Clinton Plan Attacks Medical Marijuana Initiatives, Targets Doctors

Body Count

ACT UP spokesperson Steve Michael said the proposed "Compassionate Use of Marijuana for Medical Purposes Act" is based upon a similar measure recently approved by California voters. Activists will start circulating petitions once the language of the initiative is approved by the Board of Elections and Ethics.

Activists expressed concern over the announcement by Council member Charlene Drew Jarvis and US Attorney Eric Holder to stiffen penalties for the sale and possession of marijuana. States Michael, who is HIV positive, "We need to move forward on this issue now, before Jarvis and Holder make felons out of the terminally ill." Michael adds that the DC Corrections system has a poor track record in the treatment and care of prisoners diagnosed with HIV and AIDS, including the death almost two years ago of an AIDS patient chained to a wheelchair and neglected for more than a week.

Activists are optimistic that they will be able to obtain the necessary signatures to place the medical marijuana measure on the ballot in DC.

Michael concludes, "Sixteen years into the AIDS epidemic, we have only a handful of approved, but often toxic treatments for AIDS patients. We should not make criminals out of sick and dying people who are simply trying to improve the quality and quantity of their lives."

AIDS activists are enlisting the support of other patient advocacy groups to gather the necessary signatures within the six month period.

The activists also filed an initiative with the DC Board of Elections and Ethics that amends the District's drug laws to eliminate criminal penalties for the possession of needles.

For more details contact:

ACT UP Washington DC
825 5th Street NE Suite A
Washington, DC 20002
Tel. (202) 547.6780

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ALBANY, N.Y. (AP) - The chairman of the state Assembly's Health Committee said Monday he may introduce a bill in 1997 legalizing the use of marijuana for medicinal purposes in New York state.

"It certainly requires serious examination in New York because there are many New Yorkers who would be appropriate candidates for medical use of marijuana," said Assemblyman Richard Gottfried, a Manhattan Democrat. "I don't think that it should be denied to them because it can be misused by other people."

A national debate was triggered when the Clinton administration warned doctors that it is illegal to prescribe marijuana under federal statutes, despite laws to the contrary in Arizona and California.

Advocates say research suggests that marijuana is useful in relieving internal eye pressure in glaucoma victims; in controlling nausea in cancer patients on chemotherapy, and in combating the severe weight loss associated with AIDS and the human immunodeficiency virus.

New York has the largest number of AIDS cases in the nation at some 105,000 currently.

The state permits prescription of pills like Marinol, which contain synthetic THC, the active ingredient in marijuana. Though those products have federal Food and Drug Administration approval, some advocates say they are not as effective as marijuana plants.

At one time, New York permitted some marijuana usage. In a program that lapsed with little notice, the New York state legislature in the early 1980s approved a program to provide marijuana to hospitals for cancer and glaucoma patients who are in "life-threatening or sense-threatening situations," according to the bill.

The program was named for Antonio G. Olivieri, an Assemblyman and New York City Councilman from Manhattan, who died on election day 1980 from brain cancer. He had pushed heavily for the legislation, Gottfried said.

"The program has been inactive for at least five years," state Health Department spokesman Bob Hinckley said. It is unclear how many people were treated under the Olivieri program.

Gottfried said with marijuana readily available on the streets, the state's therapeutic program likely fell out of use because of the rigorous and cumbersome approval process to gain admittance.

Cannabis advocates like Lynn Zimmer, a sociologist at Queens College, say because marijuana can be obtained illegally with relative ease there has been little impetus in New York to change the law. She said publicity surrounding Monday's announcement by federal officials would help change that.

Federal officials Monday said doctors in Arizona and California who prescribe marijuana could face criminal charges. Voters in those two states approved measures in November that relax restrictions on the medical use of some illegal drugs, such as marijuana.

"What this shows is the population understands, the voters understand, the medicinal benefits of marijuana even if they don't," said Zimmer, who sits on the national board of directors of NORML, which advocates the drug's legalization.

"This is bringing the issue to the forefront again and I'll think you'll see changes result from that in New York," she said.

Sally Cooper, director of the New York City-based People With AIDS Health Group, said she can't understand how anyone could deny the relief marijuana provides to the seriously ill and suffering.

