By Joseph b. Treaster

THE NEW YORK TIMES

NATIONAL

Sunday, November 14, 1993

Every two weeks, Rabbi Isaac P. Fried visits a businessman in Brooklyn who is dying of cancer. They talk for a while, and the rabb hands over a small bag, of marijuana with a hopeful blessing.

"May these herbs," he says, "be an instrument of healing."

The businessman, who is in his 40's, says he does not like the sensation of marijuana and is so embarassed to be using it that he would not allow his hame to be used. But, he says, it eases his chronic pain and nausea and stimulates appetite. "Without this," he said the other day, "I wouldn't be able to eat."

The businessman is one of about a dozen people to whom Rabbi Fried said he was giving the drug in quiet defiance of state and Federal laws. In recent months, in New York and elsewhere in the country, people like Rabbi Fried have joined together in clubs and loose associations to obtain marijuana - through purchases or contributions from dealers and growers - and to pass it on to sick people.

For years, people with AIDS, cancer and other diseases have argued that marijuana helped them cope with their ailments and have managed to obtain the drug through friends, relatives or street dealers. But the efforts of Rabbi Fried and others go beyond growing or buying marijuana for personal use, or the use of relatives, Instead, they make the drug available to anyone who they believe has a medical need.

"I consider this a need that has to be filled." Rabbi Fried said. "Should I buckle under the fear of an archaic law that doesn't deal with the present needs of the 1990's?"

A RENEWED DEBATE

The dispensers of marijuana as a medicine are an unconventional crowd who have mainly forsaken mainstream careers to work for what they regard as social justice. Rabbi Fried, for example, is not connected with a synagogue but says he works with the homeless, the mentally ill and otherwise troubled people, at many synagogues and in the streets.

Many of those providing marijuana have been advocates for people with AIDS, and their groups are roughly patterned after underground pharmacies that have been formed in several cities by AIDS patients and advocates to obtain unapproved medicines.

Such underground efforts are coming it a time of renewed debate on the medicinal value of marijuana. In August, California legislators endorsed a resolution urging Federal approval of its use as medicine. Before being sworn in as Surgeon General, Dr. Joycelyn Elders, the former director of the Arkansas Health Department said that if physicians felt marijuana "would be beneficial for use by the patuent, it should be available."

Still, the Clinton Administration supports the stance of the Srug Enforcement Administration that marijuana has no therapeutic value. In fact, it is fighting a lawsuit to reverse that policy, a move that some advocates and opponents say could be a first step toward legalization.

The American Medical Association says it does not condone the use of marijuana for any reason, although it supports further research into the drug.

But Rabbi Fried and other advocates cite dozens of cases in which people with AIDS, cancer, multiple sclerosis, glaucoma, epilepsy and other ailments say the drug has helped them cope with nausea and muscle spasms and has reversed drastic weight loss by giving them the desire, once again to eat. "It's a crime to keep this medicinal herb from people," said Beth Moore, an AIDS patient who helps distribute marijuana with a group in San Francisco.

"IT BRIGHTENS YOUR LIFE"

In New York, a 31-year-old graduate student named Johann, who has chronic fatigue syndrome, said that without marijuana he was often troubled by diarrhea and cramps. Rober, a 40-year-old AIDS patient, said an occasional puff of marijuana lifted him out of depression. "It brightens your life," he said. "It motivates you. Iy energizes you." Neither man would allow his last name to be use.

Others dispensing marijuana to groups of patients are operating in Philadelphia, Chigago, Seattle, Little Rock, Ark., and several other cities. Some of the largest and most visilble groups are in Washington, San Francisco adn Santa Cruz, California.

All of them function by word of mouth. But the Washington and San Francisco groups have stationery identifying them as the Cannabis Buyers' Club, and the Washington group also receives mail at a post office box.

Many of those dispensing marijuana have campaigned for the legalization of the drug, and some have been arrestedin civil protests and for dealing or growing marijuana.

VARIED PROCEDURES

They generally have little or no formal medical training, but usually decide after an interview whether a person has a legitimate medical need for the drug. Stephen J. Smith, who runs the Cannabis Buyers' Club in Washington, said he required recipients to have their doctors sign a statement saying that the doctor has explained the risks and benefits of marijuana, would consider prescribing it if it were legal and will monitor the patient's progress.

Mr. Smith, an AIDS patient who helped rally support among gay men and lesbians for Bill Clinton's Presidential campaign, said his group handed out the marijuana in the kind of plastic vials that pharmacists use in filling prescriptions, labeled for use as needed or as directed by a physician, with a warning not to drive or operate heavy machinery.

