millions on a new drug application for marijuana, since it couldn't control the other producers who grow and smuggle billions of dollars worth of illegal pot.

The DEA's opposition reflects the Reagan administration's "zero tolerance" stance on drugs. The DEA "is so caught up in the drug war, it is afraid to say the marijuana has medical uses," said attorney Frank B. Stilwell III, who represents Robert Randall's Alliance for Cannabis Therapeutics.

Politically, prescription pot is so difficult for the Reagan administration to accept that no matter what Judge Young decides, DEA administrator John Lawn is likely to refuse to reschedule marijuana. That will send the issue back to the courts, where the lawyers fighting for legalizing pot for medical use have won every appeal so far.

So while drug dealers keep hawking crack and heroin on the streets around DEA's Franklin Square offices and Washington youths die almost daily from machine guns and overdoses, government lawyers Mapes and Shirley will go on fighting against prescription pot.

The amputees in the VA hospitals and the cancer chemotherapy patients will keep smoking it illegally and Bob Randall will continue to get his 10 joints a day, grown and rolled by the United States government.

Articles appear as they were originally printed in The Washington Post and may not include subsequent corrections.