MEDICAL POT A MIXED BAG

Marijuana Eases Pain, Causes Legal Headaches

Every few hours, usually in the privacy of his garage, Richard Levin takes
a long drag off a joint.

He has his doctor's approval to smoke marijuana, and says the drug relaxes
muscles in his injury-torn back and eases the pain of Hepatitis C, a virus
that attacks the liver.

Levin, 49, of Redding and other medicinal marijuana patients who say daily
smoking has freed them from senseless days spent strung out on prescription
medication. Or living their lives confined to a bed, their bodies too
warped with pain and muscle spasms to move. Life is better, they say, with
marijuana.

And because of Proposition 215, a voter-approved initiative, it's a life
made legally possible with a piece of paper and a physicians signature.
Without his doctor's recommendation to smoke marijuana, Richard Levin is a
criminal and, perhaps more importantly, a slave to pain.

Two Shasta County trials recently tested the law, passed in 1996. One of
them was Levin's. A jury acquitted him in December of possession,
cultivation and possession of marijuana for sale. Prosecutors found 41
seedlings growing in a knee-high, 6-foot long growing box Levin erected in
his August Way back yard.

In a second case, jurors acquitted Redding mother and son Lydia and Jim
Hall last week of possessing and growing marijuana. They were convicted
however, of conspiracy to cultivate marijuana.

At Levin's house, a sign bearing a red cross and marijuana leaf hangs in
the kitchen window. His doctor's note approving marijuana use hangs in hi
s garage, near a snapshot of Levin with his 11-year-old son, Jeffrey.

In the picture, his back is bent forward at a noticeable angle.

"Looks uncomfortable, doesn't it? I thought I would be standing that wa y
for the rest of my life," Levin said.

Those were the days when Levin popped pills every few hours, using as many
a six prescription medications at a time. Some were necessary solely to
treat side effects such as nausea, constipation, insomnia, lack of appetite
and muscle spasms brought on by his primary pain relievers.

"My medicine cabinet was so jammed at one time, I couldn't believe it. I
scared myself," Levin said.

"Back then, we had a twin bed in the living room, and my back and my body
hurt so much that all I could do was lay there. I wasn't really part of
the family," he said.

Today, Levin is an at-home dad. Most days, he vacuums a little, empties
the dishwasher or does laundry while his wife, Kim Levin, is at work. About
every six hours, when he starts to feel his lower spine locking into that
awkward posture, he goes to the garage, retrieves a jar of green bud from a
pad-locked cupboard, and rolls himself a joint or marijuana cigarette.

Levin smokes about an ounce a week, from plants he grew from seed or from
cannabis bought from other marijuana patients. Patients often sell seeds
or marijuana to each other when they need it, Levin said. Sometimes they
have to buy from 93street sellers," too, who can charge as much as $275 to
$400 an ounce for green bud, he said. At cannabis buyers' clubs, dozens of
varieties are available, ranging from about $250 to $500 an ounce, Levin said.

Without his medicine, every move is painful. A serious fall in 1993 led to
four back surgeries in two years, ending his career as a carpenter. The
degenerative virus Hepatitis C weakens his liver. Some of the prescription
medications he quit taking actually added to the liver damage and left him
bedridden most of the time.

Now, he wakes up at 6 am a little crampy, smokes a joint, then helps send
Jeffrey off to school. He doesn't drink caffeine and hasn't had alcohol
since 1990, he said.

"I don't smoke around my son at all. We talk about using something for
medication and when it's abuse. He understands the difference," Levin said.

At night, Levin smokes more to get him through the night. He sometimes
sits in his back yard in a $6000 hot tub his insurance paid for, to relax
his back and ease muscle cramps.

Kim Levin used to be uncomfortable with her husband's backyard marijuana
grow. Prosecutors originally charged her with marijuana cultivation, too,
later dropped the charges. If her husband had been found guilty, he could
have served up to seven years in prison. With his court battle over, she
is more at ease, she said.

"At lest for him, it's been amazing. I'm not try to say everybody should
go out and smoke pot, but it's been great for Rick," she said.

Shasta County doctors, however, remain wary about giving recommendations to
patients.

The includes Levin's long-time physician, osteopath Dr. Andrew Solkovits.

"I did tell him that it was OK in my opinion for him to use it, but I neve
r gave written notice," Solkovits said about his treatment of Levin. "No
doctor in his right mind would give a written prescription for medicine if
he didn't know the long-term risks and benefits of the drug, and right now
there is no documentation of either."

How marijuana helps

Solkovits said Levin is the most injured patient he's treated. He said he
would issue a recommendation for another patient if he thought the benefits
outweighed the risks. Currently, Levin is the only patient to whom he's
given a recommendation to.

The doctor's note approving marijuana use for Levin is signed by a
psychiatrist, Tod Mikuriya of Berkeley. In the past four years, Mikuriya
said, he has written 3,000 recommendations for Northern California patients.

The note Mikuriya gave Levin cites California Compassionate Use Act of 1996
a voter-approved law that allows patients to grow and use marijuana as
medicine if their doctor gives an oral or written recommendation.

It is used to treat ailments such as AIDS symptoms, chronic pain, multiple
sclerosis and migraine headaches.

Jeff Jones, executive director and co-founder of the Oakland Cannabis
Buyers' Cooperative, said many marijuana users smoke the drug to curb their
intake of pharmaceuticals.

"Maybe their stomach doesn't agree with prescribed drugs, or they want to
use something natural. Probably one of the most popular reasons is because
they say it works better than the medicine their doctors are prescribing,"
Jones said.

