Patients who use marijuana fear worst if forced to stop,
Hildebrandt has Crohn's disease, a chronic inflammation of the digestive tract that gives her nausea. The 34-year-old mother of five underwent surgeries and tried various treatments, but nothing worked until she tried marijuana.
Now, she's a registered marijuana user in Oregon, one of 10 states that has allowed patients who suffer from debilitating illnesses to use the drug as a pain reliever. "Medical marijuana gave me back my life," she said. "I don't do drugs. ... I'm just a mom."
But the Supreme Court's ruling Monday that state medical marijuana laws do not protect Hildebrandt and thousands of other medical-marijuana users from federal prosecution has her fearing the worst. "I moved here to be a law-abiding citizen, and I'm not sure that I am anymore," said Hildebrandt, who lives in Lafayette, about 30 miles southwest of Portland. "I'm afraid I'll have the DEA (Drug Enforcement Administration) at my door. Yesterday, I would have told so much more (about the treatment). Now, I'm afraid."
Her remarks reflected the concern Monday of medical-marijuana users who said the court's 6-3 decision had left them with a difficult choice: Break the law in order to take a drug that makes life tolerable, or give up marijuana and be miserable. (Related story: Court rejects medical marijuana)
The California patients behind the dispute that was decided by the court, Diane Monson and Angel Raich, were defiant Monday but hopeful that somehow a Republican-led Congress would approve a federal medical-marijuana law — even though it has shown no inclination of doing so. (Related story: Pot studies difficult to organize, analyze)
"I'm going to have to be prepared to be arrested," said Monson, 48, of Oroville, Calif., suggesting that she would continue to smoke marijuana to ease back pain caused by a degenerative disease of the spine.
Raich, 39, of Oakland, called on Congress to show compassion for those who have found marijuana uniquely effective in relieving their pain. "Now is the time for Congress to step in to help us sick, disabled and dying patients," said Raich, who has an inoperable brain tumor and a seizure disorder. "Something will be done if it takes every last breath in my body."
In Washington, the message was: Don't look for action anytime soon.
U.S. Rep. Barney Frank, D-Mass., a co-sponsor of a bill that would gives Congress' blessing for states to make their own medical-marijuana laws, said the Supreme Court has "now made it clear that this is up to Congress. If Congress wants to do this, it can."
But Frank and other members of Congress suggested that even in a generation of lawmakers who came of age as marijuana became popular among youths, few are willing to go on record as voting for a bill to allow pot smoking.
"I think support is strong" for a federal medical-marijuana bill, said U.S. Rep. Ron Paul, R-Texas. "But people are still frightened a little bit by the politics of it. If you had a secret vote in Congress, I'll bet 80% would vote for it."
After taking several hours to digest the ruling, officials in California and other states with similar medical-marijuana laws — Alaska, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Vermont and Washington state — said they doubted that the decision would lead the U.S. Justice Department to significantly crack down on individual users of medical marijuana, including those who grow the leaf for their own use.
"People shouldn't panic. There aren't going to be many changes," California Attorney General Bill Lockyer said. "Nothing is different today than it was two days ago, in terms of real-world impact."
In Oregon, officials said they would temporarily stop issuing medical marijuana cards to sick people. The cards allow patients with prescriptions to possess the drug. "We want to proceed cautiously until we understand the ramifications of this ruling," said Grant Higginson, a public health officer who oversees Oregon's medical marijuana program.
Thousands of registered users
The Drug Policy Alliance, a group in Oakland that supports more lenient drug laws, estimated that there are more than 113,000 registered users of marijuana in the 10 medical-marijuana states, with more than 100,000 in California alone.
Marijuana is the most commonly used illicit drug in the USA. About 95 million Americans age 12 and older have used marijuana or hashish in their lifetime, according to the 2002 National Survey on Drug Use and Health. About 15 million people use marijuana regularly, the survey found.
The Bush administration has made marijuana a priority in its war on drugs, casting it as an entry-level drug with no scientifically proven benefits that leads many users to try more dangerous ones such as cocaine and heroin. But DEA Administrator Karen Tandy said after the ruling that the administration's focus would remain on major growers and traffickers.
John Walters, the White House's anti-drug czar, said that those who flagrantly flout federal law will be punished, but he agreed with Tandy's emphasis on major traffickers.