"It should be a fairly easy sell, but it's not," she said.

"There is quite a bit of underground marijuana use which is going to go on regardless, it's sort of an above-ground underground," Cooper said.

SACRAMENTO -- The agency that disciplines doctors in California said Tuesday it doesn't plan to send tips to federal investigators who seek to punish those who "prescribe" marijuana.

"We have neither been asked, nor are we going to propose at this time, that we instantaneously share information with the Drug Enforcement Administration if we become aware of a medicinal marijuana situation," said Ronald Joseph, executive director of the California Medical Board.

Joseph said the board has had little direct historical contact with the DEA, which can rescind a doctor's ability to prescribe medicines. Nor does it plan to establish ties with the DEA now that it wants to punish doctors who use new laws in California and Arizona that allow them to recommend marijuana to patients.

Historic conflict

At issue is a historic separation of powers between the federal and state governments over the regulation of medicine.

California has been disciplining its own doctors since 1876. The federal government, however, regulates the drugs these doctors can prescribe and who can prescribe them.

These two regulatory roles of the state and federal governments are now somewhat in conflict. Because of California's Proposition 215, doctors under state law can legally recommend marijuana. Under federal law, they can't.

Fearful of the state initiative signaling a softening of the war on drugs and allowing doctors to rampantly prescribe the narcotic, federal drug czar Barry M. McCaffrey announced a counter offensive Monday.

Doctors who are caught prescribing marijuana by the DEA stand the chance of losing the federal license that allows them to prescribe all medicines.

"The tone of the message, while stern, has an underlying theme of reason," said Dr. Jack Lewin, chief executive officer of the California Medical Association. "It implies that they're not going to go after the individual doctor who recommends marijuana to one or two critical patients who have cancer or HIV,"... he said.

In addition, federal, state or local law enforcement officials can launch their own investigations against doctors regardless of what the Medical Board does or doesn't share about tips it has received, Lewin said.

Small federal staff

Nevertheless, these anti-marijuana initiatives will depend on federal officials first learning of doctors who prescribe marijuana and then having the staff in place to punish them.

The federal government, for example, has only two administrative law judges on staff to handle all the hearings for the 700,000-some doctors who stand to lose their prescription powers.

Records weren't immediately available for how frequently the DEA revokes prescription powers for doctors who have inappropriately prescribed or become addicted to controlled substances, Martin said, "I'll be honest with you, I don't know if we keep it."

Meanwhile in California, the largest repository of complaints about physicians is the Medical Board, which receives more than 100,000 calls a year from the public.

Historically the board has shared those tips with other law enforcement agencies in a handful of circumstances, said Joseph.

Medical Marijuana Wrong Issue For War On Drugs

by Rob Killian, M.D.

I am a doctor who occasionally prescribes marijuana for my ill AIDS or cancer patients. Retired Army Gen. Barry McCaffrey and President Clinton have threatened to deny me the right to practice medicine because I recommend the use of an "illegal" drug (TNT, 12-31).

Is this what the war on drugs has come down to? A pathetic punitive action against physicians who use everything at their disposal to relieve the suffering of their patients?

When I graduated from medical school, I took an oath that I would place the welfare of my patients above all else; that I would "do no harm" to them. These are sacred vows to me.

I have seen incredible suffering already in my short career. I have worked in a hospice home for the dying as well as being actively involved in caring for HIV-positive and cancer patients in my own practice. Part of my work is to attempt to relieve that suffering.

McCaffrey, director of the Office of National Drug Control Policy, believes that American medicine has better options to give us than using marijuana. But what he is not saying is that all of those options have side effects and all cost money. There is no perfect solution to the nausea caused by drugs and chemotherapy or by illness itself. From my perspective, we often give much more harmful drugs to patients than marijuana.

Doctors are in the business of recommending powerful drugs that are dangerous, even when used correctly. The use of marijuana, while not frequent in my medical recommendations, is a relatively inexpensive adjunct to the other poisons I so frequently prescribe to battle powerful illnesses.

In my experience, marijuana - whether ingested in pill form or smoked - is a safe and quick way to relieve nausea and to increase appetite. I sickens me that I have to recommend my patients break the law to obtain marijuana that they can smoke. I find it ludicrous that this medication is not easily and safely available for my patients. I am shocked that McCaffrey's announcements do not take into consideration the cost and detriments of the other options.

