Civility, reason and compassion are the inevitable casualties of any war. And in war even victories come with body counts and consequences.

The ultimate irony of the drug prohibition is that it fails to restrain social drug use and succeeds in depriving the desperately ill of adequate medical care. It is the lame, the near-blind, the dying who are most victimized by the brutality and banal-ity of the political Punch 'n Judy act we so politely call drug control.

In the "war on drugs" there is a chemical, catechism, or cliche to suit every taste. And there is a large, familiar cast.

Zero tolerance is more than a mere phrase. It is a creed; a quest for social conformity which contrives to make us less secure while stretching the reach of agencies of enforcement.

We who are seriously ill have become lost souls, unwilling participants in this macabre charade. Non-combatants we are, as civilians, trapped between enraged armies battling over bitter spoils.

For more than a decade seriously ill patients have won many victories. It is patients who have spearheaded efforts to abolish the medical prohibition of marijuana. It is patients who persuaded 34 state legislatures to recognize marijuana's im-portant medical value. It is patients who convinced the courts marijuana can be a drug of "medical necessity."

Legal organizations as diverse in outlook as the National Association of Criminal Defense Lawyers and the National Association of Attorneys General have recognized the needs of patients and called on the U.S. government to end medical prohibitions against marijuana's therapeutic use.

In 1988, after two years of hearings and testi-mony from more than sixty witnesses, the U.S. Drug Enforcement Administration's own adminstrative law judge concluded that marijuana has important medical uses in the treatment of life- and sense-threatening diseases. After hearing the evidence Judge Young ruled the DEA-enforced medical prohibition is "unreasonable, arbitrary and capricious."

The DEA rejected the judge's historic verdict and refused to acknowledge marijuana's therapeu-tic utility or move to make the drug available to physicians for prescriptive medical use. The case is now before the U.S. Court of Appeals for the District of Columbia Circuit.

Even as political, judicial, legislative, medical and popular support for the DEA-enforced prohi-bition rapidly recedes, the population of patients with marijuana responsive diseases is expanding.

fn 1990, AIDS was decisively added to the grow-ing list of marijuana-responsive diseases. AIDS patients around the world may benefit from this action. They can thank Steve.

AIDS patients have been smoking marijuana for years to reduce the debilitating nausea and vomiting caused by HIV-infection and AZT-induced emesis. Which is to say AIDS patients smoke marijuana for the same reasons cancer patients smoke: to ease nausea and vomiting and to enhance the appetite.

But, AIDS patients, like cancer patients, seldom have the energy, or time — quite literally — to fight for legal access. Reform is for the living. The terminally ill have more pressing and immediate concerns. Particularly when they can more easily and readily purchase high quality marijuana off the streets.

Steve, sick and under arrest for smoking marijuana, was the first AIDS patient who asked the Alliance for help. Steve welcomed this contest. Against the odds he outlasted bureaucratic stone-walling and lived long enough to gain legal access to marijuana. Once he achieved this goal, and sent this signal to other AIDS patients, Steve died.

Victories and body counts.

News of Steve's success rippled outward. Persons with AIDS responded by demanding similar consideration. Physicians who treat AIDS patients, keenly aware of the limits of modern pharmaceuticals, do not cower when confronted by a politically objectionable drug which has important therapeutic implications for their patients. Instead, they demand prescriptive access.

This trend will accelerate.

This is written in high summer. My thoughts are with a young couple in Florida — Kenny and Barbra Jenks. Kenny, who is 28, has hemophilia. At some point in the mid-1980s, he received a trans-fusion of HIV-tainted blood. Now, Kenny and his wife Barbra have AIDS.

Barbra, who is 23, once weighed 155 pounds. Then, between Thanksgiving and Christmas, 1988, her weight collapsed to 112 pounds. She developed pneumonia, went into a coma.

Barbra recovered from these calamities, but she and Kenny continued to experience problems with nausea, vomiting, and diminishing weight. Other AIDS patients told the couple smoking marijuana helped to control AZT-induced nausea and vomit-ing and, as we all know, marijuana makes you want to eat.

For the next year Kenny and Barbra smoked marijuana, ate dinner, gained weight and stayed out of the hospital. Marijuana not only calmed their digestive upset, it permitted them to live fairly normal lives.

Normal lives. This comment, that smoking marijuana produces a discrete, vital alteration in perception, is consistently mentioned by the doz-ens of AIDS patients to whom I have spoken since Steve's death. They say marijuana makes AIDS a "tolerable" disease. What is it about marijuana that it makes terminality tolerable?

First, marijuana lacks the powerfully disorient-ing psychological and biochemical effects produced by most commercially prescribed tranquilizers, pain-killers and mood elevators. With marijuana, AIDS patients can avoid or significantly reduce their use of highly toxic synthetic drugs. So, instead of feel-ing "doped-up," "sedated," "like a Zombie," marijuana permits AIDS patients to feel mildly euphoric — "relaxed."

To be dying and feel "relaxed" and, more specifically, to feel "relaxed" contemplating one's personal demise — this is not an immodest benefit.

Which is to say marijuana provides AIDS pa-tients with a sense of perspective. As Steve so carefully phrased it, "When I smoke marijuana I'm living with AIDS. When I don't smoke marijuana I'm dying of AIDS."

Second, marijuana suppresses emesis and im-proves appetite. Sitting down with one's family to eat dinner without gagging on your own vomit cannot help but improve one's mental outlook and sense of physical welfare.

Kenny and Barbra Jenks were sitting down to dinner the night ten vice squad agents from the Bay County Narcotics Strike Force busted down their front door and held a gun to Barbra's head. This daring raid resulted in the seizure of two small marijuana plants. Kenny and Barbra were charged with felony cultivation with intent to distribute and are facing five years in prison.

Two days following their arrest, Kenny read an article I had written about Steve. What Steve desired most — that his efforts should help other AIDS patients — crystallized.

It must be very odd indeed to be on trial for possessing the one drug which helps you cope with a fatal disease. Considering the circumstances, there is reason to doubt threats of criminalization and long prison sentences will discourage Kenny and Barbra — or tens of thousands of other AIDS patients — from obtaining the marijuana they medically need.

DEA demands these patients get marijuana il-legally, off the streets. Patients, however, prefer to get medicines from physicians. AIDS and HIV-positive patients join cancer, glaucoma, multiple sclerosis patients and others in working to make this possibility a reality.

Barbra and Kenny are under tremendous stress but, like Steve, they have decided to stand and fight They have realized they can help other people with AIDS — just as Steve helped them. Through their trial other AIDS patients will learn marijuana can be helpful. They are, in short, beginning to sense their place — and power — in the ever screwy scheme of things.

When arrest and trial are transformed from pits of personal intimidation into platforms for issue pollination, the prohibition itself becomes unten-able. In this light Kenny and Barbra cannot lose. Regardless of the legal outcome arrived at in a Florida courtroom, the general result is certain: AIDS patients in ever increasing numbers will learn of marijuana's potential benefits, obtain the drug and gain medical relief. Whether the marijuana they employ is legal or illegal, sanctioned or con-demned is nearly irrelevant. Steve, in effect, started a social chain-letter. Kenny and Barbra are con-tinuing the process.

Under the pressure of a geometrically ex-panding opposition the medical prohibition is doomed.

Robert Randall, President, Alliance for Cannabis Therapeutics.