so-called cannabis buyers' clubs. Most visible in California, buyers' clubs originated with AIDS patients who initially formed the groups to distribute herbal medicines and imported pharmaceuticals not approved for sale in the United States. When club members found that marijuana relieved some of their symptoms, they organized supply networks, which eventually expanded to include people with other disorders.

Most buyers' clubs continue to be small and secretive; some are barely distinguishable from the informal relationships that form between many medical marijuana users, growers, and dealers. But in California, as well as such cities as New York, Seattle, Key West, Washington D.C., and Portland, Oregon, several larger buyers' clubs have begun to operate openly in recent years. Ensuing state and federal lawsuits have forced many of these public clubs to close. Those that remain open do so in cooperation with local authorities. Others have been replaced by more “low-key ” distribution networks.

There is no such thing as a typical buyers' club. Each has its own culture, determined to a large extent by its policies, patients, and physical location (see Figure 11.1). Some clubs act as marijuana purchasing agents, others as cooperative associations of patients and sometimes growers. Patients can smoke or eat marijuana on the premises at a few clubs, but most tend to operate like pharmacies, dispensing a variety of types and grades of marijuana, often at or below cost. Clubs generally require patients to present some kind of medical documentation, such as a physician 's referral, in order to receive marijuana.

At the time of writing, the future of public buyers' clubs appears to be uncertain, largely as a result of a series of lawsuits brought by the federal government against six of the most visible California clubs in 1998. The suits, which remain in litigation, can be viewed as a test of the federal government's ability to enforce the CSA in states that have enacted medical marijuana initiatives.

In at least one case, local governments have attempted to protect buyers' clubs from federal interference. When the Oakland Cannabis Buyers' Cooperative was targeted for closure in 1998, the city responded by designating its employees as officers of the city (ironically, by granting them the same privileges as undercover narcotics agents). This tactic failed to save the club, how-

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