SUPPORT FOR MARIJUANA USE GROWS IN MEDICAL CIRCLES

A new Institute of Medicine report sides with those who say it can
help the chronically ill.

In the eyes of the law, they are criminals who could go to prison for
what they do every day.

But, across the country, many chronically ill people say that smoking
marijuana provides significant relief from their often debilitating
symptoms.

"I can smoke a joint, and five minutes later, I can eat every last
drop of food," said Kiyoshi Kuromiya, 55, a Philadelphia AIDS activist
who uses marijuana to combat the nausea, appetite loss and wasting
syndrome common to AIDS patients.

Besides smoking marijuana himself, Kuromiya supplies it free to about
20 other chronically ill people in the Philadelphia area, from AIDS
patients to those suffering from neurological disorders.

His underground marijuana "buyer's club," which he calls
Transcendental Medication, has been operating since 1994, largely
financed by donations. And not just anybody can join.

"We ask for a note from the doctor before you can join," Kuromiya
said.

Last week, the prestigious Institute of Medicine, an arm of the
National Academy of Sciences, issued a long-awaited report that lends
scientific credence to the potential medical benefits of marijuana
that Kuromiya and other activists have touted for many years.

In its review of the scientific literature, the 11-member panel of
scientific experts found that the active ingredient in marijuana, the
chemical known as THC, had "potential therapeutic value" in treating
pain, controlling nausea and stimulating appetite.

Though there are more effective medicines to treat those symptoms, the
panel said that not everybody could tolerate those drugs and that some
people -- such as cancer patients undergoing chemotherapy and AIDS
patients combating wasting syndrome -- might benefit from marijuana.

Significantly, the panel said there was no conclusive evidence that
marijuana was a "gateway drug" that inevitably led to the use of
harder drugs, such as cocaine and heroin.

It also found that marijuana was not as addictive as other pain
medications that doctors can prescribe -- and not as addictive as nicotine.

Still, the panel laid out important caveats for the potential use of
marijuana as a medicine. The scientists said smoked marijuana posed
the risk of lung cancer and other health problems, and they called for
developing alternative delivery systems, such as inhalers or skin patches.

The panel also said clinical trials were needed to prove the medical
efficacy of marijuana. In the meantime, however, doctors might be
allowed to prescribe marijuana cigarettes on an experimental basis to
people suffering from chronic conditions, as long as the patients were
carefully monitored, the panel suggested.

Besides cancer and AIDS, the panel cited multiple sclerosis as a
condition with symptoms that might be treated with marijuana. It said,
though, that there was little to no evidence that the drug would help
those suffering from epilepsy, Huntington's disease, Parkinson's
disease, Alzheimer's disease or glaucoma.

The report, commissioned by the White House, is the latest in a
growing movement within the medical community and among patients
themselves to decriminalize the medical use of marijuana.

Voters in seven states have passed ballot measures permitting the use
of medical marijuana, but the legislation has not been fully
implemented because of congressional or other governmental opposition
and doctors' fear that they will be prosecuted for prescribing marijuana.

Last summer, Kuromiya and 164 other chronically ill plaintiffs filed a
class- action lawsuit aimed at forcing the federal government to
legalize medical marijuana. The suit, filed in U.S. District Court in
Philadelphia, is expected to go to trial in June.

Last week, a number of the plaintiffs hailed the panel's
recommendations, saying they put scientific evidence and patient care
ahead of politics.

"Maybe it will open some eyes to the possibility that we can look at
marijuana as a drug that can be used with care, caution and common
sense," said Sharon Brown, 35, of South Bend, Ind., who suffers from
multiple sclerosis.

Brown was forced to quit her job as a medical writer at the South Bend
Tribune after the high-dose muscle relaxants prescribed for her MS
made doing the investigative reporting for which she had won awards
impossible.

"It got to the point where I could no longer do an interview," she
said. "To work, I would have had to go off the drugs. But without the
drugs, I couldn't tolerate the muscle spasms or the pain."

Brown, a single mother now living on disability benefits, said she
discovered the therapeutic benefits of marijuana several years ago
when she took a few puffs from a marijuana cigarette offered by a friend.

"At the time, moving my legs was very painful," she said. "It felt
like each leg weighed 100 pounds. After I smoked, all of a sudden, I
could walk again without any pain. It was like a miracle."

Unlike her high-dose muscle relaxants, Brown said, the marijuana
didn't interfere with her ability to think and concentrate.

Since then, however, she said, she has reluctantly refused to use
marijuana. No matter how much it might ease her pain, she said, she
didn't want to do something illegal in front of her 12-year-old daughter.

"I have had three neurologists telling me to buy it illegally," she
said. "I will not posture illegal behavior in front of my daughter."

Trent Blood, 37, who suffers from Lou Gehrig's disease, said smoking
marijuana helps him swallow food by relaxing the muscles in his throat.

"Cannabis is my lifesaver," he said through his caretaker, Joan
McClain, at his home in Brigham City, Utah.

Diagnosed with the devastating neurological disorder in 1992, Blood
was told that he would live no more than five years. He credits the
marijuana, which he uses once a day, for his longer survival.

Blood uses a wheelchair with a brace to support the back of his head.
He has no use of his arms or legs. McClain not only feeds him every
day but also holds his joint while he inhales what he regards as his
medicine.

"Just before, he is normally upset," she said. "But when he smokes, he
calms right down and eats and drinks."

Many patients who are suing the government maintain that Marinol, the
synthetic substitute for marijuana, which is prescribed by doctors, is
far less effective than smoking marijuana in its natural state.

Most shun the laundry list of pain killers and muscle relaxants that
doctors usually prescribe, saying the medicines take a while to work
and then turn them into zombies.

"My doctors prescribe Valium and Darvon," said Carlos Abeta, 43, a
quadriplegic who lives in Colorado Springs, Colo. "The problem is that
it takes about 20 minutes for them to get absorbed into the
bloodstream."

Abeta, who lost the use of his limbs in an auto accident, said
marijuana provides immediate relief to the rapid and life-threatening
rise in his blood pressure, a medical problem known as autonomic
hyperdysreflexia, common among quadriplegics.

He said that the problem occurs about five or six times a week and
that when it does, he takes a few draws of marijuana from a pipe that
sits on a desk in the home he shares with his parents in a
middle-class neighborhood.

"It takes the blood pressure down really fast," Abeta said. "It also
relieves the migraine headaches that go along with the problem."

He said he worries about getting lung cancer from the marijuana smoke,
especially as his nerve damage has greatly diminished his lung capacity.

He'd prefer to grow his own marijuana and add it to
salads.

"But I live in my parents' home," he said, "and I'm not going to risk
their getting arrested."