Don't get me wrong. I am, like most of my colleagues, out there on the front lines of this war on drugs. I engage my patients in discussions about drug, alcohol and tobacco use. I have seen the ill effects of drug abuse and do all in my power to assist those so addicted to find treatment. I encourage all of my adolescent patients to protect their bodies and to be responsible for what they put into their bodies. I use my yearly physical exams with kids to discuss their empowerment to say no to dangerous behaviors.

But, as the general and the president must know, these are difficult discussions in a world that glamorizes drug use in the form of alcohol, tobacco and recreational drugs. This is a daily battle. And it is a very real world out here in my little clinic in Tacoma, Washington.

In our country, more harm is done to families and to society and to health by the drugs of tobacco and alcohol than by all the other recreational drugs put together. Hundreds of thousands of Americans die early deaths each year from the effects of alcohol and tobacco use. Many families live in despair over the trauma they suffer from living with a loved one who abuses alcohol.

If President Clinton and Gen. McCaffrey are truly serious about this war on drugs, maybe they should be brave enough to address the real problems behind a culture that values drug use rather than attack their colleagues who are out on the front lines every day.

McCaffrey is giving the president bad advice on this subject. I will continue to recommend marijuana for my patients when other options are dangerous or more expensive. It is good medicine to do so. If McCaffrey and the president want to punish me for doing so, then I will see them in court.

Rob Killian is a Tacoma physician.

Botched Raid Suspension Overturned:
Supervisor In Williams Case Found Not Negligent By Civil Service Panel

The state Civil Service Commission has overturned the suspension of a Boston police lieutenant who supervised a botched drug raid in which a frail Dorchester minister suffered a fatal heart attack nearly three years ago.

The commission ruled this month that the Boston Police Department "failed to demonstrate just cause" that Lt. Detective Stanley Philbin be suspended for 30 days for not supervising the raid properly.

The death of Rev. Accelyne Williams, a 75-year-old retired black minister, provoked a public outcry that resulted in a revision of police rules for executing search warrants and using confidential informants.

A team of 13 officers from the SWAT and drug-control units, using mistaken information from an informant, burst into Rev. Williams' Whitfield Street apartment on March 25, 1994. The squad chased Rev. Williams into a bedroom and wrestled him to the floor while handcuffing him.

Rev. Williams' heart attack was believed to have been linked to the emotional stress of the raid.

Philbin, a 33-year veteran of the force who has since retired, had an "ecstatic" reaction to the ruling, attorney Christopher J. Muse said yesterday. Philbin will receive about $7,500 in back pay.

"We've maintained his innocence from the beginning, and it's wonderful to achieve this result," Muse said.

Philbin, who moved to Maine, was close to retirement at the time of the raid and never returned to the force after the suspension.

Philbin received the harshest disciplinary action handed down in the case. Two other supervisors were reprimanded, three additional supervisors were reassigned, and one patrolman was suspended for 15 days.

The Civil Service action was criticized by one of the lawyers who negotiated a $1 million settlement from the city of Boston for Mary Williams, the minister's widow.

The settlement, reached in April, was the highest ever offered by the city in a wrongful-death suit.

The lawyer, James S. Dilday, said that the decision to exonerate Philbin was a decision "to exonerate the whole Police Department.

"The ultimate responsibility lay with Stanley Philbin," Dilday said. "He was the one who signed off on the process. On a baseball team or a football team, they fire the manager or the coach, don't they?"

Philbin conceded in a disciplinary hearing that he had not read the search-warrant application and that he did not attend a pre-raid briefing, both of which were required by department regulations.

However, the Civil Service Commission approved an appellate magistrate's decision that Philbin had been occupied with legitimate, time-sensitive police business when the search-warrant application was completed.

Philbin was confident that Detective Lisa Lehane, who drew up the application and conducted the briefing, had performed competently, the decision said. The warrant application was technically correct and the briefing was judged to be sound, the commission said.

However, the informant used for the raid provided a misleading tip that led police to Williams' second-floor apartment instead of the third-floor unit where police believed they would find up to 2 kilograms of cocaine and five machine guns.

