>>> Part 26 of 28...
outpatients, accepts marijuana as safe for use under medical supervision.
         33.  Richard D. North, M.D., who has treated Robert Randall for 
glaucoma with marijuana for nine years, accepts marijuana as safe for use 
by his patient
                                 - 63 -
under medical supervision.  Mr. Randall has smoked ten marijuana 
cigarettes a day during that period without any evidence of adverse 
mental or physical effects from it.
          34.  John C. Merritt, M.D., an expert in ophthalmology, who has 
treated Robert Randall and others with marijuana for glaucoma, accepts 
marijuana as being safe for use in such treatment.
         35.  Deborah B. Goldberg, M.D., formerly a researcher in 
oncology and now a practicing physician, having worked with many cancer 
patients, observed them, and heard many tell of smoking marijuana 
successfully to control emesis, accepts marijuana is proven to be an 
extremely safe anti-emetic agent.  When compared with the other, highly 
toxic chemical substances routinely prescribed to cancer patients, Dr. 
Goldberg accepts marijuana as clearly safe for use under medical 
supervision.  (See finding 17, above.)
         36.  Ivan Silverberg, M.D., board certified in oncology and 
practicing that specialty in the San Francisco area, has accepted 
marijuana as a safe anti-emetic when used under medical supervision.  
Although illegal, it is commonly used by patients in the San Francisco 
area with the knowledge and acquiescence of their doctors who readily 
accept it as being safe for such use.
         37.  It can be inferred that all of the doctors and other health 
care professionals referred to in the findings in Sections V, VI and VII, 
above, who tolerate or permit patients to self-administer illegal 
marijuana for therapeutic benefit, accept the substance as safe for use 
under medical supervision.
                                 - 64 -
Discussion
     The Act, at 21 U.S.C. n 812(b)(1)(C), requires that marijuana be 
retained in Schedule I if "[t]here is a lack of accepted safety for use 
of [it] under medical supervision."  If there is no lack of such safety, 
if it is accepted that this substance can be used with safety under 
medical supervision, then it is unreasonable to keep it in Schedule I.
     Again we must ask - "accepted" by whom?  In the MDMA proceeding the 
Agency's first Final Rule decided that "accepted" here meant, as in the 
phrase "accepted medical use in treatment", that the FDA had accepted the 
substance pursuant to the provisions of the Food, Drug and Cosmetic Act.  
51 Fed. Reg. 36555 (1986).  The Court of Appeals held that this was 
error.  On remand, in its third Final Rule on MDMA, the Agency made the 
same ruling as before, relying essentially on the same findings, and on 
others of similar nature, just as it did with respect to "accepted 
medical use."  53 Fed. Reg. 5156 (1988).
     The administrative law judge finds himself constrained not to follow 
the rationale in that MDMA third Final Order for the same reasons as set 
out above in Section V with respect to "accepted medical use" in 
oncology.  See pages 30 to 33.  Briefly, the Agency was looking primarily 
at the results of scientific tests and studies rather than at what 
physicians had, in fact, accepted.  The Agency was wrongly basing its 
decision on a judgment as to whether or not doctors ought to have 
accepted the substance in question as safe for use under medical 
supervision.  The criteria the Agency applied in the MDMA third Final 
Rule are inappropriate.  The only proper question for the Agency here is: 
Have a significant minority of physicians accepted marijuana as safe for 
use under medical supervision?
                                 - 65 -
     The gist of the Agency's case against recognizing marijuana's 
acceptance as safe is to assert that more studies, more tests are needed.  
The Agency has presented highly qualified and respected experts, 
researchers and others, who hold that view.  But, as demonstrated in the 
discussion in Section V above, it is unrealistic and unreasonable to 
require unanimity of opinion on the question confronting us.  For the 
reasons there indicated, acceptance by a significant minority of doctors 
is all that can reasonably be required.  This record makes it abundantly 
clear that such acceptance exists in the United States.
     Findings are made above with respect to the safety of medically 
supervised use of marijuana by glaucoma patients.  Those findings are 
relevant to the safety issue even though the administrative law judge 
does not find accepted use in treatment of glaucoma to have been shown.
     Based upon the facts established in this record and set out above 
one must reasonably conclude that there is accepted safety for use of 
marijuana under medical supervision.  To conclude otherwise, on this 
record, would be unreasonable, arbitrary and capricious.
                                 - 66 -
                                   IX.
 >>> Continued to next message...
___
 X Blue Wave/DOS v2.30 X
--- Maximus 3.01
---------------