LIVING WITH HIV - AND MAYBE ONLY BECAUSE OF CANNABIS

In 1996, Alice Ferguson was wasting away, and it showed. Alice is a
big woman, and never had she felt like such a foreigner in her own
skin, which hung in folds around her.

She couldn't keep anything down, couldn't stand the smell of food or
the HIV medicine she blamed for her wasting. At first, her doctors
agreed that the medication was the culprit. She took it twice a day,
and twice a day she hugged the toilet bowl for 45 minutes afterward
with nausea and vomiting that make the 24-hour flu look pleasant. It
felt like every cell was giving something up - and in a way, every
cell was.

Meals stretched to two hours as she chewed, prayed and waited to see
if her body would accept morsels, if nothing else. Even the dietary
supplement Ensure was too harsh for her body.

Within a few months, Alice had lost 128 pounds. Her doctor diagnosed
it as AIDS wasting - a drastic, involuntary weight loss tied to the
human immunodeficiency virus.

He prescribed Marinol, a product of Illinois-based Unimed
Pharmaceuticals, which contains delta-9 tetrahydrocannabinol, or THC,
the same active ingredient in marijuana. Users vary in their support
of the drug, administered to Alice as a little white ball, a gel
tablet. Alice swears by it. With her first Marinol, she was soon able
to start eating.

This week, the Supreme Court ruled that federal law does not recognize
a medicinal necessity for marijuana. The decision, written by Clarence
Thomas, suggests that 5,000 years of medicinal use of the drug never
happened. Over the eons, marijuana or its active ingredients have been
used - as in the case of Alice - to improve appetite, halt the loss of
lean-muscle mass and control vomiting and nausea. It also can limit
muscle pain and spasticity in people with multiple sclerosis, and it
can prevent epileptic seizures in some patients and alleviate some
chronic pain. Some cancer patients swear by it. So do people with AIDS.

Alice would ask a few moments of the justices' time.

"I wish I could lock myself in a room with some of these
decision-makers and just talk for about two hours," she said. "I would
say, `If you don't believe me, live what I've lived, and then make the
decision you're making this day.' At this point, I am so mad about
what's happening, and mad at other people not experiencing what I live
every day, not because we don't have programs in place but because of
ignorance."

Alice is a former crack addict, and she hesitated putting herself back
in the world of street drugs - or even in their general, legal
neighborhood. When her doctor prescribed Marinol, she laughed and
said, "Why do I need this? I can get the real thing." She was kidding.
She'd never smoked reefer. She didn't like the smell. But in her world
of illness and hope, she knows plenty about the straight street stuff.

"My best friend in life lives in North Carolina," Alice says. "She has
battled cancer in almost every major organ of her body except her
liver. I mean, she's had it all. I can remember we were 17, and we had
gone partying, and we got back to her apartment, and she dropped to
her knees with pain. I knew she had cancer, but I had never seen her
collapse under the pain. I got her inside, and thought, `What could I
do?' I could light a joint. I can tell you without question that she
went from total collapse to sitting up and taking a few puffs, to
being ready to go back out the door."

In the same vein, Marinol is not for everybody. Unlike Alice, most
people who are persistently vomiting don't benefit from medication
taken orally. Some studies say Marinol is not as strong and isn't
absorbed as quickly as marijuana. Some patients say the medicine
leaves them debilitated and anxious, the opposite effect of marijuana.

Federal anti-marijuana laws were passed in this country in 1937. Since
then, eight states have passed medicinal-marijuana initiatives.
Connecticut allows cancer and glaucoma patients to be prescribed
marijuana, but there's no place to fill those prescriptions.

Alice, a computer specialist and AIDS activist, watches clients at
Connecticut Positive Action Coalition and thinks about how the quality
of medical care so often depends on which side of the street you live.
People from particular income brackets have paved and lit access to
perfectly legal therapeutic drugs like Valium, Xanax or Zoloft.

"These are not drug addicts looking to get high," Alice said. "The
decision-makers don't know. You know what? I've come to acknowledge
that they don't want to know, because if they acknowledge what really
happens in the lives of people living with cancers and with AIDS, they
would then have to rethink 90 percent of what they do."