Police Commissioner Paul Evans had not reviewed the decision by late yesterday, police spokesman Jerry Vanderwood said. The Civil Service vote was taken in closed session Dec. 11, but copies of the ruling were not made available to the news media until yesterday.

Evans is expected to comment today, Vanderwood said, adding that "It is not unusual for the Police Department to appeal decisions from Civil Service."

However, the lawyer for the detectives union said that such a ruling from an appellate magistrate "is almost irrefutable."

"It's a fact-driven question, and the hearing officer's judgment is final," Muse said. Any appeal would have to be based on an error in law or application, he said.

In his ruling, Chief Administrative Magistrate Christopher F. Connolly wrote: "When the search warrant was ready for review, Stanley Philbin was performing his duties as a detective lieutenant counting money for a drug buy, which he could not leave until completed."

"As time was of the essence and it had been the practice of the department to rely on the review of an assistant district attorney, Stanley Philbin allowed Detective Lehane to complete a task she had done many times before," Connolly wrote.

"Stanley Philbin was available to help if help was needed. He did not neglect his duties."

Regarding Philbin's required attendance at pre-raid briefings, Connolly wrote that the lieutenant was late to that session "because again he was completing his responsibilities as a detective lieutenant" regarding the drug buy.

"Once he arrived ... he verified that everyone knew about the details of the raid and were well-briefed," Connolly said. "He used reasonable judgment under the circumstances and exercised appropriate supervision."

However, the Police Department's response to Rev. Williams' death indicated that top-ranking officials believed flaws existed in drug-raid procedures and supervision.

Lt. Detective Patricia Eagar,chief administrative officer at the drug-control unit, was reprimanded for "failure to supervise." And Deputy Superintendent Pervis Ryans was reprimanded for inadequate supervision and failing to maintain files on informants.

Three supervisors, including Superintendent Joseph V. Saia Jr., were reassigned.

Officer Paul Delaney, whose informant supplied the misleading address, was suspended for 15 days and criticized for becoming too close to the informant.

Lehane was cleared of a charge of failing to have a supervisor review the affidavit accompanying the search-warrant request.

Tommy Montgomery, president of the Boston Police Detectives Benevolent Society, said the decision "brings closure" to a troubling incident from which the Police Department learned several lessons.

"We learned that despite all the checks and balances, things can go wrong," Montgomery said.

The hemp bill lives on.

Most lawmakers thought an effort to legalize growing hemp in Colorado might die with the departure of Sen. Lloyd Casey, D-Northglenn, from the legislature this year.

But a newly elected legislator from Montrose says she will introduce similar legislation in the 1997 session. Her bill would create a commission to oversee an effort that could lead to the planting of industrial hemp crops in the state.

Rep.-elect Kay Alexander, R-Montrose, said Friday that the legislation would encourage research on three fiber crops -- one of them hemp -- to see which is the most feasible in different parts of the state.

There will be plenty of safeguards to make sure that the hemp cannot be used to create what it's most famous for -- marijuana.

"The emphasis is on doing research first and foremost," Alexander said. "There will be three different fiber crops. Hemp is one of them. The others are kenaf and sun hemp.

"We're looking at research to take out as much of (the THC, the active ingredient in marijuana) as possible, as well as genetically re-engineering the plant so that it looks different."

A hemp bill had strong support from Colorado's agricultural community this year, including researchers at Colorado State University. It was approved in the Senate on an 18-15 vote but died in the House.

Law enforcement opposed the bill on grounds that it would be difficult to determine whether a hemp plant was being grown for marijuana or for the hemp, which can be used to make such diverse products as rope, paper and clothing.

THE ADMINISTRATION'S RESPONSE TO THE PASSAGE OF CALIFORNIA PROPOSITION 215 AND ARIZONA PROPOSITION 200.

1. General: The recent passage of propositions which make dangerous drugs more available in California and Arizona poses a threat to the National Drug Control Strategy goal of reducing drug abuse in the United States. At the direction of the President, the Office of National Drug Control Policy developed a coordinated administration strategy with the other agencies of the Federal Government to minimize the tragedy of drug abuse in America.

