DEFINING `MEDICAL' COULD MAKE PRESCRIBED MARIJUANA USE

Passage of California's proposition 215 which legalizes marijuana for
medical use cleared the way for longawaited laboratory testing of the
benefits and drawbacks of pot in treating a variety of illnesses.

While several legal, challenges to the proposition are, pending, even state
Attorney General Dan Lungren the law's most vocal critic Is calling for
a threeyear study of the effectiveness and safety of medical marijuana use.

There is little common ground for opponents and proponents of the
initiative, passed into law by a 56 percent to 44 percent margin In
November 1996. But one concern they generally agree on is the need for a
more' precise definition of the "medical" in medical marijuana. Achieving
that, they say, will help set clear standards for carrying out the law.

Another concern is that despite ProposItion 215's protections for
potprescribing doctors, physicians remain unclear of their status. With
conclusive research results still years away and existing federal
prohibitions on marijuana, members of the Clinton administration have
hinted they may clamp down on doctors who recommend the drug.

There is much anecdotal evidence that marijuana relieves pain and restores
appetites. but the leafy narcotic had been caught in a Catch22.
Researchers long have been wary of testing a substance that was illegal and
so politicized, leaving a vacuum of proven scientific backing that
potentially could have legitimized and legalized its use.

"There's surprisingly little research on marijuana at all," said Dr.
Stephen Sidney, the senior epidemiologist at Kaiser Permanente In Oakland.
"It's difficult to survey people on an illegal substance.

But that has changed In the wake of Proposition 215. Sidney said. As a
researcher of causes of diseases, he conducted one of the few preliminary
surveys on marijuana's long term effects over the past two decades.

The National Institutes of Health pledged $1 million In October for doctors
at San Francisco General Hospital to study the effects of marijuana on
patients who ise the latest AIDS drugs.

Like other tests expected to follow, SF General researchers actually will
oversee the consumption of marijuana's, comparing both Its short and
longterm effects on subjects smoking and ingesting it vs. those given a
placebo.

Stephen Goodin said he's already seen the results of marijuana's medicating
powers. The 38yearold network engineer, who's been HIVpositive for more
than a decade, he smoked marijuana to relieve his nausea and help him sleep.

"You're just more comfortable," said Goodin, after recently purchasing pot
at the Oakland Cannabis Buyers' Cooperative. The Emeryville resident said
he smokes four joints a day. usually around the times he takes his doses of
10 pills of the new AIDS "cocktails." In the past 20 months, Goodin has
gone from 127 to 170 pounds.

One Berkeleybased psychiatrist believes marijuana can alleviate a number
of conditions, from depression to chronic pain to seizure disorders.

But Dr. Tod Mlkuriya worries that his continuing recommendations of
marijuana could prompt federal drug regulators to revoke his right to
prescribe any medicines and receive Medicare payments.

"At that point, I could more or less kiss my practice goodbye." said
Mlkurlya, a physician for 35 years.

Dr. Thomas Peters, Marin County's director of health and human services,
cautions that until more conclusive research is established, physicians
must limit their marijuana recommendations to patients with srious medical
reasons for its use.