I, Keith Vines, declare as follows:

1. I am an Assistant District Attorney for the City and County of San Francisco, a position I have held since 1985. I am currently Chief of the Psychiatry Unit of the District Attorney's Office. I earned my bachelor's degree from the University of Miami in 1972 and my J.D. from Cumberland School of Law in Birmingham, Alabama, in 1975, where I graduated with honors. I am a member in good standing of the State Bar of California and the Pennsylvania Bar Association.
2. After graduating law school, I enlisted in the United States Air Force. Upon enlistment in 1976, I entered the Judge Advocate Corps with the rank of Captain. I was first stationed at March Air Force Base in California where, from 1976 to 1977, I was appointed Chief of Military Justice in charge of investigation and prosecution of criminal cases. For the next eighteen months, I served as Headquarters Area Defense Counsel, representing defendants in military courts-martial and administrative disciplinary hearings.
3. In August of 1979, I was transferred to Scott Airbase Medical Center in Belleville, Illinois, where I completed classes in medical-legal studies and risk management. I was subsequently selected as one of seven Medical Law Consultants in the United States Air Force. In that post, I advised 14 hospitals and law offices in a 10-state region regarding medical malpractice claims and assisted the Assistant United States Attorney in the trials of several of these claims. I prepared position and strategy and legal memoranda on many important medical-legal issues facing military hospitals. Among the papers I prepared and lectures I delivered to hospital staff were: "Importance of Charting," "Informed Consent," "Standard of Care Applicable to Physician Assistants," "Right to Die, Determination of Death," and "Legal Authority and Procedures for Issuing Orders Not to Resuscitate." The expertise I developed in that position has been invaluable in understanding my personal treatment needs.
4. As a military officer, I received numerous commendations from my superiors. In addition, I was awarded the Strategic Air Command Junior Officer of the Year and twice received the Air Force commendation medal and Air Force meritorious service medal. I was honorably discharged from the military in 1982. I then moved to California and worked for three years in private practice, first in Walnut Creek and then in San Jose, prior to joining the Office of the San Francisco District Attorney.
5. As a prosecutor in the District Attorney's office, I have worked in both the misdemeanor and felony divisions. For two years, I served as a felony prosecutor in the office's federally-funded Federal Narcotics Strike Force, charged with implementing the nation's drug laws. As a member of the Narcotics Strike Force, I helped secure the conviction of a defendant responsible for amassing several hundred pounds of marijuana, which was then the city's second largest drug seizure. The defendant had twice before avoided prosecution by federal authorities.
6. I am a retired Air Force Captain and JAG Corps prosecutor, a former foot soldier in the war on drugs, and the proud father of a son who will turn 18 this summer. I am also an AIDS patient who credits medical marijuana as an important link to saving my life.
7. I have been HIV-positive since 1983. By 1990, my health was deteriorating. In 1993, I was diagnosed with AIDS wasting syndrome, a condition characterized by severe progressive weight loss and breakdown of muscle tissue. As a result of my wasting syndrome, I lost more than 40 pounds of lean body mass. My bones became brittle and my joints, for lack of nourishment, ached with pain. I tried to stay fit by exercising regularly. But nothing seemed to stave off my progressive deterioration.
8. A particularly devastating symptom of my illness and side effect of its treatment was (and is) my chronic and severe loss of appetite. My disease, and the medications which treat it, have drastically, perhaps permanently, altered my relationship to food. Like many AIDS patients, I have been prescribed a series of medications over the years, including ddI, AZT, d4T, 3TC, Saquinavir, Crixavan, Septra and Acyclorir. Many of these medications, singly or in combination -- particularly AZT -- can suppress appetite. I rarely look forward to sitting down to a meal. Frequently, I feel as if I just finished eating a full Thanksgiving dinner, when, in fact, my stomach is empty.
9. Yet it was (and remains) essential for me to eat regularly. My medical protocol requires as much. In 1993, I was accepted into a growth hormone study at San Francisco General Hospital. The purpose of the study was to determine whether the experimental growth hormone retarded or reversed AIDS wasting syndrome. By this time, I was a shell of my former self, having wasted to a weight previously unimaginable to me, my family, and my friends. My doctors tried to combat my condition with several treatments, but nothing they prescribed worked. I was increasingly weak and usually exhausted. Although the growth hormone was accompanied by a lengthy list of potentially serious and adverse side effects, I decided to try it. What is more, the federal government, in endorsing or permitting the hormone trial to go forward, essentially encouraged -- or at least did not discourage -- my participation.
10. As it turned out, the experimental growth hormone therapy, which required daily self-administered shots of the hormone into my stomach, took hold and stopped my wasting. In a matter of months, I regained much of my lean body mass, and with it, my strength and my hope. The growth hormone, which I have been on for the past 3 years, was recently approved by the Food and Drug Administration. That gave me new lease on life, years before the FDA completed its investigation.
11. The catch is, for the hormone therapy to be effective, the researchers explained, it was essential for me to eat 3 full meals each day if at all possible. (Saquinavir, another recently-approved drug that I take, also must be taken on a full stomach.) But the simple act of eating was difficult and often painful.