2. Objectives: An interagency working group chaired by ONDCP included the Departments of Justice, Treasury, Defense, Health and Human Services, Transportation, and Education, the Postal Service, and the Nuclear Regulatory Commission. This group met four times in November and December. It developed the following strategic objectives for our coordinated Federal response:

a. Maintain effective enforcement efforts within the framework created by the Federal Controlled Substances Act and the Food, Drug, and Cosmetic Act.

b. Ensure the integrity of the medical-scientific process by which substances are approved as safe and effective medicines.

c. Preserve Federal drug-free workplace and safety programs.

d. Protect children from increased marijuana availability and use.

3. Courses of Action: In developing this strategy, the inter-agency group gave due consideration to two key principles: federal authority vis-a-vis that of the states, and the requirement to ensure American citizens are provided safe and effective medicine. ONDCP and Federal drug control agencies have formed a partnership to undertake the following coordinated courses of action:

A. OBJECTIVE 1 -- MAINTAIN EFFECTIVE ENFORCEMENT EFFORTS WITHIN THE FRAMEWORK CREATED BY THE FEDERAL CONTROLLED SUBSTANCES ACT AND THE FOOD, DRUG, AND COSMETIC ACT

-- Department of Justice's position is that a practitioner's action of recommending or prescribing Schedule I controlled substances is not consistent with the "public interest" (as that phrase is used in the federal Controlled Substances Act) and will lead to administrative action by the Drug Enforcement Administration to revoke the practitioner's registration.

-- DoJ and Department of Health and Human Services will send a letter to national, state, and local practitioner associations and licensing boards which states unequivocally that DEA will seek to revoke the DEA registrations of physicians who recommend or prescribe Schedule I controlled substances. This letter will outline the authority of the Inspector General for HHS to exclude specified individuals or entities from participation in the Medicare and Medicaid programs.

-- DoJ will continue existing enforcement programs using the following criteria: (a) the absence of a bona fide doctor-patient relationship; (b) a high volume of prescriptions or recommendations of Schedule I controlled substances; (c) the accumulation of significant profits or assets from the prescription or recommendation of Schedule I controlled substances; (d) Schedule I controlled substances being provided to minors; and/or (e) special circumstances, such as when death or serious bodily injury results from drugged driving. The five U.S. Attorneys in California and Arizona will continue to review cases for prosecution using these criteria.

-- DEA will adopt seizures of Schedule I controlled substances made by state and local law enforcement officials following an arrest where state and local prosecutors must decline prosecution because of the Propositions. Once in DEA's possession the drugs can be summarily forfeited and destroyed by DEA. State and local law enforcement officials will be encouraged to continue to execute state law to the fullest extent by having officers continue to make arrests and seizures under state law, leaving defendants to raise the medical use provisions of the Propositions only as a defense to state prosecution.

-- Department of the Treasury and the Customs Service will continue to protect the nation's borders and take strong and appropriate enforcement action against imported or exported marijuana and other illegal drugs. The Customs Service will continue to: (a) seize unlawfully imported or exported marijuana and other illegal drugs; (b) assess civil penalties against persons violating federal drug laws; (c) seize conveyances facilitating the illegal import or export of marijuana and other illegal drugs; and (d) arrest persons committing Federal drug offenses and refer cases for prosecution to the appropriate Federal or state prosecutor.

-- Treasury and the Internal Revenue Service will continue the enforcement of existing Federal tax laws which discourage illegal drug activities.

-- IRS will enforce existing Federal tax law as it relates to the requirement to report gross income from whatever source derived, including income from activities prohibited under Federal or state law.

-- Treasury will direct the IRS to issue a revenue ruling, to the extent permissible under existing law, that would deny a medical expense deduction for amounts expended for illegal operations or treatments and for drugs, including Schedule I controlled substances, that are illegally procured under Federal or state law.

-- IRS will enforce existing Federal tax law as it relates to the disallowance of expenditures in connection with the illegal sale of drugs. To the extent that state laws result in efforts to conduct sales of controlled substances prohibited by Federal law, the IRS will disallow expenditures in connection with such sales to the fullest extent permissible under existing Federal tax law.

-- U.S. Postal Service will continue to pursue aggressively the detection and seizure of Schedule I controlled substances mailed through the U.S. mails, particularly in California and Arizona, and the arrest of those using the mail to distribute Schedule I controlled substances.

