Joan Holland's pain finally received a name in 1988, the summer she went to the beach with her husband and two little girls and kept getting knocked over by the waves. It was diagnosed as multiple sclerosis.
Over the years, the retired schoolteacher has tried seemingly everything, from the traditional to the admittedly wacky, to find even a little bit of comfort.
She had her mercury fillings removed from her teeth, after learning they might be linked to autoimmune problems. She got treatment in a hyperbaric chamber, after hearing that a man in Florida may have quelled his symptoms with extra oxygen infusions. For two years, she even kept a beehive in her Jessup back yard and subjected herself to three dozen bee stings three times a week, feeling the venom gave her more mobility.
Now, at age 57, Holland is trying something she never thought she would: marijuana.
She is one of the hidden legions of the chronically ill who use the illegal drug to ease their pain, to help them sleep, to soothe their nausea just enough so they can keep food down. The drug, classified legally the same way as heroin, is not approved for any of those uses.
This year, Maryland legislators passed a law to reduce penalties for those caught using marijuana for medical purposes. Though still opposed by many who think the state has gone too far toward making marijuana legal, the law isn't a panacea for people like Holland - those for whom it was designed to help the most. If she is caught with marijuana, she is breaking the law. She can be arrested. She can be prosecuted. And if a judge doesn't believe her story, she can be jailed.
Forced to `sneak'
"We're in a better situation than we were, but we're not home free yet," she said. "It's still requiring that you sneak around and hide."
Possession of marijuana remains illegal under federal law, and Holland fears constantly that the Drug Enforcement Administration will knock on her door. Dr. Andrea Barthwell, deputy director for demand reduction at the White House Office of National Drug Control Policy, rejects the term "medical marijuana," instead calling it "medical excuse marijuana." She says those who push for laws like Maryland's are "feeding off the pain and suffering of people" in pursuit of their real goal: complete legalization of marijuana.
"There's no basis in medical [knowledge] for taking a crude plant material and providing it as medicine," she said. "It has not passed the test of having medicinal value. ... You've created a system where a skinned knee and a tennis elbow will be presented in a court of law to explain marijuana use."
State Sen. David R. Brinkley, a Republican who represents Frederick and Carroll counties and one of the main sponsors of the bill, said the current law was the only compromise that would satisfy those legislators who refused to pass anything to contradict federal law - despite laws in several other states that do just that.
"The minute that the federal government changes its stance, we can be a little more selective about what we do," said Brinkley, a cancer survivor. But, he conceded, "you're crawling."
"You've got to crawl before you can walk before you can jog before you can sprint."
It's unclear if anyone has used the law - which went into effect Oct. 1 - as a defense. Gov. Robert L. Ehrlich Jr. signed the legislation after intense lobbying from the White House and others to veto it.
Many people remain afraid to talk publicly about their use of the drug. One man with a serious nerve disorder said he didn't want to give his name because his parents don't know he has turned to it. One with multiple sclerosis said he wanted to talk but works for the federal government - which is a drug-free work zone.
`I was desperate'
Lawrence Silberman, 52, has been in remission from cancer - in his case, non-Hodgkin's lymphoma - for going on 18 months. But when he was the sickest, on chemotherapy, wired on steroids, he couldn't sleep. He would wake up after an hour or so in bed feeling as if he had swallowed a pot of espresso. Someone suggested he try marijuana.
"I would go downstairs around 11 o'clock," said the Burtonsville carpenter. "I would stand on the toilet, turn on the exhaust fan and take one or two puffs on the marijuana and blow it into the exhaust fan."
He felt like a teen-ager, sneaking around, but he had teen-agers in the house.
"I didn't want to be flagrant. I was desperate," he said. "People have kids who turn them in, for goodness' sake."
When Silberman would go for chemotherapy, which would take up to four hours, he would talk with other patients receiving theirs. And talk sometimes turned to the benefits they were feeling from using marijuana. "We were all in the same boat," he said. "Those aren't people who are going to be lying to each other."
Lacks safe, legal source