PRESCRIPTION POTHEADS

WHAT'S A NICE GIRL LIKE YOU DOING WITH A JOINT LIKE THIS? TAKING HER
MEDICINE - AND RISKING A JAIL TERM. NOW THAT MARIJUANA IS USED TO TREAT
EVERYTHING FROM AIDS TO ANOREXIA, MORE AND MORE YOUNG WOMEN ARE BECOMING
CASUALTIES OF THE WAR ON DRUGS.

One late night last June, Lee, 22 and two of her friends pulled their car
over to a curb in crime-ridden downtown Oakland. They wanted to buy
marijuana, which Lee smoked every day. She was completely out, and couldn't
get in touch with her regular contact, a dealer-slash-friend. So there she
was, on a dark, desolate corner where she'd heard she could score some weed.

A man rode up on a bicycle. "You want a twenty-dollar bag.?" he asked. Lee,
who was in the driver's seat, sensed danger as she put the bill in his
hand. Sure enough, he whipped out a knife. "Give me all your jewelry and
money," he ordered. When he leaned into the car, Lee noticed a gun peeking
out of his jacket. She pulled three rings off her left hand. On was a
cherished friendship band her god-sister had give her seven years ago, when
Lee tested positive for the HIV virus.

Lee has AIDS wasting syndrome, a mysterious and often fatal effect of HIV
that causes drastic weight loss. Smoking marijuana is the only thing that
allows her to keep food down, a prerequisite for taking her AIDS
medication. ATZ, a highly toxic drug, has to be ingested on a full stomach.
At 5'3" and 95 pounds, Lee couldn't afford to lose another ounce.

That late night in June, she couldn't stop throwing up. "I felt like all my
insides had flooded out, and I realized my last dose of ATZ for the day was
way past due," she says. At that moment, Lee felt she was living the domino
effect: She had to smoke to eat. She had to eat to take her medicine. She
had to take her medicine to stay alive.

But as miserable as she was without marijuana, scoring some could have
landed her in jail. It's against federal law to buy the drug - even if
you're a patient using it as medicine. And the law is not above
incarcerating the very sick: An estimated 350 terminally or chronically ill
patients are serving terms for growing or smoking marijuana. Six thousand
or more are arrested each year. Lee could have been one of them.

"The government approach is inhumane," says Chuck Thomas of the Marijuana
Policy Project in Washington, D.C., an advocacy group that wants to
legalize medical marijuana. "They bust ill patients' doors down, drag them
downtown, take their mug shot and throw them in jail like common
criminals." The Drug Enforcement Administration (DEA) admits Lee could do
time if she were caught with as little as one joint. "We're not out looking
for AIDS patients, but people who use marijuana are breaking the law," says
DEA spokesperson Rogene Waite. "And we follow the law on this."

Meanwhile, some members of Congress are trying to make sure the law stays
restrictive. The House of Representatives is expected to vote this fall on
the first-ever antimedical marijuana legislation, Resolution 372,
introduced by Rep. Bill McCollum (R.-Florida). It would be a major step
toward derailing efforts by five states and the District of Columbia to
legalize medical marijuana. Eight members of the House have cosponsored the
legislation, apparently eager to score antidrug points with voters in
November. But their strategy may backfire, since popular sentiment seems to
be on the side of the states - 79 percent of the 1,001 voters polled by the
American Civil Liberties Union are in favor of legalizing marijuana for
medical use. If the resolution fails and the federal government ultimately
revises its stance, Lee may one day pick up her pot at the local pharmacy.

The Criminally Ill?

Marijuana is illegal, but it's also good medicine. Ninety human studies
indicate that cannabis sativa (the species name for marijuana) relieves
many of the symptoms that accompany AIDS, multiple sclerosis (MS), epilepsy
and chemotherapy treatment for cancer. Unfortunately, most of the studies
have not met strict Food and Drug Administration guidelines, and the FDA
has not approved further research. So marijuana remains classified with LSD
and heroin as a Schedule 1 drug (that means it's highly addictive, has no
therapeutic value and can't be prescribed by a physician).

There are three main medical uses for marijuana; as an antinauseant and an
appetite stimulant (for AIDS and chemo patients); as an antispasmodic, or
muscle relaxant (for spasms that accompany MS, epilepsy and paraplegia).
Most of the medical establishment - including the American Medical
Association, the American Cancer Society, the American Public Health
Association and many state nurses' organizations - support research into
therapeutic use of this versatile drug.