-- DEA together with other Federal, state and local law enforcement agencies will work with private mail, parcel and freight services to ensure continuing compliance with internal company policies dictating that these companies refuse to accept for shipment Schedule I controlled substances and that they notify law enforcement officials of such activities. Federal investigations and prosecutions will be instituted consistent with appropriate criteria.

B. OBJECTIVE 2 -- ENSURE THE INTEGRITY OF THE MEDICAL SCIENTIFIC PROCESS BY WHICH SUBSTANCES ARE APPROVED AS SAFE AND EFFECTIVE MEDICINES IN ORDER TO PROTECT PUBLIC HEALTH

-- The Controlled Substances Act embodies the conclusion of the Congress, affirmed by DEA and HHS, that marijuana, as a Schedule I drug, has "high potential for abuse" and "no currently accepted medical use in treatment in the United States." To protect the public health, all evaluations of the medical usefulness of any controlled substance should be conducted through the Congressionally established research and approval process managed by the National Institutes of Health and the Food and Drug Administration. Currently there are a few patients who receive marijuana through FDA approved investigations.

-- HHS to ensure the continued protection of the public health will: (a) examine all medical and scientific evidence relevant to the perceived medical usefulness of marijuana; (b) identify gaps in knowledge and research regarding the health effects of marijuana; (c) determine whether further research or scientific evaluation could answer these questions; and (d) determine how that research could be designed and conducted to yield scientifically useful results.

-- HHS will undertake discussions with medical organizations throughout the nation: (a) to address the "compassionate use" message; and (b) to educate medical and public health professionals by underscoring the dangers of smoked marijuana and explaining the views of NIH that a variety of approved medications are clinically proven to be safe and effective in treating the illnesses for which marijuana is purported to provide relief, such as pain, nausea, wasting syndrome, multiple sclerosis, and glaucoma.

C. OBJECTIVE 3 -- PRESERVE FEDERAL DRUG-FREE WORKPLACE AND SAFETY PROGRAMS

-- Transportation Workers: Department of Transportation has issued a formal advisory to the transportation industry that safety-sensitive transportation workers who test positive under the Federally-required drug testing program may not under any circumstance use state law as a legitimate medical explanation for the presence of prohibited drugs. DOT is encouraging private employers to follow its example.

-- Federal Contractors and Grantees: Under the Drug-Free Workplace Act, the recipients of Federal grants or contracts must have policies that prohibit the use of illegal drugs. Each Federal agency will issue a notice to its grantees and contractors to remind them: (a) of their responsibilities; (b) that any use of marijuana or other Schedule I controlled substances remains a prohibited activity; and (c) that the failure to comply with this prohibition will make the grantee or contractor subject to the loss of eligibility to Federal grants and contracts. Further, Federal agencies will increase their efforts to monitor compliance with the provisions of the Act, and to institute suspension or debarment actions against violators -- with special priority given to states enacting drug medicalization measures.

-- Federal Civilian Employees: HHS will issue policy guidance to all 130 Federal Agency Drug-Free Workplace program coordinators, the 72 laboratories certified by HHS to conduct drug tests, and trade publications that reach medical review officers. This policy guidance states that the Propositions do not change the requirements of the Federal Drug-Free Workplace Program, which will continue to be fully enforced for federal civilian employees nationwide. Medical Review Officers will not accept physician recommendations for Schedule I substances as a legitimate explanation for a positive drug test.

-- DoD and the Military Services: The Department of Defense will instruct civilian employees and military personnel in the active, reserve and National Guard components, that DoD is a drug-free organization, a fact that is not changed by the Propositions. The requirement that all DoD contractors maintain drug-free workplaces will continue to be enforced.

-- Nuclear Industry Workers: The Nuclear Regulatory Commission will continue to demand drug-free employees in the nuclear power industry, and will develop a formal advisory to emphasize that its drug free workplace regulations continue to apply.

-- Public Housing: The Propositions will not affect the Department of Housing and Urban Development's continued aggressive execution of the "One Strike and You're Out" policy to improve the safety and security of our nation's public housing developments. HUD's principal tool for implementing "One Strike" will be the systematic evaluation of public housing agencies screening and evictions efforts through the Public Housing Management Assessment Program. This program will give HUD a standard measurement of the progress of all public housing authorities in developing effective law enforcement, screening, and occupancy policies to reduce the level of drug use, crime, and drug distribution and sales in their communities.

