ADVOCATES OF MARIJUANA FOR MEDICINAL USE TOUT ITS BENEFITS; OPPONENTS
SAY IT SENDS THE WRONG MESSAGE ABOUT DRUGS TO KIDS

J.F. Oschwald smoked marijuana a few hours ago, but his slow, deliberate
speech and awkward limp aren't the result of inhaling the drug. The Lyons
resident is a paraplegic because he was involved in a near-fatal highway
accident 20 years ago. Marijuana, he says, calms his severe muscle spasms.

Oschwald, 51, is one of an untold number of Coloradans who risks criminal
prosecution to smoke marijuana for medical reasons. He supports a
constitutional amendment that would, if approved by voters Nov. 7,
decriminalize marijuana for people who can legally claim a medical need.

Amendment 20 would create a registry of patients who can possess no more
than 2 ounces of marijuana and six marijuana plants. Coloradans would need
a physician's recommendation to use marijuana for "debilitating medical
conditions" that include, but are not limited to, cancer, glaucoma, HIV and
AIDS. These residents could smoke, eat or otherwise ingest marijuana in
their home.

Opponents say there are safer alternatives to using marijuana for pain or
other symptoms. Law enforcement agencies and politicians say Amendment 20
sends the wrong message to kids.

Campaign organizers say the issue must focus on terminally or seriously ill
Coloradans who find marijuana the most effective remedy for their pain and
symptoms. They find no harm or mixed messages in providing one more
alternative for doctors and their patients.

Medical experts on both sides of the debate agree that the average voter
faces a tremendous challenge because of the political, moral, emotional and
historical context of marijuana as an illegal drug in this country.

Smoked medicine

"As a doctor, it doesn't make any sense to say smoking medicine is good
long-term use for glaucoma, multiple sclerosis, cancer or HIV," says Frank
Sargent, a urologist and co-chair of Coloradans Against Legalizing
Marijuana. "Our society for the last 10 years has been telling kids that
smoking cigarettes is bad, and now they want to send mixed messages that
smoking marijuana is OK."Sargent points to a National Academy of Sciences
Institute of Medicine study commissioned by the White House Office of
National Drug Control Policy last year, which concludes "marijuana smoke is
an important risk factor in the development of respiratory disease."

"There are safer alternatives, Sargent says. Physicians prescribe Marinol,
a synthetic pill form of tetrahydrocannabinol or THC - one of the active
ingredients of marijuana - to stimulate appetite in HIV patients. They
prescribe Zofran to curb nausea in cancer patients undergoing chemotherapy.
Zofran, unlike Marinol or heavier narcotics, doesnÕt leave patients in a fog.

"I took an oath to give the best quality of care and to do the least
physical harm. That might sound corny, but it's true," Sargent says.

Weighing health risk

Michael, who asked that his last name not be used because of the stigma
associated with his illness, quit smoking cigarettes but has smoked
marijuana every day since 1997, when he dropped nearly 30 pounds because of
HIV.

Michael was diagnosed with HIV in 1986 and has since been on a quest to
cure himself with herbs, vitamins and organic foods. He avoids doctors'
offices and medication, but he couldn't ignore rapid weight loss four years
ago.

"I was down to 110 pounds. I was emaciated - I looked like I came out of a
prison camp," says Michael, who now weighs 136 pounds.

The Boulder resident tried Marinol for one month, but it didn't increase
his appetite. A friend suggested he try marijuana. He smokes daily, once
before lunch and dinner.

"It only takes half a joint to get my appetite going. I feel mildly high,
but it doesn't affect anything I'm doing, like my reactions," he says.

Arguing science

The National Multiple Sclerosis Society is listed in Sargent's campaign
literature as opposed to the initiative.

"I wouldn't say we are opponents, but our position at this point is that no
double-blind clinical evidence shows smoking marijuana benefits people with
multiple sclerosis," Denver-based spokesman Dan Lawrence says.

Lawrence points to a study published this spring in the journal Nature,
which shows cannabinoids (derivatives of marijuana) control tremors in mice
with EAE - a mouse disease similar to multiple sclerosis. He also points
out that marijuana exacerbates one symptom of multiple sclerosis, which is
not being able to think clearly.

"We can't dismiss concerns about cognitive deficit. You could talk to 10
people who use marijuana and they might anecdotally say they feel better,
but until the studies are done, we can't tell people to go out and smoke
marijuana."