"I don't think anybody makes a career out of arresting and punishing low-level users," he said.
The high court's ruling Monday came four years after it ruled that federal anti-drug laws could be used to shut down cannabis cooperatives that sell marijuana for medical purposes. The cooperative at issue in the case was set up in California after the voters there in 1996 passed the nation's first medical-marijuana law.
Federal enforcement of that ruling has been sporadic, however, and dozens of clubs continue to dispense marijuana to patients.
Several California cities, including San Francisco, Oakland, Huntington Beach and Modesto, have cracked down on marijuana co-ops and dispensaries recently. Oakland limited the number of clubs last year, and San Francisco in April put a moratorium on new clubs while the city's Board of Supervisors decides how to regulate the more than 40 facilities in the city.
Monday's case dealt with whether federal law could be used against those who possess or grow marijuana in small amounts, for their personal use. Such prosecutions are rare but are not unheard of: In August 2002, federal agents seized six plants from Monson's home and destroyed them in an incident that led to her involvement in Monday's case.
Writing for the court's majority Monday, Justice John Paul Stevens called the California dispute a "troubling" case because of the legal and ethical dilemmas faced by Monson, Raich and other medical-marijuana users.
"The case is made difficult by strong arguments that (Raich and Monson) will suffer irreparable harm because ... marijuana does have valid therapeutic purposes," Stevens wrote. "The question before us, however, is ... whether Congress' power to regulate interstate markets ... (covers) drugs produced and consumed locally."
Stevens also cited the government's argument that medical marijuana laws could inspire abuses such as unwarranted prescriptions that could lead to interstate drug trafficking violations.
"One need not have a degree in economics," Stevens wrote, "to understand why a nationwide exemption for the vast quantity of marijuana (or other drugs) locally cultivated for personal use (which presumably would include use by friends, neighbors and family members) may have a substantial impact on the interstate market for this extraordinarily popular substance."
Relying on a 1942 ruling that permitted government restrictions on local wheat farming, the majority said Congress may regulate purely intrastate activities — such as the personal growing of marijuana — if it finds that failing to regulate them would harm the U.S. government's ability to regulate the commodity.
Stevens was joined in the majority by Justices Antonin Scalia, Anthony Kennedy, David Souter, Ruth Bader Ginsburg and Stephen Breyer.
Dissenting were two conservatives, Chief Justice William Rehnquist and Clarence Thomas, and Sandra Day O'Connor, who is usually at the political center of the divided court. The dissenters said states should have the right to set their own course in dealing with medical marijuana.
O'Connor said the majority was giving the federal government far too much authority. "The government has made no showing in fact that the possession and use of homegrown marijuana for medical purposes, in California or elsewhere, has a substantial effect on interstate commerce," she said.
'A war on patients'
Despite predictions by California's Lockyer and others that the ruling's impact on the vast majority of marijuana-using patients would be minimal, advocates for medical marijuana called the ruling a huge disappointment.
"In the war on drugs, we have had a war on patients," said Sandra Johnson, a lawyer and ethicist at Saint Louis University. "This is a tremendous setback. ... Untreated pain is a public health issue."
Randi Webster, a co-founder of the San Francisco Patients Co-op on the edge of the city's Haight-Ashburydistrict, said she wasn't surprised by the ruling. "The first thing I thought was, what a crying shame that once again politics is taking the place of compassion," she said.
"We're very disappointed," said Sandee Burbank, director of the non-profit Mothers Against Misuse and Abuse, known as MAMA, in Oregon. "It's going to make it harder for doctors and patients to have access (to medical marijuana) because of the fear."
She says her group, which provides information about the benefits and risks of medical marijuana, will work harder to push Congress to resolve the issue.
"My phone's been ringing off the hook," she says, describing patients who are afraid that U.S. officials will take their plants away. In Oregon, she said, many medical marijuana users grow their own plants. More than 10,000 residents have had permission from the state to do so.
In Washington, Walters, the anti-drug czar, saw the ruling as a rejection of the idea that marijuana is a proven pain reliever.
"The medical marijuana farce is done," he said. " I don't doubt that some people feel better when they use marijuana, but that's not modern science. That's snake oil."
Ritter reported from San Francisco, Koch and Biskupic from Washington. Contributing: Donna Leinwand and Andrea Stone; wire reports