'MAJOR BUMMER' FOR POT USERS

Many Plan To Keep Smoking In Bay Area

Medical marijuana users across the Bay Area scoffed at the U.S. Supreme
Court for discounting the drug's role in easing their pain, with some
vowing to keep using cannabis even if they must resort to illegal means.

"It's just a major bummer and a serious slap in the face," said Dave
Stanley, walking out of the Oakland Cannabis Buyers Cooperative yesterday
morning. "It just goes against the will of the people."

A war veteran whose medical conditions include traumatic arthritis, Stanley
said he needs marijuana to fall asleep at night.

"It just allows me to lead a more normal life," he said.

Stanley's sentiments were echoed by many medical marijuana users, who have
come to rely on the drug as a way to ease their suffering.

Advocates say marijuana improves energy levels and relieves pain associated
with such diseases as AIDS, glaucoma, multiple sclerosis and cancer. It can
also stimulate appetite and reduce nausea caused by chemotherapy.

Angel McCalry, who is anorexic and has been using cannabis since 1998 to
gain weight as well as soothe the side effects of a brain tumor and a
seizure disorder, said the drug helped her in ways no synthetic medicine
ever could.

"If it wasn't for cannabis, I'd be sitting in a wheelchair right now,"
McCalry said.

Research has shown that THC, the active ingredient in marijuana, kills pain
to the central nervous system by tapping the circuitry at the base of the
brain and modulating pain signals in much the same way morphine and other
opiates do. Opiates generally are more effective than cannabis at reducing
pain but may cause nausea and other unwanted side effects.

In San Mateo County, where a first-of-its-kind study to determine
marijuana's potential benefits for AIDS patients has just gotten under way,
officials said the Supreme Court ruling will not halt the study.

In November, the federal Drug Enforcement Administration agreed to provide
government-grown marijuana to 60 patients for a two-year study to determine
its potential benefits.

Backers see the study as a way to find out whether marijuana relieves pain
and promotes appetite as well as proponents maintain, and to see whether
patients can follow a strict regimen on the drug.

San Mateo County will be the first local government in the country to
distribute the otherwise illegal drug for outpatient research.

"If we find that, in fact, marijuana does lessen the pain and suffering in
the dying -- I fully expect we will indeed find that to be the case -- God
help us if we don't use it," said San Mateo County Supervisor Mike Nevin, a
former San Francisco police inspector who opposes decriminalizing marijuana.

Nevin added that the Supreme Court ruling makes the study even more
important because the results are expected to help persuade Congress and
the Bush administration to change laws regarding medical marijuana.

Not everyone sees the Supreme Court decision as bad news.

Citizens for a Drug-Free Berkeley, a nonprofit organization dedicated to
creating healthy and drug-free communities, embraced the ruling as a
"victory for those wanting to live in a safe, healthy environment."

"I only hope that the city of Berkeley and others desiring to smoke weed
for so-called 'medical purposes' will now follow the law," said Kevin
Sabet, founder and president of Citizens for a Drug-Free Berkeley. "If they
don't, we will see them in court."

Meanwhile, operators of cannabis clubs in the Bay Area worried about the
immediate effect of the court ruling, which may force them to shut their
doors for good and leave their clients with few alternatives.

"I think people are scared that they'll have to go to the streets to get
their medicine," said Greg Howell, manager of the Californians Helping
Alleviate Medical Problems, in the Castro.

"The needs aren't going to go away," added Wayne Justmann, director of the
San Francisco Patients Resource Center on Divisadero Street. "People who
have used cannabis in the past and present and know the health benefits
will still need it and will find a way to get it."

Stanley said he is undeterred by the Supreme Court ruling and intends to
keep on using marijuana.

"I certainly don't plan to stop," he said. "It's a quality-of-life decision.

I like being out of pain. I've seen the promised land and I'm going to stay
there."

Alternatives to pot Yesterday's U.S. Supreme Court ruling, which upheld a
federal ban against the medical use of marijuana, was based partly on a
finding that there are adequate alternatives to pot. Here's a look at some
conditions that have other proposed treatments:

NAUSEA Marijuana is often used as an anti-emetic in cancer and AIDS to
combat the nausea that can accompany chemotherapy and AIDS-related
infections or drug treatments. Two other options now include the drugs
Zofran and Kytril. "There is a new generation of anti-emetics now that can
completely cut out nausea and vomiting," said Dr. Gary Cohan, a Los Angeles
physician who treats many AIDS cases.

WASTING Pot's supporters claim it helps stimulate appetite, and the drug is
being tested in cases of AIDS-related wasting. Patients can try instead a
drug called Marinol, a synthetic form of THC, the active ingredient in pot.
Although Marinol doesn't work for everybody, some doctors say it is more
effective and lasts longer than pot.

PAIN Pot has not been proved effective as a pain reliever, although many
pain sufferers swear by it and some doctors say it can help in cases where
standard options don't work. Among the many alternatives now are
long-acting forms of opiates and new anti-inflammatory drugs designed to be
easier on the stomach. In cases of hard-to-treat neuropathic pain,
alternatives to marijuana include a drug called gabapentin, or Neurontin,
originally used to control convulsions.

MULTIPLE SCLEROSIS Some people with multiple sclerosis say that smoking
marijuana alleviates the spasticity and muscle stiffness that accompany it.
FDA-approved alternatives include Baclofen, Tizanidine and Valium. Dr.
Douglas Goodin, neurologist and director of the MS Center at the University
of California at San Francisco, said the three drugs are typically tried in
sequence and can also be used in combination. "You can achieve reasonably
good success in most cases of mild to moderate spasticity," he said.
Baclofen can be delivered by a surgically implanted pump in severe cases.
The pump "almost always works," Goodin added, although the chief side
effect -- weakness in the leg muscles -- restricts use of the pump to those
who have lost voluntary use of their legs. . Chronicle staff report