MEDICINAL POT WORRIES ADDICTS IN RECOVERY

Haight Ashbury Free Clinics founder David Smith oversees hundreds of
group-therapy sessions each year for recovering drug addicts, but the woman
who whipped out a marijuana cigarette at a recent gathering baffled even him.

"I'm smoking it because I'm HIV-positive," she said.

"She totally discombobulated the whole group," recalled Smith, who oversees
the drug treatment of about 5,000 HIV-positive people; two-thirds got the
disease from using drugs.

"Had she pulled out an inhaler that looks like medicine, then it wouldn't
have caused a problem, but the marijuana she got from the cannabis buyers
club that you smoke in a joint looks like dope."

It's a conflict under debate in recovery centers across the country. While
legal experts, scientists and politicians wrangle over the Supreme Court's
ruling last Monday that rejected marijuana as a medical necessity, people
battling the human immunodeficiency virus and the lure of addiction have a
much more personal choice to make.

They know marijuana offers relief for aching joints and the nauseating
effects of AIDS and its arsenal of drugs. They know it stimulates the
appetite to combat AIDS-related wasting disease.

But smoking pot may also mean breaking a pledge to stay drug-free and
risking falling back into a habit that could kill them more quickly than
any disease.

Noah Briones, a 40-year-old crisis counselor, told his future roommates he
didn't want to smell pot smoke wafting from the bedrooms before he moved
into a San Francisco cooperative for people with HIV and substance abuse
problems.

"It was upsetting to me, so I said, 'Look, this is going to be a trigger
for me,' " he said.

But Greg, a member of Briones' Redwood City HIV support group, swears by
the marijuana he smokes every day. "It increases my appetite and puts me in
a better state of mind," said Greg, who did not want his last name used for
fear of being stigmatized. He isn't comfortable about smoking pot. "I've
been clean for 15 years -- well I call myself clean -- but my buddy wants
to beat me up" for using marijuana.

Like the woman who pulled out a joint at the San Francisco group therapy
session, recovering addicts who choose to use pot are setting off a stir.

Some centers, such as the Sitike Counseling Center in South San Francisco,
won't accept clients who reveal they use medicinal marijuana.

"The group doesn't want to connect with them; they want to stick with
people who are clean and sober," said Rhonda Ceccato, Sitike's director.
"Most of our clients have a lot of difficulty having anyone in their group
who is under the influence, and they don't care why they're under the
influence -- methadone, marijuana, Vicodin, whatever -- it doesn't fit well
with a clear abstinence model."

Individual Choice:

Other centers are more flexible, like Redwood City's AIDS Community
Resource Consortium, which encourages individual choice for the 400
recovering addicts with HIV who visit the center each month.

"If pain or nausea or lack of appetite is such that it is killing them,
they have to weigh between that and their recovery, then we help them
through that analytical process," executive director Michael Edell said.
"Does your body have to live so you can stay in recovery? Or do you stay in
recovery and not live?"

Symptoms Tracked:

In San Mateo County, some of these conflicts may arise in a recently
launched two-year study of medicinal marijuana. All of the HIV-positive
participants have a history of drug use and suffer from neuropathy -- a
largely untreatable symptom of AIDS that causes excruciating pain in the
arms and legs.

Researchers want to see whether marijuana will relieve participants'
symptoms. They also will track whether the 35 rolled joints passed out to
study participants each week will be smoked as prescribed, or end up on the
streets.

Word of the study has spread through the county's drug treatment centers,
intensifying the debate about whether marijuana is safe for a person
precariously perched between drug addiction and a deadly disease.

Nationwide, 237,000 injection drug users make up more than 31 percent of
total AIDS cases among adolescents and adults, according to the Centers for
Disease Control in Atlanta. The tally, which does not include HIV infection
rates, includes cases reported from 1981 through June 2000. In California,
9,600 AIDS cases among IV-drug users were reported through April of this year.

In the absence of effective legal remedies for many of HIV's maladies, many
patients in recovery, such as 50-year-old Burton Stevens, resign themselves
to live with the pain. Stevens was in a San Francisco hospital last week,
undergoing treatment for pneumonia.

"I've toyed with this decision of medical marijuana a lot," said Stevens,
who is two years in recovery and struggles with neuropathy. "Myself, I
don't dare touch it -- it would lead to going back to using full time --
the speed, the meth -- because when I used marijuana, I used marijuana to
get loaded."