A coalition of federal law-enforcement agencies in Washington is recommending that the U.S. government criminally prosecute physicians who prescribe marijuana for medical reasons under two ballot initiatives approved in California and Arizona, according to sources.
Concerned about the complex legal issues as well as the practical dilemmas involved in enforcement of state laws that conflict with federal law, the agencies have identified physicians as the most effective pressure point. The new state laws will allow doctors to prescribe marijuana in some medical situations.
At the same time, however, sources said that the agencies are recommending that the Justice Department not seek to overturn the new laws by filing civil lawsuits arguing that they are unconstitutional.
The recommendation to prosecute doctors is the strongest signal yet that Washington intends to fight the new laws aggressively, and it gives President Clinton added impetus in what would be a politically unpopular task of trying to nullify initiatives approved by a majority of voters in the two states.
The sources said that Clinton, who had not been expected to announce any federal response to the initiatives until early next month, now may act on the recommendations as early as today.
"It's in his court now," a Justice Department source said Thursday. "All of the agencies have worked together to craft the best policy possible. We've put together all of our advice. And he's got it."
Many senior law enforcement officials in Washington, most notably Gen. Barry R. McCaffrey, director of the White House Office of Drug Control Policy, spoke in opposition to the initiatives even before the election. But the recommendations represent the first unified and official government response. They were drafted by officials from half a dozen agencies, including Justice, McCaffrey's office, Treasury, Transportation and the Drug Enforcement Administration.
Although officials said that physicians or other medical professionals are rarely criminally prosecuted for prescribing illegal drugs, such as marijuana, Thomas A. Constantine, the DEA administrator, told Congress recently that the activities of doctors are still closely monitored by federal authorities.
Constantine testified that in the last two years, the licenses of more than 900 physicians either have been surrendered or revoked for a variety of fraudulent prescription practices.
"The California and Arizona initiatives do nothing to change federal drug-enforcement policy," Constantine said. "We can take both administrative and criminal actions against doctors who violate the terms of their DEA drug registrations that authorize them to prescribe controlled substances."
He noted that doctors are registered with the DEA to prescribe drugs from lists of legal substances--specifically those known as Schedule II, Schedule III and Schedule IV drugs. Physicians are not allowed to prescribe Schedule I substances, which include marijuana and other illegal narcotics.
"Technically, those doctors who prescribe or recommend Schedule I substances are violating federal law," Constantine said.
Atty. Gen. Janet Reno also has spoken out about the initiatives, noting that federal law bans the possession and transfer of illegal drugs like marijuana for any purpose. She emphasized that federal prosecutors will apply the law on a "case-by-case basis."
"Federal law is still in place," she said. "And the requirements of federal law are still in place. And it will be enforced and people should be advised of that."
The California measure, Proposition 215, makes it legal for medical patients to possess marijuana as long as its use is recommended by a physician. The Arizona law permits patients to use marijuana for pain relief or some special treatments if at least two physicians agree that it would be helpful and they can cite scientific analysis to show the benefits.
Federal officials, in forming their recommendations for Clinton, also were concerned about a variety of practical dilemmas posed by the conflict between state and federal law. The officials hope that cracking down on physicians will eliminate such questions as:
* Can federal officers seize marijuana as contraband from individuals claiming to have medical prescriptions for their use?
* How should federal agents respond if state and local police--barred by the new laws from taking action--ask them to arrest sick people suspected of using marijuana?
* What should federal prison officials do about inmates in U.S. facilities in California and Arizona who might obtain medically prescribed marijuana?
Constantine, Reno and other officials continue to scoff at the arguments advanced by some influential health care providers who say that the drug is physically beneficial. The officials argue that the drug is harmful and have cited information from a number of sources, including the American Cancer Society.
Said Constantine: "Why should we allow a few individuals, who write checks in the comfort of their upper-class homes, to dictate policies which we know are harmful?"
In Sacramento, state Atty. Gen. Dan Lungren is closely watching the federal government's response, according to a spokesman.
"He wishes the federal government would clarify its position on what it intends to do," said spokesman Steve Telliano. "Proposition 215 is very poorly written and the result is that the citizens of California and law enforcement as well are unsure what to expect from the federal government.
"Because this law directly clashes with federal law, how will it be interpreted at the federal level?"