SPECIAL REPORT: IS MARIJUANA AN EVIL WEED, OR AN UNTAPPED WEAPON IN OUR
MEDICAL ARSENAL?

Sue, a 35-year-old former counselor for retarded adults, smoked marijuana
every day for a year. It was the only thing that relieved the debilitating
nausea she suffered after a blood vessel ruptured in her brain. When the
medications her doctor had prescribed proved only minimally effective, she
tried dronabinol, a prescription synthetic form of THC, the primary active
ingredient in marijuana.

But Sue still couldn't keep anything down, including the dronabinol. "I
was nauseated or vomiting every moment of every day and literally wasting
away, she recalls. Then she learned that for conditions like hers, smoking
marijuana has several advantages over dronabinol: It's cheaper, doesn't
have to be swallowed and digested, it acts faster with fewer side effects,
and because it can be smoked one puff at a time, its easier to control the
dose. So she tried it.

"Taking just a few puffs relieved my nausea enough that I could eat," she
says. She no longer smokes marijuana but credits it with saving her life
and sanity. Yet she's angry that she had to break the law. "People treat
this thing that helped me so much like such an evil," she says. "They'd put
me in jail for it."

Pot Politics

Since 1978, 36 states have passed legislation recognizing marijuana's
therapeutic value in a variety of ailments. But for 60 years, the federal
government has prohibited its use in any form, even though not a single
death has been linked to marijuana's medical use.

Politics distinguish marijuana from other potential pharmaceuticals,
preventing it from undergoing the scientific testing that any new drug must
undergo. Scientists can legally get marijuana only from one federally
regulated farm, and research requests often have been denied. Meanwhile,
thousands of sick people must get or grow the plant illegally, risking
prosecution and exposure to product impurities.

Because research has been so stymied, the spectrum of expert opinions on
marijuana's future in medicine ranges widely. "We have 5,000 years of
recorded experience to show us it's not toxic," says Lester Grinspoon,
M.D., associate professor of psychiatry at Harvard Medical School and
co-author of Marihuana, the Forbidden Medicine (Yale University Press,
1997). "In fact, the U.S. government has spent millions of do1lars trying
to prove toxicity but has come up with nothing."

Is Reefer Madness?

Cannabis (marijuana's Latin name) was widely prescribed in the United
States for pain relief until it was made illegal in 1937. In 1970, despite
copious anecdotal evidence of its effectiveness and safety, the Drug
Enforcement Administration designated it a "Schedule I" drug, meaning that
like heroin, it's considered unsafe, with no recognized therapeutic value
and a high potential for abuse. (Reclassifying it as a Schedule 2 drug
would let doctors prescribe it.) In 1976, the U.S, Food and Drug
Administration began a compassionate Investigational New Drug program
allowing government-sanctioned marijuana use in certain medical cases. In
the late '70s and early '80s, more than 35 states passed legislation
establishing marijuana research programs. Most were rendered defunct by
Federal regulations.

The IND program was suspended in 1991 because the flood of applicants
resulting from AIDS was seen as an obstacle to the Bush administration's
war on drugs. Today, only eight people use marijuana legally in this
country because of a grandfather clause. But years of anecdotal evidence
and at least 65 human studies established medicinal marijuana use as
legitimate for these conditions:

Cancer

The best-substantiated use is to relieve chemotherapy-induced nausea,
vomiting and appetite loss. A 1991 Harvard Medical School survey of 1,035
oncologists found that 54 percent favored making marijuana a prescription
drug; 44 percent said they'd broken the law by suggesting that patients get
it illegally. AIDS

Marijuana's ability to combat "wasting syndrome" by increasing appetite has
been well-documented.

Glaucoma

By reducing pressure in the eye caused by fluid buildup, inhaled marijuana
can slow or halt this sight-robbing disease. Many ophthalmologists counter
that marijuana can accelerate vision loss by reducing blood flow to the
optic nerve, and that new glaucoma drugs make it unnecessary.

Multiple Sclerosis, Spinal Cord Injury

Marijuana may relieve muscle pain and spasms, tremors and urinary
incontinence.

Epilepsy, Related Disorders

Might help prevent seizures in up to 30 percent of patients not helped by
standard drugs.

Pain

Marijuana may be helpful for migraine headaches; inflammatory and
autoimmune diseases such as arthritis, scleroderma and lupus; colitis;
Crohn's disease; and menstrual cramps and premenstrual syndrome. This use
is well worth investigating: In 1996, more than 7,000 Americans died of
gastric bleeding from taking aspirin or other non-steroidal
anti-inflammatory drugs such as ibuprofen.

The debate will only be resolved when large numbers of people are allowed
to use marijuana under medical supervision. As Harvard's Grinspoon says:
"Doctors, not the federal government and the DEA, need to be in charge of
this. And we need to get over our misconceptions about it. Many patients
who use marijuana don't even really like it. It's just the only thing that
works for them.

THE POT SMOKED AND THE DAMAGE DONE

"To withhold marijuana for medical use because some people abuse it would
be like withholding Valium or morphine for the same reason, says Mary Lynn
Mathre, M.S.N., R.N., C.A.R.N., addictions consultant at the University of
Virginia Health System in Charlotesville and editor of Cannabis in Medical
Practice; A Legal, Historical and Pharmacological Overview of the
Therapeutic Use of Marijuana (McFarland & Co., 1997).

Marijuana has drawbacks, especially when used as a recreational drug, but
they generally don't apply to medical use. To sum up the evidence:

Lung Damage

Heavy marijuana smoking can be hazardous to the lungs, but medicinal users
generally don't smoke enough for it to be a serious risk. Marijuana also
can be ingested in foods or teas, but the results take longer to be felt
and last longer and the dose may be harder to control.

Mental Impairment

Because it can cause short-term impairment of judgment, concentration,
recall and coordination, people are advised not to use marijuana before
driving or performing other complex tasks.

Dependence

"Problems with psychological dependence, accidents and lack of motivation
may occur among heavy recreational users, but most medical users taper off
or stop when the symptoms are relieved," Mathre says. No valid evidence
shows that using marijuana recreationally or medically leads to the use of
"harder" drugs. As for the argument that legalizing marijuana for medical
use will open the door to full-scale legalization, that hasn't proved true
of morphine and other opiates.

Antisocial Behavior

No human studies have shown that marijuana use leads to increased aggression.