-- Safe Work Places: Department of Labor will continue to implement its Working Partners Initiative, providing information to small businesses about workplace substance abuse prevention programs, focusing specific attention on trade and business organizations located in California and Arizona. DOL will accelerate its effort to post its updated Substance Abuse Information Database (SAID) on the Internet. SAID will provide information to businesses about workplace substance abuse and how to establish workplace substance abuse prevention programs. DOL will give priority to its efforts in California and Arizona.

-- DOL's Occupational Safety and Health Administration will send letters to the California and Arizona Occupational Safety and Health Administrations reiterating the dangers of drugs in the workplace and providing information on programs to help employers address these problems.

-- DOL's Mine Safety and Health Administration will continue to strictly enforce the prohibition on the use of alcohol and illegal drugs notwithstanding these Propositions.

D. OBJECTIVE 4 -- PROTECT CHILDREN FROM INCREASED MARIJUANA AVAILABILITY AND USE

-- HHS and the Department of Education will educate the public in both Arizona and California about the real and proven dangers of smoking marijuana. A message will be tailored for preteens, teens, parents, educators, and medical professionals. Research demonstrates that, marijuana: (a) harms the brain, heart, lungs, and immune system; and (b) limits learning, memory, perception, judgment, and the ability to drive a motor vehicle. In addition, research shows that marijuana smoke typically contains over 400 carcinogenic compounds and may be addictive. The message will remind the public there is no medical use for smoked marijuana and will educate the public about strategies to prevent marijuana use. The message will also remind the public that the production, sale, and distribution of marijuana for medical uses not approved by DEA violates the Controlled Substances Act and the Federal Food, Drug, and Cosmetic Act.

-- HHS will analyze all available data on marijuana use, expand ongoing surveys to determine current levels of marijuana use in California and Arizona, and track changes in marijuana use in those states.

-- HHS will develop the survey capacity to assess trends in drug use in all states on a state-by-state basis.

-- The Department of Education (ED) will use provisions of the Safe and Drug Free Schools Act to reinforce the message to all local education agencies receiving Federal Safe and Drug Free School funds that any drug possession or use will not be tolerated in schools. This affects approximately 95 percent of school districts. Notwithstanding the passage of the two Propositions, local education agencies must continue to: (a) develop programs which prevent the use, possession, and distribution of tobacco, alcohol, and illegal drugs by students; (b) develop programs which prevent the illegal use, possession, and distribution of such substances by school employees; and (c) ensure that programs supported by and with Federal Safe and Drug Free Schools funds convey the message that the illegal use of alcohol and other drugs, including marijuana, is wrong and harmful. ED will review with educators in Arizona and California the effect Propositions 200 and 215 will have on drug use by students. They will also communicate nationally with school superintendents, administrators, principals, boards of education, and PTAs about the Arizona and California Propositions and the implications for their states.

-- ED will develop a model policy to confront "medical marijuana" use in schools and outline actions educators can take to prevent illicit drugs from coming into schools.

-- ED will develop model drug prevention programs to discourage marijuana use. These models will be disseminated to the states at a Spring 1997 conference.

-- ONDCP and DOT will provide recommendations pursuant to the October 19, 1996 Presidential directive to deter teen drug use and drugged driving through pre-license drug testing, strengthened law enforcement and other means. The recommendations will underscore the point that the use of marijuana for any reason endangers the health and safety of the public.

5. Legislative Enactments: ONDCP, HHS and DOJ will work with Congress to consider changes to the Federal Food, Drug, and Cosmetic Act and the Controlled Substances Act, as appropriate, to limit the states' ability to rely on these and similar medical use provisions. The Administration believes that working with Congress is the course of action that will affirm the national policy to control substances that have a high potential for abuse and no accepted medical use. The objective is to provide a uniform policy which preserves the integrity of the medical-scientific process by which substances are approved as safe and effective medicines. We will also consider additional steps, including conditioning Federal funds on compliance with the Controlled Substances Act and the National Drug Control Strategy.