There's also plenty of anecdotal evidence indicating that marijuana
provides relief from migraine, PMS and anorexia nervosa. Centuries ago,
woman used cannabis to ease labor: In 1994, a 1,600-year-old tomb was
unearthed near Jerusalem, revealing remnants of marijuana in the abdominal
cavity of a teenage girl who apparently died in childbirth.

Still, physicians are forbidden by federal law to prescribe it, and even in
states where they can (Arizona, Connecticut, Louisiana, New Hampshire,
Vermont, Virginia and Wisconsin), doctors are warned by the federal
government that they risk prosecution, and patients can't legally obtain
it. "Marijuana has never been recorded to have caused a single death in
thousands of years," says Lester Grinspoon, M.D., a Harvard psychiatric
professor and author of Marijuana, the Forbidden Medicine (Yale University
Press, 1997). "Nor has THC" - the active chemical in marijuana - "been
demonstrated to harm any organ system or tissue, even after millions spent
by the government to find toxicity." Recently, the White House spent a
million more: In February 1996, it commissioned the Institute of Medicine,
a D.C.-based arm of the National Institutes of Health, to study the
research on smoked marijuana's medicinal properties. Results should be
announced before the end of 1998.

At the moment, the White House argues that legalizing marijuana - even for
patients - would send the wrong message to children. "Marijuana is
dangerous," says Brian Morton, spokesman for the Office of National Drug
Policy, which reports directly to the President. "Walk into any drug-abuse
treatment center and a teenager will tell you that marijuana is addictive
and has ruined her life." Opponents of legalization believe that advocates
are using the medical issue as a Trojan horse. "Many people out there are
wishing as hard as they can for a back door to open so that they can smoke
pot and say, Oh, cool, this is medicine," says Morton.

Advocates who believe that marijuana should be used strictly as medicine
are lobbying the FDA to test and approve therapeutic cannabis. Considering
the FDA's labyrinthine process, approval is millions of dollars and many
years away. What will Lee - and the tens of thousand of other patients
smoking marijuana - do in the meantime?

A Different Kind Of Health Club

I met Lee at the Oakland Cannabis Buyers' Cooperative, a club in Oakland,
California, that sells marijuana to patients who have a doctor's
recommendation. The only daughter of divorced parents, Lee grew up with her
mom and step-dad in a tough San Francisco neighborhood, where, at age 15,
Lee was raped by an acquaintance. "I thought he was trying to get me
pregnant, so I told him I'd be down at the clinic in a minute to abort it,"
Lee says. "He told me, 'I'm giving you something the clinic can't cure'" -
HIV.

Ever since Lee was robbed, she has been replenishing her supply at the
club. There are nearly two dozen cannabis clubs in California. During the
'80s, they operated underground. Then in November 1996,California became
the first state to pass an initiative - Proposition 215 - allowing doctors
to recommend marijuana, and patients to possess and grow it for their own
use. But because Proposition 215 does not mention clubs specifically, the
question of their legality is still up in the air, causing members constant
anxiety over the possibility of raids (three clubs have been raided in
recent years), jail time and being forced to by marijuana on the streets.

Although state officials have accused clubs of promoting a let's-party
atmosphere (and, truth be told, some of San Francisco's clubs have a
reputation for being lax in their controls, casting suspicion on all the
rest), Oakland's Cooperative has a distinctly unfestive atmosphere. With
its sparse rooms and fluorescent overhead lights, the club resembles a
rundown office. Members must show photo Ids to two security guards posted
at the entrance to every room, and again when they purchase the cannabis.
They're restricted to buying a quarter-ounce a day; if they buy more they
get a verbal warning. If they ignore it, they can be banned from the club
for life. The club sells a variety of strains, from "Sativa," which quiets
nausea, to the ironically named "Government's Choice," which relieves pain.
Also sold on the premises; pipes and rolling papers; tinctures to drink in
tea; and marijuana-laced brownies and banana nut muffins prepared by the
club's baker.

But none of these goodies tempt Lee. "I used to love food," she says. "I
loved anything fattening. My favorite foods used to be french fries,
cashews and pistachios." Her appetite vanished after she contracted HIV.
During the summer following her high school graduation, Lee went from 130
pounds to 105 pounds. By February, her weight dropped to 90 pounds. She
couldn't eat or sleep; had sever pains from neuropathy, an ATZ-related
disorder; and was, understandably, depressed.

