CANNABIS CONTROVERSY

Medical Marijuana Pits Politicians Vs. Scientists — With Patients In The Middle

Spunky and cheerful at 64, Dorlene W. is a grandmother, a retired secretary
and now — driven by her own crippling arthritis and the suffering of others
— a marijuana user and dealer who visits New York every month to buy the
best weed.

"I do not use the street dealers with dirty stuff; I come to the city for
the clean, medical kind," says Dorlene, who lives in upstate Elmira and
says that, though the drug has eased her pain, she still can't walk "really
well."

But getting it is a risky business.

"I live alone on $567 a month disability, in a federally funded housing
project," says Dorlene. She sells her New York stash for cost plus
expenses, and stays with a friend in the Bronx to keep prices low.

The law is on to her: She had a lawyer talk, privately, to local officials
before she started. "They can arrest me and could evict me," she says. But
she believes "they will not bother me as long as I keep it decent, don't
sit on the porch or drive down the street smoking, and don't have kids in
and out — which I don't."

Armed with a doctor's letter saying she needs pain relief, Dorlene gets
enough pot in New York to smoke daily. The 14 members of her buyers' club
also have letters attesting to their medical need.

"But if they legalized medical marijuana, my life would be so much easier
and simpler," she says. "Oh heavens, yes, I would be safe from arrest."

Decades after advocates began campaigning for medical marijuana, said to
ease a host of illnesses, the drug is pushing itself past political and
scientific opponents and straight into the national medicine chest.

Science may come to the rescue of Dorlene and others like her with new
formulations and delivery systems that remove marijuana's euphoric high but
retain its medical benefits — making it more politically and medically
acceptable.

Atlantic Technology Ventures Inc., located in the Empire State Building, is
working with a lab-made marijuana derivative, CT-3, the brainchild of
biochemist Sumner Burstein at the University of Massachusetts.

It provides "no psychotropic activity," says Atlantic's Michael Ferrari.
Lab studies show CT-3 may work for chronic pain and inflammation; the
company has finished Phase 1 human trials that test safety.

New Delivery Systems

In Oxford, Miss., Dr. Mahmoud ElSohly, who thinks inhaled pot smoke poses a
health hazard, is working on a THC suppository made from twice-purified
derivatives of plants grown for authorized federal trials.

The suppository effectively treats nausea and is politically acceptable,
though ElSohly's aim was to devise a delivery method that meets industry
standards and delivers a consistent, effective dose without side effects.

Eight states have medical marijuana laws carefully worded to circumvent
federal prohibitions, and similar ones are pending elsewhere — including a
New York bill sponsored by Assemblyman Richard Gottfried (D-Manhattan).

The People Say Yes

The Supreme Court now has before it a federal challenge to California's
medical marijuana law, but even if the Court rules against the defendant,
the Oakland Cannabis Buyers' Cooperative, advocates say the law will remain
on the books subject to local enforcement and sympathies.

Many doctors approve patients' use in extreme need. Richard Brookhiser, a
politically conservative Manhattan columnist, smoked marijuana — in the
men's room at New York Hospital, with the discreet knowledge of his doctors
— to quell severe nausea during chemotherapy treatments in 1992.

Brookhiser says "the stubbornness and cowardice of the political class"
resists medical marijuana, though "referendums always pass by wide
margins." He also thinks support may come from unexpected quarters.

"Maybe George Bush has more freedom, because he did not begin his political
life on the national stage with an idiotic lie about pot use," Brookhiser
says, citing former President Bill Clinton's 1992 claim that he never
"inhaled."

For now, the prohibition against medical use is "political correctness gone
berserk," says Gottfried. "Morphine, Valium and steroids are prescribed
legitimately thousands of times a day. It doesn't undercut our drug efforts."

Among those who oppose medical marijuana use, some believe it's a dangerous
gateway drug to more lethal narcotics. Others who may battle drug addiction
feel it leads to relapse.

Yet pot use among teens fell in California after a medical marijuana law
passed in 1996, says Chuck Thomas at the Marijuana Policy Project in
Washington, D.C.: "It seems to send the right message, that [marijuana] is
a medicine and these are people taking it because they are very sick."

Though doctors like those attending Brookhiser and Dorlene privately voice
no objections to medical marijuana, some scientists argue that it wreaks
molecular havoc. "All these [positive] claims over the past 25 years have
proven illusory," says Dr. Gabriel Nahas at the NYU School of Medicine. His
studies show pot impairs DNA in sperm and immune cells.

Cannabis stays in the system a long time, can contribute to car accidents
and foster cognitive problems, critics point out. Some users get high;
others crash. Plants vary; there's no way to meter or control dosages.

Dr. Roger Waltzman, a cancer doctor at Mount Sinai Hospital in Manhattan,
says THC is a "very effective" anti-nausea drug and appetite stimulant, but
is already available in the FDA-approved Marinol, a synthetic THC.

Pot smoke is different, he says. "There is a potential for bacteria and
fungi on the leaf, rolled up with who knows what else, which is
particularly worrisome for people with cancer or HIV whose immune systems
are compromised."

Proponents of natural marijuana insist that Marinol is too concentrated
and, as a pill taken by mouth, ill suits a patient beset by wrenching
nausea. They also say the other compounds in pot besides THC are beneficial.

Safe and Effective

"Marijuana is the safest therapeutically active substance known to man,"
says Tracy Blevins, Ph.D., who specialized in pharmacology at the
University of Texas and dresses as Medical Marijuana Barbie (to make the
issue seem less "threatening," she says). Also, other chemicals in the
plant — such as cannabidiol, said to ease inflammation — have medical
potential, Blevins says.

Patients don't argue. As a cancer survivor, Brookhiser, now 46, isn't
worried about side effects.

"Lots of medicines have side effects and complications," he says.
"Chemotherapy itself is a poison." He's glad, he says, that he lives in New
York and that when his treatments "got rough" his wife was easily able to
find marijuana for him. "It seems like everyone is a dealer when you get in
a situation like this," he says.

"But suppose my parents were in this situation — they are in Rochester — or
my aunts, in Johnstown, N.Y.? They wouldn't know what to do. They would
have a harder time."

They might, like Dorlene W., make a pact with the local police and start
dealing.

Chemical Properties

Marijuana, or cannabis, contains hundreds of chemical compounds.
Tetrahydrocannabinol — or THC — is the best known. It's also the source of
the marijuana high and seems to have the most medical uses. Activists like
Dana Beal at Cures Not Wars in New York say marijuana — the whole plant,
not just THC — is harmless and can ease serious maladies like depression,
muscle spasms, pain and anxiety when nothing else seems to help.

Among the most compelling claims for the plant:

It reduces violent nausea caused by chemotherapy, a side effect that can
make patients so sick they may quit treatment or grow dangerously frail.

It's an appetite stimulant that counters severe anemia and anorexia in HIV
and AIDS patients.

It quiets uncontrollable tremors in patients with multiple sclerosis, and
also assists their voluntary movement.

It eases glaucoma, decreasing inner eye pressure — though it may also
decrease inner eye fluid and needs to be taken almost constantly; Arizona
researchers are studying its potential use for the disease.

In 1999, a stunning report by the Institute of Medicine in Washington,
D.C., urged scientists to explore THC and other cannabis chemicals, pursue
new delivery systems and test the drug for both harm and benefits. Today,
the National Institute of Drug Addiction is conducting limited studies.

But the IOM report warned that smoke from the plant can make lungs more
vulnerable to respiratory disease and, perhaps most ominously, cause
cellular changes that can lead to cancer.