*This article first appeared on SFGate.com
San Francisco has been a mecca for gay people for nearly a century thanks to its relatively welcoming culture. Michael Koehn was a 24-year-old living in Wisconsin when he decided in 1970 to set out for San Francisco, because it was “the place you wanted to be if you were gay … you could be free … you could build a family, you could build a life,” he recently told SFGATE.
He settled into San Francisco’s vibrant cultural life and found a steady job working for the city. But then the 1980s came and the HIV/AIDS epidemic began. The signs of the crisis were all around the city. He saw people with telltale skin blotches of Kaposi sarcoma in the Castro. Friends were dying. And then the crisis came directly into his own life: He and his boyfriend George Manierre were diagnosed with HIV in 1985.
Like many others, Koehn and Manierre turned to cannabis for relief. Koehn recently told SFGATE it helped ease the pain of the disease and allowed him to keep working. News of marijuana’s benefits quickly spread in San Francisco and a tight-knit community formed to supply the medicine (including a grandmotherly brownie baker) and fight for its legalization.
This was during the deepest depths of pot prohibition in the 1980s, when Ronald Reagan was president and reefer madness was at its peak, but these activists fought for cannabis reform and quietly forged a path that millions of Americans are walking every day as they enjoy access to legal and medicinal pot.
And without the local San Francisco activists who risked their lives for it, today’s legal cannabis market might never have come to be.
The first signs of America’s HIV epidemic came as a frightening mystery in the spring of 1981. Medical reports began circulating of otherwise healthy men in Los Angeles and New York who suddenly came down with fatal lung infections, pneumonia and a skin cancer called Kaposi sarcoma, according to HIV.gov.
Researchers had no idea what was happening, but they were seeing the first signs of the coming epidemic and the unique effects of HIV. HIV, or human immunodeficiency viruses, is a name for two different viruses that attack our immune system and weaken our ability to fight off other infections. If left untreated, an HIV infection will eventually progress to AIDS, or acquired immunodeficiency syndrome, when the virus has weakened the victim’s immune system so much that they cannot fight off other infections.
The term HIV wouldn’t be coined for years, but these first signs of the epidemic in 1981 were evidence of people infected with HIV who had extremely weakened immune systems that were susceptible to various diseases and cancers.
HIV has never been a gay person’s disease — it has always affected people of all sexual orientations — but by the end of 1981 it was becoming clear that the disease was spreading quickly among gay and bisexual men. San Francisco’s gay community was quickly hit by the disease. The UCSF Medical Center was home to one of the first clinics to treat the disease and some of the earliest advocates for treating HIV and AIDS.
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In a complete coincidence, San Francisco in the 1980s was also at the forefront of the burgeoning American cannabis industry. Before long, these two worlds would collide.
Koehn and Manierre’s battles with HIV began four years after the beginning of the epidemic, but there were still barely any medications to help fight HIV. It wasn’t until 1996 that there was an effective treatment for slowing HIV’s progression into AIDS. So people infected with the virus were desperate for any medicine that would help. Koehn remembers people going to traditional markets in Chinatown looking for herbal options and even in desperation turning to implausible remedies like licorice in the hopes it would provide relief. But cannabis, which was already common in San Francisco, quickly became the go-to drug for many AIDS patients.
Cannabis couldn’t cure AIDS, but it was a salve for many of the disease’s symptoms, including increasing appetite, reducing pain, easing nausea, and reducing anxiety. Cannabis also helped treat the side effects of the early antiviral drugs that were being prescribed by the late 1980s that could cause extreme nausea, headaches, and insomnia.
Koehn said cannabis helped him cope with the virus and continue to work, and it helped his partner as well. But the disease overtook his boyfriend George quickly, and he died just six months after his diagnosis.
Koehn was heartbroken and saw the loss he felt rippling across his entire community in San Francisco.
“It was a very solemn time,” Koehn recently told SFGATE. “People were dying and then it got worse and worse. People’s friends and lovers, their very important people, were just dropping dead.”
The misery of the AIDS crisis was compounded by the American government’s nearly complete negligence to fight the surging epidemic. The Reagan administration publicly laughed at the disease when reporters started asking questions in 1982 about the government’s response. A lack of federal funding delayed fighting the disease, and people continued to die, with more than 40,000 AIDS patients dying in 1995 alone.
These overlapping dynamics surrounding the epidemic — the deadly misery of the disease, the government’s inaction, and the benefits of medical marijuana — swirled together in San Francisco and eventually formed into America’s new medical marijuana movement.
The emerging marijuana reform movement was led by two colorful characters: Dennis Peron, a fearless cannabis advocate willing to face off with any police or politician, and Mary Jane Rathbun, a grandmotherly figure who became an unlikely face of marijuana in America.