He admits marijuana isn't for everyone. Some patients buy cannabis from
the clinic for a few weeks, then sign out of the program because it isn't
effective for them, he said.

For others, marijuana saves them from ulcerated intestines, livers damaged
by harsh medications, or pain while waiting for the prescription drugs to
take effect, Jones said. Relief from smoked marijuana is instant.

And cheap.

"It's pennies on the dollar if they grow it themselves like you grow
tomatoes in your back yard , it's free," Jones said.

Reluctant doctors

There is a prescription pill form called Marinol with the ingredient THC
(tetrahydrocannabinol), the active substance found in marijuana. But
compared with the price of home-grown marijuana, some patients can't affor
d Marinol unless their health insurance covers it, said Redding
psychiatrist and pain specialist Dr. Richard Powell. He estimates a
noninsured prescription would cost a patient about $400 a month.

"I've had some patients in the past that did (buy it without insurance).
But it gets expensive, so they had to stop," he said.

Jim Hall, 39, of Redding, had been a patient of Powell's for more than a
year and said he had been "eating handfuls of prescription narcotics all
day." The drugs left him strung out, depressed and sick to his stomach, h
e said.

Hall suffers chronic pain from a back injury when he was a truck driver. He
warped his spine trying to keep an unsecured load of computers from falling.

He and Powell discussed Marinol, but Hall couldn't afford it, Powell said.
Instead, Powell wrote him a recommendation to smoke marijuana in January
1997, according to Hall's attorney, Eric Berg.

A week later, after Powell studied the law more carefully, he said he
changed his mind about medicinal marijuana.

"When I read it, I thought "This looks terrible." As a doctor, how th e
heck do I know what they're going to get? Are they going to take too much
or too little? " Powell said.

He sent an overnight letter to Hall, rescinding his recommendation. Now,
Powell said, he is strictly against "grow-your-own" cannabis gardens and
won't recommend smoking marijuana again. Marinol, on the other hand, come
s in a measurable, pharmacy-grade form and has proven successful for some
of his patients, he said. He wrote about four prescriptions for Marinol
last year.

Other doctors seem disinclined to talk about what they do, or don't
recommend regarding marijuana products. For this report, four Redding
doctors did not respond to calls about the subject; two declined to
comment; and one doctor's representatives said his office has a policy
against recommending marijuana because "marijuana serves no medical purposes."

A last resort

After failing to get approval from four doctors, Hall drove to Berkeley
seeking help from Dr. Mikuriya, who gave him a written recommendation.

Hall's mother, Lydia, 62, suffers from glaucoma. She got a note from Dr.
Frank Fisher of Redding, who awaits trial on three counts of manslaughter
for allegedly over-prescribing opiate painkillers.

In March, law enforcement officers searched the Hall's Tidmore Lane home i
n Redding and confiscated about 240 plants. Four months later, the Halls
were charged with possessing and growing marijuana, as well as conspiracy
to sell the drug.

Without their doctors' notes, the Halls could well have been convicted on
all counts.

Hall maintains that Shasta County physicians told him they are against
marijuana for political reasons, not medical reasons.

"Everybody's afraid," Hall said. "I've had several doctors say, 'I have
no problem with it, but I can't do it. I don't want to lose my license.'"

Mikuriya said other doctors frequently give oral recommendations but refuse
to put their word in writing. Most patients want more concrete
authorization, he said.

"When they get to me, they've pretty much been rejected and pushed aroun d
by the medical establishment. Why? Doctors are worried about the intrusion
of the feds. It's a legitimate fear," Mikuriya said.

As for Levin, he's glad one doctor wasn't afraid to consider marijuana a s
medicine. He feels like he's gained his life back, he said. The
drugged-up, bed-ridden "vegetable" who used to watch his family function
without him is now an active husband and father. His body will never go
back to what it used to be, but life is still better with marijuana.

"You try to find as much good in it as you can. the thing I'd really lo ve
is to go back to work. I loved my job. But this gives me a chance to
spend time with my son," he said.

Inset:

Marijuana Facts: Cannabis has been smoked, eaten and inhaled for thousands
of years. So what does marijuana actually do?

Benefits *Relieves chronic pain *Increases appetite for AIDS or cancer
patients, curbs nausea from chemotherapy *Inhibits reflexes in muscle
sclerosis, other muscle disorders *Calms patients with mood disorders

Drawbacks *Smoking damages lungs *Impedes complex motor skills *During use,
impairs short-term memory, learning, especially abstract concepts *Possible
dependence, but withdrawal symptoms are mild and short-lived

Comparison with conventional drugs: *Longer-lasting, immediate effect
*Fewer side effects; many pharmaceuticals can cause muscle spasms,
constipation and fatigue *Drugs such as Vicodin damage liver; Percodan
upsets stomach *No reported marijuana overdoses

Sources: "Marijuana and Medicine: Assessing the Science Base," publish ed
in 1999 by the Institute of Medicine; and "Marijuana as Medicine: A Plea
for Reconsideration," published in 1995 in the Journal of American Medical
Association

Inset #2

To learn more about medicinal marijuana, or to read California's
Compassionate Use Act, check these Web sites: *www.kubby.com Home page of
Proposition 215 co-author, Steve Kubby, and American Medical Marijuana
Association *www.mikuriya.com/althealth Essays and information from a
doctor who recommends marijuana for thousands of patients
*www.prop1.org/thomas/iom_report/iomlv.htm The Institute of Medicine's 199
9 report on medicinal marijuana