12. To stimulate my appetite one of my physicians prescribed Marinol, a synthetic derivative of THC, which is one of the main active ingredients of marijuana. I found, however, that I could not tolerate Marinol's harsh and unpredictable side effects--side effects that I tried to endure despite only a marginal improvement in appetite. Not infrequently, a single Marinol capsule would make me feel "stoned" for several hours, such that I was unable to function at a level at which I felt comfortable or competent. Other times the Marinol put me right to sleep. Because I continued to work full-time as an Assistant District Attorney, this was for me an unacceptable state of affairs. I need to be at the top of my game. Marinol deprived me of something I have always valued deeply: a sense of control over my mind and body.
13. I informed my physicians that I could no longer tolerate the Marinol because of the unacceptable side effects. At that point, two of my doctors suggested that I try marijuana. They explained that in their practices, they had observed that for many AIDS patients, smoking marijuana stimulated appetite better than its synthetic cousin, and did so without many of the deleterious side effects of Marinol.
14. This suggestion caused me some consternation. Although Marinol did not work well for me, I appreciated the fact that it was a licit medication, my use of which, if discovered, would not jeopardize my career in law enforcement. On both a personal and professional level, I am committed to upholding the law. But the fact remained: Marinol did not provide me the relief I needed. Despite the risks I faced as a District Attorney, I obtained a small amount of marijuana from a local Cannabis Buyers Club and brought it back to my apartment. I felt torn, yet I had been put in an impossible situation. Technically, I was breaking the law, yet I was doing so to comply with the therapies that were fighting my wasting and the HIV.
15. I found that it took only two or three puffs from a marijuana cigarette for my appetite to return. Moreover, the beneficial effect took place within minutes rather than the hours that I sometimes waited after swallowing a Marinol capsule. Because I only required a small dose to stimulate my appetite, I did not need to get stoned in order to eat.
16. I have three or four physicians whom I regularly consult about my health. I have found that my doctors don't always agree in their assessments and therapeutic recommendations. If all of my physicians had told me not to try medical marijuana, I would not have smoked it. If even one of my doctors had tried to discourage me from using marijuana as an appetite-stimulant, or had even remained silent in the face of my inquiries, I might have not taken the risk. So many of the decisions regarding my medical treatment involve balancing competing issues. With respect to Saquinavir, a protease inhibitor that I now take, two of my doctors recommended against it and one promoted it. I spent a lot of time discussing Saquinavir with these physicians so that I could make the best informed decision possible. I ultimately decided to go with the recommendation of the one physician over the other two.
17. I am aggressive in matters concerning my care and treatment. It is not enough that a person with a medical license tells me to do something. I must establish a personal connection with the doctor and trust in my heart that this doctor is wholly committed to my well-being. While I can and do spend a great deal of time and energy learning about my illness and the available treatments, in the end I place a great deal of faith in my treating doctor. This faith can only come through a relationship of trust built up over a series of conversations and visits.
18. The government's threats against physicians who recommend medical marijuana jeopardize the core of my relationships with my doctors. The government has stated in no uncertain terms that physicians are not to engage in candid discussions with their patients regarding the efficacy of marijuana. Such a policy prevents me, the patient, from receiving what may be the best and most reliable medical advice. At the very least, it places me in the position of not knowing whether my physician sincerely believes what he or she tells me about marijuana, or whether the message is filtered or modified to avoid potential sanctions.
19. In many ways I am fortunate. I have the strength and acumen to seek and obtain the best advice possible regarding my medical care. But even for me, a success story when it comes to experimental therapies, the struggle for information takes its toll. Many seriously ill people lack my stamina and fortitude and are therefore less able to overcome the obstacles placed in their path. The government's threats against doctors are just such an obstacle. I fear for the patient's ability to get the best treatment for a condition and to cultivate a meaningful and trusting relationship with a physician.
20. I remain on my growth hormone therapy and I continue to take 15-20 pills a day as part of my antiviral and vitamin regimens. I also use medical marijuana as needed to stimulate my appetite. My marijuana use is quite modest. I find that I need to take a couple of puffs only two or three times a week, in the evenings, in order to eat. There are also periods of weeks at a time when the marijuana is unnecessary. I do not smoke before or during business hours. I have not become addicted to marijuana. I continue to work, as I have for the past 12 years, as a city and county prosecutor. The thought processes and motor skills that I use on the job are not the least impaired by the couple of puffs of cannabis I occasionally take before an evening meal. I am not a danger to myself or others. Perhaps most important, I am not wasting away. I am still contributing to society rather than draining its resources. I am thriving on my own, rather than existing as a burden -- either financially or emotionally -- to my family, friends, or the government.

    I declare under penalty of perjury under the laws of California and the United States of America that the foregoing is true and correct .

    Executed this 14th day of February, 1997, at San Francisco, California.

    Keith Vines