At that time, the FDA had approved only two medications for AIDS wasting
syndrome: Megace, a hormone that promotes weight gain, but which nauseated
Lee; and Marinol, synthetic THC. But researchers haven't yet figured out
how to separate the therapeutic elements in THC from the narcotic ones. And
since THC's rate of absorption is highly variable - even for the same
patient at different times of the day - and Marinol's effects take an hour
to be felt, patients are unable to regulate the amount of the drug they
take in. "Marinol made me so high, all I could do was sit and stare at the
wall," says Lee. And at $300 a month, it was prohibitively expensive: Lee
receives $475 monthly from Social Security (because of her unpredictable
health, she hasn't been able to hold down a job) and her rent is $425.

Frustrated, her doctor finally told her, "Your biggest problems are that
you can't eat or sleep. Since he Marinol didn't work, you should smoke a
joint." So Lee did - and gained 30 pounds in three months. Smoking pot is
the only way to keep weight on," Lee says. It also lets her sleep and
soothes her anxiety: I hadn't gotten a good night's sleep since I was
raped," she says, "Now, I don't wake up screaming."

For the next two years, Lee smoked marijuana and maintained a weight of
about 120. But then she began to feel guilty: "I started to think I was a
drug addict. And I didn't like getting high because I felt like I was out
of control." The way social-service workers treated her reinforced those
fears: "I told them what I was using medically: AZT, Delaverdine - a
protease inhibitor - and marijuana. They said, 'No, marijuana is a drug,'
and marked me down as a substance abuser."

Lee began to hate the smell of pot. The taste stuck in her throat like
cough medicine. So she stopped smoking. "I dropped down to 95 pounds and
landed in the hospital. I told myself, Whether you feel like a drug abuser
or not, you have to smoke. It's not an option, just as my AIDS medications
aren't an option," she says. "I would love to throw marijuana out the
window, along with AZT. But until the FDA approves something that works,
it's the only choice I have."

The Fight For Tokers' Rights

Traci, 25, is another member of the Oakland Cannabis Buyers' Cooperative.
She suffers from an eating disorder, which began when she was 11, shortly
after her parents divorced. "Not eating makes you sick, makes you feel
weak," says Traci. "I had to take a nap the second I got home from school."
Last November, she caught pneumonia because her immune system was weak. She
was throwing up uncontrollably, and lost 20 pounds. "I had to go to the
emergency room, where they put me on fluids for 11 days."

When she got out, a friend who's heard that marijuana can help eating
disorders offered her a joint. "After we smoked, I was like, Gee, I'm
hungry. I wanted to eat for the first time in my life," Traci says, still
marveling at the effect marijuana has had on her. Her doctor, relieved,
recommended it so she could buy it at the Oakland club. Soon, Traci was
growing her own cannabis in her bedroom closet, and she gained 22 pounds in
five months. "I buy clones, which are small plants, at the club," says
Traci. "It takes nine weeks to yield a half-ounce, enough to last for two
weeks." That's a massive savings - each plant costs $8, while the street
value for a half-ounce is $150-$200. "If marijuana were legal, the street
price would drop, and more patients could afford to buy it," she points out.

When her plans aren't mature enough for use, Traci buys from the club. She
pulls a bag out of her purse, marked "not for resale." See this? This is
dirt weed, called Bammer. It was only $16. I mix it with this" - she whips
out another bag, containing the Bomb, which costs $55 - "which averages out
to a cost of about $30 a week. It lasts longer and still helps me eat."
What if the club were shut down? "I have some seeds put away," she says.
"Worst case" Id go to the streets."

The dangers of street purchases aside, Traci doesn't relish certain aspects
of marijuana. "It messes with my equilibrium. I bump into stuff more," she
says. "Ill knock into the side of a table, and my dad will look at me like,
'Hello - you're stoned.'" Lee describes her side effects in terms of mental
incapacity: "My short-term memory is shot," she says flatly. "I recommend
that anyone who smokes medicinally keep a daily record of their
medications. Sometimes when I'm high, I don't remember if I'm on my first
or second AZT dosage."

Many doctors believe cannabis is too untested to justify use by anyone not
suffering from a terminal illness. This reasoning leaves Traci out in the
cold. Three weeks after meeting her, I call to ask for her response to
those who believe that her disorder isn't serious enough to merit marijuana
use. She has just eaten dinner and seems slightly fuzzy, but when her
answer comes, it's sharp and focused. "I would tell these people hat
they're wrong," she says. "I don't use marijuana lightly. A healthy person
shouldn't smoke it just because they are stressed out. But look at me - I
just ate dinner. This medicine has changed my life."

