EXPERIMENTAL FEDERAL PROGRAM TRIES TO MEASURE NEED FOR MEDICAL MARIJUANA

An experimental federal program may offer the best available answer to the
question of how much marijuana is enough for medical use.

For years, the National Institute on Drug Abuse has provided about a
half-pound of marijuana a month to a handful of seriously ill patients. The
government grass is grown on a heavily guarded 7-acre plot at the
University of Mississippi.

The university farm ships 300 perfectly rolled cigarettes, each containing
about a gram of marijuana, to the patients' doctors each month.

"I only know of one that is using at that level, but you do develop a
pretty heavy tolerance to marijuana if you smoke it all the time," said
Steven Gust, special assistant to the director of the National Institute on
Drug Abuse. "Most of the patients use one or two a day, probably."

Gust offered only vague information about the program, which he said
stopped accepting patients in 1992. He said he thinks there were never more
than 14 patients, and the number has dwindled to fewer than 10 -- none of
whom suffers from AIDS.

Dr. Francis Podrebarac, a semi-retired Seattle psychiatrist who suffers
from AIDS, believes the federal pot program is "really a smoke screen for
shutting down the medical use of marijuana." Still, he said the program's
10-joint-a-day standard may be the best official guidance for Washington
authorities who are trying to determine what constitutes a 60-day supply
under the state's two-year-old medical marijuana initiative.

That still leaves questions about how many plants are needed to produce the
finished product. Farming is an uncertain proposition, for marijuana as
well as wheat, and crop yields vary widely, Podrebarac said.

The former Western State Hospital psychiatrist would know. He is now the
medical director of Capitol Hill Compassion, a Seattle nonprofit
organization that delivers medical marijuana to about 200 patients.

"We don't have any patients who are just party dudes," Podrebarac said,
noting about three-fourths of them have AIDS. "They are all very sick people."

Gust said medical marijuana patients can get the same benefits from
marinol, a federally approved prescription form of THC, the drug in
marijuana leaves. But Podrebarac said the pills are about five times
stronger than smokable marijuana, so potent they often upset patients'
digestive systems.

Marinol made him vomit, Podrebarac said.

Smoking is better, anyway, he said. The drug goes straight into the
bloodstream, and the dosage is much easier to control.

"You smoke until you get enough, and then you stop," he said. "If you smoke
too much, you fall asleep."

Some state legislators believe the Washington Department of Health should
answer Initiative 692's questions, but they've failed to pass bills
requiring the department to get involved.

"If we were given that responsibility, we would certainly take it on," said
Sue Shoblom, the department's director of health professions quality
assurance. "But it will definitely be a tough rule-making job for whoever
winds up getting the job."

The problem, Shoblom said, is that there is "a wide range of thinking on
that subject and not a lot of science to back it up."

Until health professionals come up with scientific answers or legislators
find answers through the political process, the job falls to the judicial
system. Case by case, police, prosecutors and courts are slowly
establishing the outer limits of Initiative 692.

"Maybe that's not a bad thing, to define what it's not rather than what it
is," Shoblom said.