"We try to operate as close to legitimate as we can," said Mr. Smith, who supplies about 50 people.

Although marijuana is widely available in the United States, Mr. Smith and others say many sick people are either unwilling or unable to make a connection with a dealer. Moerover, for many sick people, it is too expensive - $400 an ounce for the best quality.

Rabbi Fried and others in New York said they provided marijuana free. But Mr. Smith and some others use a sliding scale.

"Some get it free, some get it at cost and some pay a little more," he said. "Those who can afford it subsidize those who can't."

Opponents of marijuana therapy say smoking marijuana is more harmful to the lungs than smoking tobacco. But advocates say that some patients smoke as little as one marijuana cigarette a week and that many take it as a tea or mixed in brownies, spaghetti sauce and other foods. One distribution group in San Francisco sells small water pipes that members say removes some of the tars from the drug.

A synthetic form of marijuana is available by prescription, bu patients say it does not work as well.

Since 1976, the Federal Government has been providing marijuana to a handful of patients as a treatment of last resort. But the Bush Administration closed the program to newcomers, saying it undermined its policy against illegal drugs. The Clinton Administration is reviewing the decision.

Rabbi Fried, who is 45 and has a master's degree in Hebrew letters from the Ohr Jerusalem Rabbinical Academy in Israel, said he discovered about a year ago that giving sick people marijuana helped them "relax and deal with their pain and suffering better." He does not use marijuana himself, he said, and he is not campaigning for its legalization. But he said. "If marijuana can relieve pain and suffering, it shouldn't be denied to people."

He said he sometimes obtained marijuana from a former dealer and marijuana advocate who also supplied about a dozen sick people in New York. But mostly, he said, he depends on two friends, a market researcher and a small businessman, who spend a few hundred dollars a month to buy marijuana for him to dispense.

Another man who says he is helping 10 to 12 people in New York, Victor Hernandez, a 33-year-old medical researcher and advocate for AIDS patients, said his supplies were all donated by dealers and friends.

Some distributors take elaborate cloak-and dagger precautions to avoid arrest. But others make their rounds as causally as if they were delivering baskets of fruit.

The marked researcher who assists Rabbi Fried said that regardless of the law, the New York police do not seem to make much of a fuss over marijuana. "Technically, it's illegal," he said. "But it's almost decriminalized. It's not as thought you're really breaking the law."

Mr. Hernandez, who has a doctorate in public health from Harvard University and has never been in trouble with the police, said he thought arrest was very unlikely. "Who's going to bust someone with such a squeaky-clean background who's helping people out and not getting money from it?" he asked.

But Deputy Chief Frank Biehler, the commander of the New York City Police Department's Narcotics Division, has no sympathy for people like Mr. Hernandez and Rabbi Fried. He has never come across any group giving marijuana to the sick. But if he did, he says, he would make arrests on the spot.

Under New York Law, Chief Viehler said, possession and distribution of marijuana is a misdemeanor punishable by fines of up to $250 and six months in jail. The Federal penalty for a first offense of conspiring to distribute small amounts of marijuana is up to five years in jail.

To Chief Biehler, the advocates of using marijuana as medicine are quacks, and, he said, "They're not going to dissuade me one iota that they're in violation of the law."

Whether a New York jury would agree has yet to be tested. But elsewhere, juries and judges have responded with leniency. Just a few weekds ago, a jury in San Diego acquitted a 39-year-old AIDS patient who testified that he had been growing marijuana to ease his nausea and stimulate appetite.

Although they are not pressing the point, some of the groups seem to be preparing for a showdown that they believe could force a relaxation of legal barriers. In Washington, Mr. Smith said that he had a lawyer on call and that several Washington firms had offered to defend him at no cost should the authorities move against him and the 50 AIDS patients he is supplying.

Dennis Peron, the 47-years-old founder of the Cannabis Buyers' Club in San Francisco, the largest in the country, ays he and a few volunteers are providing a half-dozen marijuana cigarettes to about 500 people who make contact every week or two. Mr. Peron, who has been arrested more than a dozen times for possession and sale of marijuana, said he did not personally collect or distribute the durg, but instead left those tasks for is associates.

All the groups say they regard careful screening of applicants as crucial to their credibility. "I don't want to supply some college student who wants to get high," said Mr. Smith, from the Washington group. "The D.E.A. sees me as a drug dealer. I see myself as a pharmacist."