SUPREME COURT TO HEAR MEDICAL-MARIJUANA DEBATE

OAKLAND, Calif. (AP) A few years ago, an author writing about death
asked ailing AIDS patient Michael Alcalay how he was accepting dying.

"I'm not accepting it," Alcalay retorted.

Alcalay is alive today thanks in part, he believes, to doses of
marijuana that helped him keep his medicines down and appetite up as he
fought the disease.

On Wednesday, Alcalay will be in the courtroom as lawyers try to
persuade members of the U.S. Supreme Court that federal antidrug laws
should not prevent marijuana from being given to seriously ill patients
for pain relief.

"Once the justices recognize what's really at stake in this case, if any
semblance of justice prevails then so will we," said Robert Raich, a
lawyer representing the Oakland Cannabis Buyers' Cooperative.

The cooperative is a distribution club operating under California's
Proposition 215, the voter-approved law that allows the possession and
use of marijuana for medical purposes on a doctor's recommendation.

That's where Alcalay used to get his marijuana. But he's had to look
elsewhere since the federal government sued the cooperative and five
other California pot clubs in 1998 to prevent them from distributing the
drug.

A federal judge sided with the government. But last year, the U.S. Court
of Appeals for the Ninth Circuit ruled that "medical necessity" was a
legal defense.

California officials, including Attorney General Bill Lockyer, argue
that the state has the right to enforce its medical marijuana law, which
was approved by voters in 1996. Distribution clubs sprang up because
Proposition 215 is silent on how patients will get marijuana, outside of
growing and harvesting it themselves.

The Supreme Court is not looking directly at Proposition 215 but rather
at whether medical necessity may be used as a defense against federal
drug bans. It's unclear whether the justices will decide on that general
issue or rule more narrowly on how lower courts have handled this case.

If the court affirms the necessity defense, it could make it easier to
distribute medical marijuana in California and the eight other states
with similar laws - Alaska, Hawaii, Oregon, Washington, Arizona, Maine,
Nevada and Colorado.

The club remains open, but only to sell legal hemp products and maintain
a membership database.

Justice Department lawyers declined to comment on the case. They have
argued that allowing clubs to hand out marijuana compromises the
government's ability to enforce federal drug laws.

Advocates say marijuana is a reliable and nontoxic therapy that in some
cases is the only relief for patients.

That point of view was endorsed recently by the Institute of Medicine.
The institute, which was asked to examine the issue by the White House
drug policy office, said that because the chemicals in marijuana ease
anxiety, stimulate appetite, ease pain and reduce nausea and vomiting,
they can be helpful for people undergoing chemotherapy and those with
AIDS.

Institute officials also warned that smoking marijuana can cause
respiratory disease and recommended development of forms of the drug
that could be taken in other ways.

Alcalay, 59, a physician who serves as the club's medical director,
started using marijuana to keep down his medication after doctors
diagnosed his HIV in the 1980s. HIV turned into AIDS and in the
mid-1990s Alcalay almost died from an intestinal illness that ran
roughshod over his weakened immune system.

Although he lost 35 pounds off his 165-pound, 5-foot-10 frame, he said
small doses of marijuana helped make meals palatable. "I don't like
getting stoned. I like to be in control," he said.

He credits marijuana with keeping him alive until the advent of drugs
that boosted his immune system and wiped out the intestinal bug.

Alcalay didn't make it into the book about dying, and recently, he ran
into the author.

"He was surprised to see me," Alcalay said.