ARGUMENTS AGAINST MEDICAL MARIJUANA UP IN SMOKE

James McDonough does make some valid points in his column on medical
marijuana, but he fails to consider a number of points, too ("Science
vs. the pot smoking pitch," Commentary, May 4).

First, while inhaling smoke of any kind is obviously not healthy, for
the people suffering from cancer, AIDS or other conditions that may
benefit from marijuana, inhaling smoke is the least of their problems.
In addition, for those suffering the severe nausea that accompanies
chemotherapy or complications from AIDS and cannot swallow the pill
form of marijuana, smoking a joint is the quickest and most efficient
way to quell the nausea. How can a pill help if the patient cannot
keep it down?

Second, although reduced sperm or testosterone levels may be a result
of heavy marijuana usage, again, for someone suffering from cancer,
AIDS, multiple sclerosis, or any of the numerous conditions that could
be eased by marijuana, it hardly seems worthwhile to be worried about
such trivial side effects. The reduced chance of conceiving a child is
hardly a concern for someone in constant pain.

The problems Mr. McDonough describes in the conflict between state and
federal laws, as well as the lack of regulation in the California
cannabis clubs, can be easily remedied if the federal government
allows doctors to begin prescribing marijuana without being subjected
to the possibility of arrest. Once doctors are allowed to prescribe
marijuana, the need for unregulated cannabis clubs will be gone. Far
more dangerous substances are currently prescribed by physicians.
There are no valium clubs or morphine clubs for the simple reason that
they are not necessary. With proper regulation and supervision, the
incidents of underage patients or those who have questionable need for
marijuana will disappear.

Finally, what Mr. McDonough overlooks is the fact that the government
will not allow the additional research needed to develop safer, more
effective methods of delivering the useful substances contained in
marijuana. The Institute of Medicine has called for further study, but
the organization has been denied the marijuana needed for such
research. Gen. Barry McCaffrey, White House drug policy director, has
stated that the useful ingredients in marijuana could conceivably be
delivered through an inhaler, similar to that used by asthma
sufferers. Yet, trials necessary to develop such inhalers has not
moved forward.

In the end, until safer methods of delivering the beneficial
substances contained in marijuana are developed, smoking marijuana is
the only relief for critically ill patients, most of whom are willing
to suffer the relatively insignificant side effects to relive the pain
and nausea they endure every day.

MIKE EPSTEIN
Washington