MEDICAL MARIJUANA - MAINSTREAM SCIENCE LEERY OF MEDICINAL POT USE

Patients claim unique relief.

How medicinal is pot?

For Kathy E., a mother of four in Sonoma County, cannabis makes the
difference between misery and a life that is merely uncomfortable.

"It gives me relief now," said Kathy, who suffers from a chronic
immune system disorder that for 15 years clouded her days with
flu-like symptoms. "I do just enough to where I feel better. It gets
me just to the level where I can function."

But for Dr. Shan Lin, who tends to patients with the eye disease
glaucoma, marijuana's benefits in reducing the short-term, damaging
pressure inside the eye do not outweigh its negative effects, such as
depressing patients' nervous systems.

"We have new treatments for glaucoma, including eye drops and
surgery," said Lin, an assistant professor of ophthalmology at the
University of California at San Francisco.

While ailing patients defend smoking pot as a way ease the symptoms
of a range of diseases, scientists say conventional drugs properly
given can achieve the same or better results.

The debate continues in the wake of a U.S. Supreme Court ruling last
week that a federal anti-drug law makes no exception for seriously
ill patients in California who use pot for health reasons.

But one thing is clear: Nobody knows precisely why marijuana brings
the relief that its users insist they get. And patients say the
synthetic drugs currently in use, most of them in pill form, are poor
alternatives for the natural thing.

Long-term studies are being done to determine how the ingredients in
cannabis soothe nausea and ease the pain from cancer and multiple
sclerosis.

Scientists are questioning whether the therapy of users such as Kathy
could be replicated in a larger population that included people who,
unlike her, have not smoked cigarettes and have not used marijuana as
a recreational drug.

Although wary of cannabis, the medical establishment is exploring the
possibility that a limited number of patients could use the drug for
short periods under close supervision, and preferably administered
through a drug delivery system other than smoking.

The case for medicinal marijuana owes much to the testimony of
patients in extremis, such as those with AIDS, terminal cancer, acute
pain that does not respond to drugs and, like Kathy, chronic ailments
against which conventional medicine offers few powerful remedies with
mild side effects.

Advocates say pot is not a drug but an herb that contains 400
chemicals acting together. It is easily administered through
inhalation and acts more quickly than pills.

In Kathy's case, marijuana's major attributes are that it acts fast
and is not taken through her highly tender stomach while both
relieving her pain and stimulating her appetite.

"The marijuana seems to have a way of really getting deep inside to
where I can at least function," she said.

Critics of marijuana as medicine note that it sedates many people and
prompts anxiety in some others. Furthermore, many patients are averse
to smoke of any kind.

An alternative legal drug, a pot derivative called dronabinol, which
is marketed as Marinol, has been around since 1985 to fight nausea
associated with chemotherapy and AIDS-related weight loss. But
cannabis users say they should still be allowed to have marijuana.

"People describe a different kind of high," said Janet Joy, who
directed a 1999 study of medical marijuana for the national Institute
of Medicine. "They react more positively to the marijuana high than
to the Marinol high."

Cannabis patients also like the herb because they are able to control
the dose, said Mary Lynn Mathre, editor of "Cannabis in Medical
Practice."

Mathre is a member of a group called Patients Out of Time and a
consulting nurse at the University of Virginia Medical Center. She
said pot users believe the whole plant is better medicine than any
derivative.

"It's the other chemicals in the plant that help the natural
cannabinoids get into the system," Mathre said. "That's one of the
reasons they say they prefer an herb rather than Western medicine
wanting an active ingredient. It's almost like vitamin C: You'll get
a better quality vitamin C from an orange."

For more information on medical marijuana from patients' viewpoints,
see http://medicalcannabis.com For scientific reports on medical
marijuana, go to http://www.nih.gov/news and
http://www.nap.edu/books/0309071550/html