PRESCRIPTION FOR POT?

At its worst, Laura Campbell's pain wakes her up at night. She rocks or
paces the floor. In the mornings she might vomit.

"It's hard to think, hard to think straight. You're just going through the
motions," said Campbell, 32, who lives outside Cullman. "I'm almost
animalistic, because of the pain."

As men will do, her husband tries to fix it. Her monstrous combination of
fibromyalgia and spinal arthritis makes quelling her pain almost
impossible. "Except, if we have the money, he can go out and buy an illegal
substance," Campbell said, weary frustration in her voice.

What Campbell says helps her most is marijuana. For a tee-totaling North
Alabama Baptist, it's been a lot for her to reckon with.

Yet she has decided to go public with her condition and her clandestine
self-medication in hopes that marijuana will become legal for specific
medical purposes if enough patients and doctors speak out. A bill
introduced this legislative session would allow doctors to prescribe
marijuana to patients suffering with fibromyalgia and other conditions such
as glaucoma, HIV and cancer. The drug would remain illegal for everyone else.

Some physicians support it, saying marijuana is safer and more effective on
certain patients than conventional drugs. They say legal painkillers such
as Lortab, Xanax and Oxycotin are stronger and more addictive. Other
doctors say the risk of sending the wrong message to young people outweighs
any benefit of marijuana.

"If the medical community makes a statement that this should be used to
treat a certain illness, then that gives credibility to a drug which is
mind-altering and would be abused," said Dr. Marsha Raulerson, a Brewton
pediatrician and president of the Alabama Chapter of the American Academy
of Pediatrics.

For patients such as Campbell, whose symptoms do not lessen with
prescription medicines, marijuana is already credible, legal or not.

Fibromyalgia, a chronic pain illness, is characterized by musculoskeletal
aches, pain and stiffness, fatigue and sleep disturbances, according to the
National Fibromyalgia Association.

Campbell's arthritis is a genetic condition, and the swelling in her spine
causes pain all over. The most common conventional medicines used to treat
this kind of severe pain are morphine-or codeine-based, and Campbell says
both give her side effects such as vomiting and diarrhea. She believes
she's allergic to them.

Also, "If I take a pill, I'm hallucinating. I'm Lucy in the sky with
diamonds," she said. With marijuana, she can smoke a "tiny bit," put it
down, wait five minutes and if it doesn't work, she can take a little more.

"I never get high, and that's very important," she said.

Its other uses:

Besides acting as an analgesic for chronic-pain patients, marijuana is used
as an appetite stimulant and anti-nausea drug.

Doctors believe it works in the part of the brain that controls hunger and
nausea. But they don't understand the precise biochemistry, said Dr. Amos
Bailey, director of Palliative Medicine at the Birmingham VA Medical
Center. Bailey also started the palliative care unit at Cooper Green
Hospital, where terminal cancer patients receive hospice care.

Legal drugs do not work on everyone. Doctors may try three or four
medicines on a cancer patient, and that patient may still be wracked with
nausea and may still lose weight, he said.

"Having something such as marijuana that's part of the class of drugs you
can use means you have possibilities for people who do not respond to
conventional treatment," Bailey said.

Bailey and his staff occasionally prescribe Marinol, a drug that is legal.
It contains a synthetic from of THC, the major component of marijuana. But
there are drawbacks to Marinol.

It costs from $400 to $800 a month, more than triple that of common
cholesterol medications or painkillers. And because Marinol comes in pills,
patients cannot control the dosage as well as they can with smoked
marijuana. Also, marijuana, like all herbal remedies, has other active
components not replicated in the synthetic forms.

"Quite frankly, this is something that patients may have already taken into
their own hands," he said. "And it makes sense to me when patients tell me
the Marinol helped some, but the marijuana helped more," Bailey said.

He never recommends marijuana, instead he reminds patients that marijuana
is illegal and they could get into trouble.

But in the delicate dance between law-abiding physicians and desperately
sick patients, it is understood that some patients use marijuana on their own.

It can be an excellent treatment, especially for Vietnam-era veterans who
are comfortable using marijuana. "If it were legal, it would make it a lot
easier to have these discussions, and for selected patients, I think it
would be helpful," Bailey said. "I don't think we should make people
criminals if we can avoid it, particularly very sick people."

Helpful for AIDS patients:

Rep. Laura Hall, D-Huntsville, who is sponsoring the bill, watched her son
die from AIDS, and that's one of her motivations in trying to legalize
medicine that would have given him some relief.

HIV/AIDS patients use marijuana as an appetite stimulant to fight
AIDS-related weight-loss in part because conventional treatments aren't
very good or have undesirable side effects, said Dr. Michael Saag, a
professor of medicine at the University of Alabama at Birmingham and
director of its AIDS center.

One, called Megace, a progesterone, stimulates the appetite, but it lowers
testosterone levels, creating fatty pockets. Certain steroids that can
cause weight gain also suppress the immune system. Anabolic steroids create
desirable lean body mass. But they cost about $1,000 a month, Saag said.

There are downsides of marijuana use - bronchitis and lung problems - but
much less than in someone who is a regular cigarette smoker, Saag said.
Also, some people dislike the euphoria and say it interferes with their
day-to-day life, while terminally ill patients might benefit from the sense
of well-being it causes in some.

Saag gives other reasons to legalize this controversial drug for medical
purposes. He's never known of a marijuana addict. "There's certainly a
psychological dependence, but that's different than physical addiction," he
said. And he's never seen a marijuana-related death, nor known of anyone to
overdose on it. "I've seen them OD on alcohol, Lortab, Xanax, Valium," he said.

"Marijuana should have been approved a long time ago, and I think we need
to pull back and look at why it isn't," Saag said. "I think it really boils
down to a traditional association of marijuana going back decades, maybe a
century, where it was viewed as an abused substance, to protect young
people. They didn't see it as a benefit, they only saw it as a risk, and
they outlawed it," he said. "I think that's a bit anachronistic."