Rathbun was a waitress selling cannabis brownies in the Castro when the AIDS crisis hit, and she soon became known as “Brownie Mary” after she started distributing thousands of weed brownies to AIDS patients around the city. Rathbun’s flagrant distribution of pot made her a target for the authorities and she was arrested multiple times, yet she refused to give in.
David Goldman, Koehn’s husband today, was living on Noe Street in the 1980s, working as a teacher and an advocate for AIDS patients, and remembers Rathbun as a “salty” woman when it came to the authorities. He recently told SFGATE that he remembers her saying that “if those narcs think they’re going to take away the medicine from my kids … they can go f—k themselves in Macy’s window.”
Rathbun’s multiple arrests made a picture-perfect image for the ridiculousness of the existing marijuana laws, with a woman who looks like a grandmother being arrested for giving medicine to patients who were suffering from a terrible disease.
While Rathbun hit the streets distributing brownies across San Francisco, Peron worked inside San Francisco City Hall and the state Legislature to change the actual laws. Peron had been selling cannabis in San Francisco since the 1970s, but his work took on a new importance when the AIDS crisis hit in the 1980s and his own partner, Jonathan West, was diagnosed with the disease.
The police raided Peron’s house in 1990 and arrested him for possession. Peron’s partner, who at this point was weeks away from dying, took the stand saying the pot was for his own use. The court eventually freed Peron.
Peron and Rathbun worked together to change the laws. Rathbun testified at City Hall, and the Board of Supervisors passed a resolution in 1992 calling on the local police to deprioritize medical marijuana enforcement. And then Peron opened his Cannabis Buyers Club at Church and 14th Street in 1994, running the country’s first medical marijuana dispensary in broad daylight.
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In 1996, Peron took his fight to a statewide ballot initiative, writing Proposition 215 which allowed anyone in California to grow and use cannabis if they had a doctor’s recommendation. Voters approved the measure handily, and from that moment, the little movement that started in the Castro had officially blown up into something much larger.
Californians didn’t invent medical marijuana. It’s one of the oldest medicines in human history. And San Francisco wasn’t even the first place in America to use medical marijuana. Cannabis tinctures were a common medicine in 19th-century America.
But that entire history was forgotten by the 1980s, when the depths of America’s War on Drugs had turned marijuana into a highly illegal and deeply stigmatized drug. Almost no Americans saw pot as a legitimate medicine. In 1985, 73 percent of people thought marijuana should be illegal (today the situation is reversed, with 70 percent of people believing marijuana should be legal).
AIDS patients using cannabis and the people providing the drug were risking their freedom, but the clear benefits it was providing steeled their resolve to continue fighting for the drug.
Terrance Alan was willing to take risks when he was working to supply marijuana to AIDS patients in the 1980s and 1990s. He was also HIV-positive, his own partner died in 1993 from HIV six months after he was raided for growing cannabis in the city. So Alan developed a dispersed growing technique by setting up small grow operations in the spare rooms of AIDS patients’ homes. That way the patient, who often was too sick to work, would have their own medicine and Alan would pay their rent and utilities. And Alan would have a place to grow cannabis. Eventually, he had 16 of these dispersed grow houses set up across the city.
“There were moments the lawyers would tell us that we should be careful but, you know, I looked around and everybody was dying,” Alan said. “I was mad. … I was just so pissed off that I don’t think [being] scared was part of it.”
Alan now owns the Flore Dispensary in the Castro, named after the cafe where Peron and Rathbun first smoked a joint together.
This fearlessness in San Francisco eventually led to a national and global movement. California’s legalization of medical cannabis in 1996 was followed by dozens of other states. Eventually, the momentum moved beyond California itself, as other states moved to legalize adult-use cannabis before California had taken that step. The marijuana reform train also took turns that the original advocates didn’t even favor — Peron eventually became a vocal opponent to recreational legalization before he died in 2018, arguing that legalization would hurt small farmers in favor of big businesses (in some ways, he was right).
But San Francisco’s gay community is still widely recognized as the birthplace of marijuana legalization. Those early medical marijuana activists left a clear imprint on the cannabis laws we have today, according to Jonathan Caulkins, a public policy professor at Carnegie Mellon University. They pushed cannabis reform forward, even as that reform took the shape of voter initiatives instead of legislative laws, which Caulkins sees as a detriment to improving policy.
“Deciding what drugs work by popular vote or acclaim is a seriously flawed approach vulnerable to all sorts of quackery and industry manipulation,” Caulkins said in an email to SFGATE. “So I see the legacy as checkered, but the importance and influence are indeed very large.”
Regardless of your opinion on where marijuana laws have ended up in America, it’s clear that the gay community in San Francisco was where this latest movement started. The next time you buy a pre-rolled joint or fancy edible, remember that the reason you’re able to buy it and safely enjoy it without fear of the police is largely because of the efforts of some fearless AIDS patients and their friends in San Francisco three decades ago.