Charles Steinberg, M.D. of the Boulder Beacon Clinic, which specializes in
HIV treatment, says the science is clear enough on the benefits of medical
marijuana.

The Institute of Medicine study concludes that "scientific data indicate
the potential therapeutic value of cannabinoid drugs, primarily THC, for
pain relief, control of nausea and vomiting, and appetite stimulation." The
study also says inhaling marijuana may be more effective for patients who
donÕt respond to Marinol.

Of Steinberg's 150 HIV patients, only 12 use marijuana medicinally. Most of
those patients began using on their own.

"This is Boulder and most of my patients are well familiar with marijuana,"
Steinberg says. "It's not like I am suggesting it to them for the first
time. My approach is to start with Marinol, and if that doesn't work, I ask
if they have considered trying (smoking) marijuana. I don't tell them to go
out on the street and buy marijuana, I can't tell them to do something
illegal."

Steinberg is careful to discuss side effects and tells patients not to
drive when using marijuana. "It's the same thing I would tell a patient
with a twisted ankle on codeine."

Regarding the harmful carcinogens from smoking marijuana, Steinberg says
physicians have to weigh potential harm with benefits. Someone suffering
with cancer expected to live only two years might be a good candidate. "And
then it might not be the right thing for a 14-year-old track star. The
amendment just gives us one more alternative, another choice."

Message to kids

Some argue marijuana as a legal medical alternative sends the wrong message
to kids.

"I have spent a lot of time around the state visiting schools, and it is
very evident that there is a significant drug problem in the middle and
high schools," Colorado Attorney General Ken Salazar says. "For us as a
society to embrace using drugs for a limited purpose sends the wrong
message and will lead young people down the path of drugs and violence."

Julie Roche, director of the Amendment 20 campaign, Coloradans for Medical
Rights, says medical marijuana debates always end up going into the "drug
war thing."

"I feel we're not arguing the same issue. We are only talking about a small
percentage of Colorado's population that might benefit from the
initiative," she says.

Salazar joins state Treasurer Mike Coffman and the Colorado Legislature in
a letter from Gov. Bill Owens to the voters, urging them to reject the
amendment. The underlined passage in the letter reads: "Drug dealers
dispensing "medicine" to sick people? Not in Colorado - not on my watch -
not if I can help it!"

Oschwald was charged with possession of marijuana years ago. If Amendment
20 passes, he plans to stop buying joints from dealers and start
cultivating his own plants.

"In the big picture, some guy smoking pot for medical reasons should be a
blip in the police radar. I hope they have better things to do than - and
pardon me if this sounds bad - busting a cripple marijuana smoker."

Access a problem

The County Sheriffs of Colorado joins ColoradoÕs politicians who are
opposed to Amendment 20."We believe (Colorado's measure) is something of a
sham," Boulder County Sheriff George Epp says.

"Proponents in California and Oregon saw (initiatives) as a way to get
their foot in the door for legalizing non-medical use and there's no
control for dosage like any other pharmaceutical drug. The big issue
recently has been that (state amendments) still violate federal law, so how
is that going to work?"

Proponents say many legal and moral issues could be solved if government
labs would grow and regulate marijuana for medical programs. But that won't
happen as long as marijuana remains listed by the federal government as a
Schedule I drug along with heroin and LSD. Schedule I drugs are deemed to
have no medicinal value, unlike cocaine and morphine, which are Schedule II
drugs that can be medically used. Cocaine cannot be prescribed; it is mixed
with opiates and salts to create pain medication.

The Drug Enforcement Administration held hearings on making marijuana a
Schedule II drug four years ago. The DEA's administrative-law judge said,
"It would be unreasonable, arbitrary and capricious for DEA to continue to
stand between those sufferers and the benefits of this substance in light
of evidence in this record." The DEA overruled the judge's order.

The federal government's refusal to change marijuana's status is the main
reason proponents are taking their cause to the voters.

"The government is too leery to study or look at marijuana as an
alternative," Roche says.

"The main point is we are trying to give doctors and patients one more
option without fear of becoming a criminal."

Web sites for Amendment 20:

Opponents: Coloradans Against Legalizing Marijuana,
http://www.anti-marijuana.org

Proponents: Coloradans for Medical Rights, http://www.medicalmarijuana.com