The marijuana she smokes every two waking hours makes life bearable for Angel Raich. It eases the pain from an inoperable brain tumor, scoliosis and several other permanent disabilities. It's the only thing her doctors will prescribe, because she has severe allergies that cause violent reactions to traditional medicine.
In Oakland, Calif., where Raich lives, that's no problem. A 1996 state law permits patients to grow and smoke marijuana on doctors' recommendations.
But on Monday, the U.S. Supreme Court will hear arguments in a case that's likely to settle a conflict between that California law and a 1970 federal ban on illegal drugs.
The Justice Department says federal authority is supreme in this matter, and the Drug Enforcement Administration already has raided one California patient's house and destroyed her cannabis plants. If the court favors the government's view, more raids would follow in the 11 mostly Western states that have legalized medical marijuana.
Anti-drug groups support the federal government, saying approving medical marijuana could boost support for the recreational use of drugs.
Raich and her supporters say medical marijuana is a matter for the states to decide, and for doctors to decide for their patients.
"Without cannabis, my life would be a death sentence," Raich, 39, says on a Web site about her struggle. "Cannabis was responsible for getting me out of my wheelchair and restoring mobility on the whole right side of my body. For years I felt as if I were suffering in hell. I will not go back to hell for anyone or anything."
The case is one of the most watched on the Supreme Court's docket this term, one that involves the justices in a high-profile social issue and tests court conservatives' commitment to a line of decisions that restrain federal intrusion into state matters.
It began in California in 2002, when DEA officers raided the Oroville home of Diane Monson, who was growing marijuana in her garden to ease back pain. The raid at Monson's home - and several others - was tied to a crackdown on medical marijuana inspired in part by the war on terrorism. President Bush has said the illegal drug trade helps finance terrorists.
Under Chief Justice William H. Rehnquist, the high court generally has favored state authority over federal influence, establishing a long line of cases that have reduced Congress' authority to regulate interstate commerce.
But the Supreme Court took a stab at curbing marijuana use in 2001 when it ruled against clubs that distributed medical marijuana, which the clubs had deemed a "medical necessity." The ruling forced Raich's supplier to close but left unsettled whether federal authorities could block states from permitting marijuana to be used for medical reasons.