>>> Part 19 of 28...
her the relief from her multiple sclerosis symptoms that marijuana has.
         15.  During the early stages in the development of her illness 
Ms. Hirsch found that smoking marijuana improved the quality of her life, 
keeping her spasms under control.  Her balance improved.  She seldom 
needed to use her cane for support.  Her condition lately has 
deteriorated.  As of May l987 she was experiencing severe, painful 
spasms.  She had an indwelling catheter in her bladder.  She had lost her 
locomotive abilities and was wheelchair bound.  She could seldom find 
marijuana on the illegal market and, when she did, she often could not 
afford to purchase it.  When she did obtain some, however, and smoked it, 
her entire body seemed to relax, her spasms decreased or disappeared, she 
slept better and her dizzy spells vanished.  The relaxation of her leg 
muscles after smoking marijuana has been confirmed by her personal care 
attendant's examination of them.
         16.  The personal care attendant has told Ms. Hirsch that she, 
the attendant, treats a number of patients who smoke marijuana for relief 
of multiple sclerosis symptoms.  In about 1980 another patient told Ms. 
Hirsch that he knew many patients who smoke marijuana to relieve their 
spasms.  Through him she met other patients and found that marijuana was 
commonly used by many multiple sclerosis patients.  Most of these persons 
had told their doctors about their doing so.  None of those doctors 
advised against the practice and some encouraged it.
         17.  Among the drugs prescribed by doctors for Ms. Hirsch was 
ACTH.  This failed to give her any therapeutic benefit or to control her 
spasticity.  It did produce a number of adverse effects, including severe 
nausea and vomiting which, in turn, were partly controlled by rectally 
administered anti-emetic
                                 - 44 -
drugs.
         18.  Another drug prescribed for her was Lioresal, intended to 
reduce her spasms.  It was not very effective in doing.  But it did cause 
Ms. Hirsch to have hallucinations.  On two occasions, while using this 
drug, Ms. Hirsch "saw" a large fire in her bedroom and called for help.  
There was no fire.  She stopped using that drug.  Ms. Hirsch has 
experienced no adverse reactions with marijuana.
         19.  Ms. Hirsch's doctor has accepted marijuana as beneficial 
for her.  He agreed to write her a prescription for it, if that would 
help her obtain it.  She has asked him if he would file an IND 
application with the FDA for her.  He replied that the paperwork was 
"overwhelming".  He indicated willingness to put the paper work together.
         20.  When Greg Paufler was in his early twenties, employed by 
Prudential Insurance Company, he began to experience the first symptoms 
of multiple sclerosis.  His condition worsened as the disease 
intensified.  He had to be hospitalized.  He lost the ability to walk, to 
stand.  Diagnosed as having multiple sclerosis, a doctor prescribed ACTH 
for him, an intensive form of steroid therapy.  He lost all control over 
his limbs and experienced severe, painful spasms.  His arms and legs 
became numb.
         21.  ACTH had no beneficial effects.  The doctor continued to 
prescribe it many months.  ACTH made Paufler ravenously hungry and he 
began gaining a great deal of weight.  ACTH caused fluid retention and 
Paufler became bloated, rapidly gaining weight.  His doctor thought 
Paufler should continue this steroid therapy, even though it caused the 
adverse effects mentioned plus the possibility of sudden heart attack or 
death due to respiratory failure.  Increased dosages
                                 - 45 -
of this FDA-approved drug caused fluid to press against Paufler's lungs 
making it difficult for him to breathe and causing his legs and feet to 
become swollen.  The steroid therapy caused severe, intense depression 
marked by abrupt mood shifts.  Throughout, the spasms continued and 
Paufler's limbs remained out of control.  The doctor insisted that ACTH 
was the only therapy likely to be of any help with the multiple 
sclerosis, despite its adverse effects.  Another, oral, steroid was 
eventually substituted.
         22.  One day Paufler became semi-catatonic while sitting in his 
living room at home.  He was rushed to the hospital emergency room.  He 
nearly died.  Lab reports indicated, among other things, a nearly total 
lack of potassium in his body.  He was given massive injections of 
potassium in the emergency room and placed on an oral supplement.  
Paufler resolved to take no more steroids.
         23.  From time to time, prior to this point, Paufler had smoked 
marijuana socially with visiting friends, seek some relief from his 
misery in a temporary "high".  He now began smoking marijuana more often.  
After some weeks he found that he could stand and then walk a bit.  His 
doctor dismissed the idea that marijuana could be helpful with multiple 
sclerosis, and Paufler, himself, was skeptical at first.  He began 
discontinuing it for a while, then resuming.
         24.  Paufler found that when he did not smoke marijuana his 
condition worsened, he suffered more intense spasms more frequently.  
When he smoked marijuana, his condition would stabilize and then improve;
spasms were more controlled and less severe; he felt better; he regained 
control over his limbs and could walk totally unaided.  His vision, often 
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