MARIJUANA AS MEDICINE STILL DEBATED TOPIC

Medicine: Report is expected to kick Prop. 215 into high gear although it
cautions against inhaling smoke.

The mission was clear. The questions, straightforward. Can marijuana
relieve health problems? Is it safe for medical use?

Investigators at the Institute of Medicine spent the past 18 months
sorting through the vast and contradictory body of scientific evidence
in search of answers. They held workshops in Irvine, in New Orleans,
in Washington, D.C. They listened to passionate testimonials and dry
data. And Wednesday, they said what many doctors and nurses had long
believed: yes.

"Hot dog!" said Dr. S. Clarke Smith of Anaheim, who became convince of
marijuana's medicinal properties 20 years ago when his beloved
mother-in-law was dying of pancreatic cancer. Chemotherapy left her
nauseous, weak and miserable. She was wasting away - until those
"Alice B. Toklas brownies" baked with marijuana.

"For six months she was nausea-free and gained weight," said Smith,
who authored medical association resolutions favoring marijuana for
medical use, and expects the report to make doctors feel more secure
prescribing it. "It's a travesty not to let people with advanced
cancer and wasting syndrome use it."

The IOM report is expected to breathe fresh life into working out the
kinks in California's problematic Proposition 215. Voters passed the
medicinal marijuana initiative in 1996, which allowed doctors to
recommend marijuana to patients. Patients were supposed to be free to
use cannabis without fear of punishment.

It hasn't worked out that way.

Interpretation and enforcement vary widely from county to county, and
the state has yet to work out a distribution system for medicinal
marijuana. While cannabis clubs - which give pot to patients, usually
for a cash donation - operate in Los Angeles with impunity, the head
of Orange County's club sits in jail on a six-year prison sentence.
And the co-director of Orange County's club is heading to trial on
similar charges.

"I hope that this report calms some of the paranoia," said James
Silva, attorney for cannabis club directors Marvin Chavez and Jack
Shachter. "I know that this will influence the climate. I hope it
encourages prosecutors in Orange County to be reasonable and
reconsider the prosecution of patients."

Change is in the air: California's attorney general has called on the
Legislature to modify the medicinal marijuana law and address the
thorny issues of distribution and cannabis clubs. And today, Anna
Boyce will sit down with Orange County Sheriff's Department officials
to discuss how the law is enforced here.

Boyce, the Mission Viejo registered nurse who helped author Prop. 215,
couldn't get the previous sheriff to meet with her.

"I feel more comfortable with the present sheriff," she said. "At
least we have an open-door policy here."

Deputy District Attorney Jeff Ferguson said that the law enforcement
community has always been in favor of medical marijuana - which is
prescribed, administered, dispensed and taken in a "medical manner."
The problem is that California's law is now more akin to "pick some
grass, smoke it and let me know how you feel next week,'" he said.

"What this report makes unequivocal is that marijuana from a vegetable
plant is definitely the negative way to go," he said.

The study was one of the most comprehensive assessments of medical
marijuana ever done and cost the government nearly $900,00. While it
spoke well of the drugs, it also laid out its dangers.

"Marijuana has potential as medicines, but it is undermined by the
fact that patients must inhale harmful smoke," said Dr. Stanley
Watson, a co-chairman of the research panel.

"Until researchers develop a safe and effective delivery system,
caregivers must consider the health problems that can result from
smoking when deciding whether to recommend marijuana to patients,"
Watson said.

The study suggests that marijuana smoking be allowed only through
institutional settings, with prescribing doctors over-seen by other
professionals, and be considered experimental and short term as work
continues on safer delivery mechanisms, such as inhalers.

"Now there will more and more research," said Tom Umberg, a prominent
Orange County Democrat who is deputy director of the White House
Office of National Drug Control Policy. "Science, not politics, should
drive the issue."

MARIJUANA CONTENT HAS VARIOUS USES

Research indicates that the active ingredients in marijuana can be
helpful in treating a wide array of medical conditions:

Pain relief: Three studies on cancer pain have shown that THC, an
active component of marijuana, is as effective as codeine in reducing
pain. THC curved nausea and enhanced feelings of well-being. Studies
on acute pain and migraine headaches have been less conclusive.

Wasting in AIDS patients:

The standard treatment of appetite stimulants has not proven
successful. Marijuana is a promising treatment.

Multiple sclerosis and movement disorders:

There is some evidence that marijuana compounds can help patients have
more motor control.

Epilepsy:

Despite anecdotal reports that marijuana controls epileptic seizures,
there is little evidence to support this.

Alzheimer's disease:

One study showed THC improved appetite and reduced disturbed behavior
in patients.

Glaucoma:

Both marijuana and THC reduce the eyeball pressure but the effect
lasts only a few hours and requires high doses. Other treatments are
more effective.