A step ahead of the law, "Compassion Club" sells marijuana to patients referred by MDs

When Hilary Black, founder of Vancouver's Compassion Club Society, worked at a hemp-product retail store a few years ago, customers with AIDS, cancer and multiple sclerosis frequently asked about finding marijuana to help relieve their pain. Convinced that there was a need for medicinal marijuana, Black went to Holland and California to learn how buyers' clubs for cannabis operated in those places. In May 1997 she opened an office and began supplying medicinal marijuana herself. FIGURE

Figure. Hilary Black's Compassion Club sells marijuana to about 700 patients

"By the end of the summer I had 100 members, with prescriptions from their doctors," she says. Initially, rental space for the operation was hard to find, but a year ago the club, a registered provincial charity, moved to its present location in East Vancouver.

The club now has 700 members, ranging in age from 18 to 92, who have been referred by about 100 doctors. Three-quarters of the members have AIDS, around 15% have multiple sclerosis or experience chronic pain, and the remainder are cancer patients. Some of the AIDS patients are newly diagnosed, while others have had the disease for 13 years. New members attend a registration session, during which they sign a contract promising not to redistribute the marijuana. They pay $15 a year for the club's services, which include a wellness centre with counsellors and herbalists, and treatments such as acupuncture and yoga. A 30% markup on the cost of the cannabis covers the club's expenses. The marijuana costs between $5-$10 per gram, with each gram providing enough of the drug to make 4 joints.

Who refers patients to the club? "It is mostly oncologists and HIV/AIDS specialists who are willing to write the recommendations," says Black. "I suppose that is where the benefits of [medicinal marijuana] are the most well known, so they probably face the least amount of criticism from their peers."

The club gives prospective members a package of information for their doctors, which includes a referral form, academic papers supporting the medical use of marijuana and a copy of a letter to Black from the club's lawyer, which details his opinion that prescribing medicinal marijuana is lawful. The club uses between 10 and 15 suppliers; only a day's supply is kept on the premises.

How hard was it for the first members to obtain prescriptions? "For some it was very hard," says Black. "Doctors have a way of putting their words together very care-fully. Rather than saying, 'I prescribe cannabis for my patient,' they might say, 'John Smith is HIV positive and he tells me that cannabis helps relieve his symptoms,' or 'my patient would like access to the services at the Compassion Club.' Other doctors are more direct: 'My patient needs medicinal marijuana.'"

Dr. Morris Van Andel, deputy registrar of the College of Physicians and Surgeons of British Columbia, advises doctors to write a "confirmation" of a patient's medical condition, which suggests that the condition may be improved by marijuana, rather than an illegal prescription. "If I were a [practising] doctor, I would say, 'I am writing to confirm that Mr. Smith is HIV positive and that he has indicated that his chronic pain is helped by marijuana and therefore should such a substance be available to him, that on the basis of my knowledge of him, he should be eligible for that type of help.' Whether the Compassion Club has a way of making this substance available to that person is a decision between the patient and them. But that's quite different from the physician saying, 'Please give this patient marijuana.'"

Black says doctors like the Compassion Club because it offers recovering drug addicts a refuge from street dealers. "This is a safe place where they are not going to be asked if they want other drugs."

What do the police think of the Compassion Club? "It has not been one of our priorities, in terms of our drug investigations," says Constable Anne Drennan of the Vancouver Police. "There are some things we won't tolerate, such as when it becomes evident that the drug being sold is not strictly for medicinal purposes, but if the club abides by certain rules and regulations, they are not a priority for us. We are very much aware of the organization and what is going on there."