DESPITE HEALTH CLAIMS, U.S. BLOCKS MARIJUANA USE

Paul Boone says he never intended to start smoking marijuana. But last
summer, when the cancer that was attacking his liver made him so nauseous
that he lost 40 pounds, he became desperate.

So the 35-year-old computer consultant searched the Internet for a local
head shop.

Then he went and bought two pipes and called a friend who had offered to
find him some marijuana.

And when Boone lit up that first day back in September, he says, the relief
was almost instant.

"I couldn't believe how fast it stopped my nausea," says the Harford
County, Md., resident, who has since regained 20 pounds despite six rounds
of chemotherapy. "I still can't believe it works. I didn't believe it at
the time."

Boone is one of many patients across the country who say they have come to
depend on marijuana as part of their treatment.

Cancer patients smoke it to cope with the effects of chemotherapy, AIDS
patients to stimulate hunger and gain weight and people suffering from
neuromuscular disorders to ease pain and muscle spasms.

The growing demand of these patients for marijuana has led to a striking
reform of state criminal laws.

In the past five years, eight states have approved measures allowing
patients with certain medical conditions to smoke marijuana under a
doctor's supervision.

Legislatures in five additional states have begun to consider the matter.

But the federal government continues to classify marijuana as a Schedule I
narcotic, meaning that its use is a crime under any circumstances.

And in a case pending before the Supreme Court, the government is trying to
undercut the state measures and put an end to the medical use of pot.

The case involves six "cannabis clubs" that sprang up in California after
the approval of Proposition 215, the first of the state initiatives to
legalize medical marijuana.

Started by local activists, the clubs began growing marijuana and selling
it to patients whose doctors had cleared them to use the drug.

Local officials gave their blessing to this arrangement, and county
prosecutors agreed not to interfere.

But the Justice Department sued three years ago to shut down the clubs,
saying their activities violated federal laws against possessing or
distributing marijuana.

A U.S. District Court judge initially granted the government's request.

But after being reversed by an appeals court, he ruled that the clubs could
continue to serve patients who face imminent harm and have no other choice.

The government appealed to the Supreme Court, which likely will issue a
decision by early summer.

The stakes are high. If the court sides with the government, it would
significantly disrupt the medical marijuana movement.

Although the case involves only the right of clubs to distribute marijuana
- -- not the right of patients to smoke it -- closing down the clubs would
leave patients with no legitimate source of the drug.

If the court rules for the cannabis clubs, however, it could put a stamp of
legitimacy on medical marijuana.

It could also jump-start efforts to legalize its use for patients nationwide.

"It would be tremendous," says Alan St. Pierre, executive director of the
National Organization for the Reform of Marijuana Laws.

"It would galvanize and institutionalize the concept that marijuana is
medicine."

When the case was argued before the Supreme Court last month, the justices
sent conflicting signals.

While a few appeared sympathetic to the claim that marijuana is sometimes
medically necessary, others seemed skeptical.

And some justices, while allowing that the drug may have benefits,
questioned whether it was possible to distinguish between those patients
who need it from those who simply enjoy its effects.

The dispute among the justices reflects a larger societal rift. Since first
rising to national attention in the late 1980s and early 1990s, the medical
use of marijuana has been vigorously debated.

Supporters say marijuana is an ancient remedy that has been classified
unwisely as a dangerous drug.

They say it stops nausea, stimulates hunger, relieves pain and soothes
nerves, all of which can help the seriously ill cope with their diseases
and the often brutal treatments that accompany them.

They also argue that marijuana is valuable in treating glaucoma, epilepsy
and multiple sclerosis.

Most opponents don't deny that marijuana provides some benefits; indeed, a
study commissioned by the federal government concluded that the drug has
"potential therapeutic value."

But they argue that any benefits are outweighed by other considerations.

For one thing, critics say, smoking marijuana -- like smoking tobacco --
can lead to lung cancer and other respiratory diseases.

They also argue that marijuana carries undesirable side effects, such as
paranoia and dizziness.

But their biggest fear is that the medical use of marijuana would increase
drug use in general.

They express particular concern that if children saw adults smoking pot to
treat illnesses, they would be encouraged to smoke it themselves.

Robert Maginnis, a vice president at the Family Research Council, which
supports the government's case, says researchers are studying ways to
replicate the benefits of marijuana without the hazards.

Until they succeed, he says, other medicines can help patients cope with
their suffering.

Hormone pills, for instance, help build muscle mass and increase weight,
while prescription drugs such as Zofran ease nausea.

And Marinol, a drug that contains one of the active ingredients of
marijuana, helps stimulate hunger.

But doctors say such drugs have drawbacks.

Testosterone causes mood swings and often leads to prostate enlargement,
which, some doctors fear, raises the risk of prostate cancer. Zofran is
costly -- about $30 a pill.

As for Marinol, many patients say it makes them sleepy. In addition, it
takes up to two hours to start working, while marijuana provides almost
instant relief.

As for Boone, he says he's an unlikely spokesman for the medical marijuana
movement.

Although he tried marijuana once in high school, he has always opposed
drugs and used to think that medical marijuana was just an excuse for
"hippies" to get high.

When he became ill and got no relief from other medicine, Boone says, he
changed his mind.

Now, he's frustrated that a drug that helps him so much is still illegal.

"I'm not a kingpin or anything," he says. "I'm just a guy with cancer."