"I Don't Use Marijuana Lightly"

On her honeymoon in November Nita noticed that her pants didn't fit quite
right. One month later, she felt a mass in her abdomen. "The doctors did a
sonogram and, at first thought it was a cyst," says Nita, 32, a nurse in
Washington, D.C. "They did surgery two months later and discovered it was
ovarian cancer." Her doctors decided to ill any vestiges of the cancer with
chemotherapy.

Even with Nita's nursing experience, chemo was more than she was prepared
for: "I didn't know my bones could ache. I felt like I was eighty years
old, and disintegrating from the inside out." The treatment was more than
her new husband could handle, too. "I was getting sicker and sicker," Nita
explains. They divorced a year later.

During her first round with chemotherapy, she took Compazine for the
nausea. "It caused restlessness - I could not sit or lie still, and had to
walk constantly to get any relief, she says. Then her doctor prescribed
Tigan, another antinauseant, which had the same side effect. After that
came Ativan, which helped her eat, but "I was becoming addicted, and it was
distressing to have to take five Ativans to not be nauseous. So finally, I
gave up."

That's when Nita started using marijuana. She had smoked it recreationally
after college and found that it worked on her insomnia. "This time, it
helped me with my eating, nausea and depression." She continued smoking it
for a year after chemo to counter the deep funk she had sunk into. "I found
that marijuana made me face the things in my life that kept me depressed,"
she says.

She liked the therapeutic effect so much, she kept right on smoking even
after she fully recovered - and discovered a disquieting effect. "When I
became well, marijuana gave me auditory hallucinations," Nita says. "I
heard voices, people talking to me who weren't around." She hasn't smoked
since. Nita still thinks the benefits of cannabis outweigh its risks: "It
seems cruel to withhold such a powerful medicine."

Besides, there are ways to take cannabis without smoking it. Nita talks
enthusiastically about scientists who are developing other THC-delivery
systems like inhalants and liquids that offer patients the therapeutic
benefits of medicinal marijuana at the precise dosage needed without the
most devastating side effect - lung damage (See "How Weed Works...[sidebar
below]). Researchers are also working to isolate the ingredient or
mechanism that causes the high, which will make marijuana less threatening,
both politically and physically.

I call Lee to tell her about these new developments. She's not herself,
speaking in a monotone rather than her usual ebullient way. She says that
she'd like take a trip next week, but sounds unconvinced that she'll be
able to. Her legs are sore, she can't stand for very long, and she doesn't
want to risk traveling with pot. She's too nauseated to eat, and her weight
is dropping rapidly. We discuss the possibility that marijuana may be
eligible for FDA submission under a new drug exemption, which would speed
up the process. Medicinal marijuana could theoretically be approved within
five years. "Five years?" Lee asks. "I could be dead by then."

[SIDEBAR] HOW DOES WEED WORK?

THC (tetrahydrocannabinol), the main psychoactive ingredient in marijuana,
acts primarily in two parts of the brain: the hippocampus - the seat of
feelings, memory, action - and the cerebellum, which controls movement. No
surprise, then, that smoking pot results in a temporary impairment of
short-term memory and motor coordination and a distorted sense of time,
according to Dennis Petro, M.D., a neurologist and drug researcher in
Arlington, Virginia.

Cannabis also mimics a neurotransmitter called anadamide (anada means bliss
in Sanskrit), which researchers theorize is the brain's natural defense
against stress, pain and nausea. The euphoria that marijuana users
experience - and the increased appetite, a.k.a. "munchies" - may be a
result of "marijuana over-doing it: People may already have just the right
amount of anandamide," explains Billy Martin, Ph.D., professor of
pharmacology at Virginia Commonwealth University.

Apparently, pot has another, surprisingly protective effect on the brain.
In July, researchers at the National Institutes of Health announced the
discovery that cannabidiol - a non-high-inducing substance in the marijuana
plant - is a potent antioxidant that, in lab tests on fetal rats, prevents
death of brain cells. Eventually, cannabidiol might be used to stem brain
damage from stroke, Alzheimer's and Parkinson's disease.

Pot has one major pitfall: Its smoke exposes the longs to three times more
tars and five times more carbon monoxide than tobacco. "If marijuana were
legalized," says Mary Lynn Mathre, R.N., president of Patients Out of Time,
a nonprofit group that educates doctors about medical marijuana, "we could
regulate what's in it, diminishing these effects."

Copyright 1998 by the Conde Nast Publications Inc.

Checked-by: Richard Lake