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          2.  Two highly qualified and experienced ophthalmologists in 
the United States have accepted marijuana as having a medical use in 
treatment for glaucoma.  They are John C. Merritt, M.D. and Richard D. 
North, M.D.  Each of them is both a clinician, treating patients, and a 
researcher.  Dr. Merritt is also a professor of ophthalmology.  Dr. North 
has served as a medical officer in ophthalmology for the Department of 
Health, Education and Welfare and has worked with the Public Health 
Service and FDA.
                                 - 35 -
          3.  Dr. Merritt's experience with glaucoma patients using 
marijuana medicinally includes one Robert Randall and, insofar as the 
evidence here establishes per petitioners' briefs, an unspecified number 
of other patients, something in excess of 40.
          4.  Dr. North has treated only one glaucoma patient using 
marijuana medicinally - the same Robert Randall mentioned immediately 
above.  Dr. North had monitored Mr. Randall's medicinal use of marijuana 
for nine years as of May 1987
          5.  Dr. Merritt has accepted marijuana as having an important 
place in the treatment of "End Stage" glaucoma.  "End Stage" glaucoma, 
essentially, defines a patient who has already lost substantial amounts 
of vision; available glaucoma control drugs are no longer able adequately 
to reduce the intraocular pressure (IOP) to prevent further, progressive 
sight loss; the patient, lacking additional IOP reductions, will go 
blind.
          6.  Robert S. Hepler, M.D., is a highly qualified and 
experienced ophthalmologist.  He has done research with respect to the 
effect of smoking marijuana on glaucoma.  In December 1975 he prescribed 
marijuana for the same Robert Randall mentioned above as a research 
subject.  Dr. Hepler found that large dosages of smoked marijuana 
effectively reduced Robert Randall's IOP into the safe range over an 
entire test day.  He concluded that the only known alternative to 
preserve Randall's sight which would avoid the significant risks of 
surgery is to include marijuana as part of Randall's prescribed medical 
regimen.  He further concluded in 1977 that, if marijuana could have been 
legally prescribed, he would have prescribed it for Randall as part of 
Randall's regular glaucoma maintenance program had he been Randall's 
personal physician.
                                 - 36 -
Nonetheless, in 1987 Dr. Hepler was of the opinion that marijuana did
not have a currently accepted medical use in the United States for the
treatment of glaucoma.
          7.  Four glaucoma patients testified in these proceedings.  
Each has found marijuana to be of help in controlling IOP.
          8.  In 1984 the treatment of glaucoma with Cannabis was the 
subject of an Ophthalmology Grand Rounds at the University of California, 
San Francisco.  A questionnaire was distributed which queried the 
ophthalmologists on cannabis therapy for glaucoma patients refractory to 
standard treatment.  Many of them have glaucoma patients who have asked 
about marijuana.  Most of the responding ophthalmologists believed that 
THC capsules or smoked marijuana need to be available for patients who 
have not benefited significantly from standard treatment.
          9.  In about 1978 an unspecified number of persons in the 
public health service sector in New Mexico, including some physicians, 
accepted marijuana as having medical use in treating glaucoma.
         10.  A majority of an unspecified number of ophthalmologists 
known to Arthur Kaufman, M.D., who was formerly in general practice but 
now is employed as a medical program administrator, accept marijuana as 
having medical use in treatment of glaucoma.
         11.  In addition to the physicians identified and referred to in 
the findings above, the testimony of patients in this record establishes 
that no more than three or four other physicians consider marijuana to be 
medically useful in the treatment of glaucoma in the United States.  One 
of those Physicians actually wrote a prescription for marijuana for a 
patient, which, of course, she was unable to have filled.
                                 - 37 -
         12.  There are test results showing that smoking marijuana has 
reduced the IOP in some glaucoma patients.  There is continuing research 
underway in the United States as to the therapeutic effect of marijuana 
on glaucoma.
Discussion
     Petitioners' briefs fail to show that the preponderance of the 
evidence in the record with respect to marijuana and glaucoma establishes 
that a respectable minority of physicians accepts marijuana as being 
useful in the treatment of glaucoma in the United States.
     This conclusion is not to be taken in any way as criticism of the 
opinions of the ophthalmologists who testified that they accept marijuana 
for this purpose.  The failure lies with petitioners.  In their briefs 
they do not point out hard, specific evidence in this record sufficient 
to establish that a respectable minority of physicians has accepted their 
position.
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