HIGH COURT REFUSES TO RULE IN MEDICAL POT CASE

The U.S. Supreme Court on Tuesday refused to rule on a case that would have
allowed the federal government to punish doctors who recommend pot to their
patients.

In eight states with medical marijuana laws, the high court's decision was
seen as a victory. But in Arizona, where voters twice have passed medical
marijuana laws, the impact was less clear-cut.

"Obviously I'm happy," said Dr. Jeff Singer, a Phoenix surgeon and a
longtime proponent of Arizona's medical marijuana movement. "But I would
have been happier if they would have taken on the case and openly affirmed
the decision (of the lower courts)."

The 9th U.S. Circuit Court of Appeals in San Francisco ruled last fall that
doctors have a constitutional right to talk about and even recommend
marijuana to their patients. In most of the states that have medical
marijuana laws, a recommendation from a doctor is all patients need to use
the illegal drug.

But in Arizona, the law allows doctors to "prescribe" marijuana, and that
one word could make a difference.

The idea of the Arizona law is that a patient stopped by local police must
show a prescription from a doctor to avoid prosecution for possession of
marijuana. But writing a prescription for pot is against federal law, and
the Appeals Court ruling didn't deal with that issue.

Singer says California's law offers a better option for Arizona patients
because all they need is a verbal recommendation from a doctor to begin
smoking pot, and that is now protected by the ruling of the Appeals Court.

"My goodness, this is so incredible," said California cancer patient Angel
Raich, who smokes medical marijuana every two hours that she is awake.
"Hopefully, there'll be more doctors now that will feel safer in
recommending cannabis to patients that need it."

Proponents of medical marijuana maintain it is beneficial to patients
suffering from pain, nausea and other side effects associated with cancer
and wasting diseases such as HIV/AIDS and other ailments.

But Singer remains fearful of government reprisals and refuses to prescribe
the drug here because federal law still prohibits it. In fact, the federal
government has threatened to revoke doctors' federal licenses to write
prescriptions for narcotics if they prescribe marijuana for their patients.
It also has threatened to refuse doctors federal reimbursement from Medicare
and Medicaid, which effectively would put them out of business, he said.

Phoenix attorney Chuck Blanchard, former chief counsel for the Office of
National Drug Control Policy, said the Supreme Court's refusal to take the
case speaks more to the First Amendment right of free speech rather than
issues surrounding medical marijuana.

"It may give doctors more comfort to talk to their patients," he said. But
the prosecution of doctors is "more of a threat in the background than a
reality."

The real issue, whether people who use medical marijuana can be prosecuted
under federal law despite state laws that make it legal, has not been
addressed, he said. The few courts that have ruled on it say federal law
supersedes the state law.

In Arizona especially, the medical community has not been as eager to
prescribe marijuana, he said, not because doctors fear prosecution, but
because there are better alternatives.

Arizona voters have twice approved ballot measures to legalize marijuana use
for medical purposes. The first measure, in 1996, was challenged by the
Legislature and then-Gov. Jane Hull, who argued that the Food and Drug
Administration first needed to approve marijuana as a legal drug. Proponents
fought back and put another proposition on the ballot in 1998, which voters
overwhelmingly supported.

The problem for patients remains supply. Unlike Canada, which distributes
marijuana through its health department, Arizona does not provide the
illegal substance, and patients must find supplies through drug dealers and
others.

To Brian Helander, a registered nurse and executive director of the HIV
medical and social support group Body Positive, the issue of medical
marijuana is moot.

"It's something that's relatively routine for us in the medical community,"
he said.

But Helander cautioned that medical marijuana wouldn't be the first thing
prescribed for patients suffering nausea. He listed an oral form of the
active ingredient in marijuana, THC, as well as suppositories and other
anti-emetics.

Dr. Gregory Mayer, executive medical director for Hospice of the Valley,
said he doesn't believe marijuana is as effective an appetite enhancer and
anti-nausea medicine as other, legal drugs on the market.

"Is it really a wonder drug out there that's so much better?" Mayer said.
"In my opinion, it's not, from a pharmacological perspective."