DEBATE FIRES UP OVER MEDICAL MARIJUANA USE

In a recurring dream, John Donovan can run without pain. He races
down a football field as he did in middle school and glides down a
flight of stairs with ease.

But in reality, the 25-year-old Red Bank resident wakes up to a
relentless aching in his joints, mainly his hips, knees and ankles.

Just a few months after the onset of juvenile rheumatoid arthritis,
when he was 16, Mr. Donovan struggled to run or even walk quickly, he
recalled. He now walks with a heavy limp and spends some days in bed,
trying to move as little as possible.

For Mr. Donovan -- who doesn't drink alcohol or smoke cigarettes --
daily hits of marijuana from a glass pipe lessen his pain, without
inflicting the severe nausea and other side effects he experiences
from prescribed painkillers.

He spends $400 to $600 a month to buy an ounce of marijuana from
friends, and he usually smokes the illegal plant in the afternoon to
remain "clear headed" in the daytime, he said.

"I'd much rather go to a pharmacy, but right now my choice is I have
to go and partake in an illegal activity to acquire something that
could be beneficial to me," he said. "That's not a choice that I want to make."

Mr. Donovan, who qualifies for TennCare under a disability category,
said he is an avid proponent of a bill pending in the Tennessee
General Assembly that would legalize medical marijuana use for people
with certain conditions, such as cancer, multiple sclerosis and
epilepsy, with a physician's recommendation.

Chattanooga oncologist Dr. B.W. Ruffner said he never has felt the
need to suggest marijuana to a cancer patient.

"I don't think there are any benefits that you can't get in other
ways," he said.

For nausea control, a synthetic form of THC -- the active ingredient
in marijuana -- is available legally in pill form as Marinol, said
Dr. Ruffner, president of the Tennessee Medical Association.

"That's a cleaner, safer way to give somebody cannabinoids if that's
what you want to do," he said.

Legislative Outlook

The Tennessee bill, pending in the House Health and Human Resources
committee, has no real chance of passing this session, as its
counterpart in the Senate has not been debated yet, said the House
sponsor, Rep. Jeanne Richardson, D-Memphis. She's hopeful about the
bill's chances next session.

Next week the House committee likely will consider amending the bill
to create a study committee on the issue, she said.

The suggestion of further study was made by Rep. Joey Hensley,
R-Howenwald, who opposes the bill. The family medicine doctor said
he's concerned about the lack of clinical guidelines for doctors to
follow in recommending marijuana to patients.

"I'm a physician myself, and I have no idea how to prescribe
marijuana and what it's really for," he said. "I don't deny that it
probably does help with nausea for people with cancer, but I don't
know about all these other things it's claimed to help."

Rep. Richardson said she's fully in support of a study committee on the issue.

"The study can't hurt us, because the more you objectively look at
it, the more you understand" the benefits of medical marijuana, she
said. "I've read the studies. I know what's out there, and I think if
we can get people to do the same, I think it will pass."

A supporter of the bill, Rep. JoAnne Favors, D-Chattanooga, said
she's heard from many pain medicine specialists who believe medical
marijuana should be available to their patients.

"It has less side effects than many of the legal narcotics that we
have prescribed for us, the hydrocodone and some of the others that
have caused considerable addiction," said Rep. Favors, who is a
registered nurse.

Rep. Stacey Campfield, R-Knoxville, voted against the bill when it
was in the House government operations committee. He worried the bill
would result in the "free-for-all" of the medical marijuana program
in California, where he said people easily can access marijuana when
it is not medically warranted. California became the first U.S. state
to legalize medical marijuana in 1996.

"As it was written, (the bill) was too wide open for me," Rep. Campfield said.

Tennessee's bill would create one of the more highly regulated
programs in the nation, said Tamar Todd, staff attorney for the New
York-based Drug Policy Alliance, which advocates for the reform of
drug laws, including legalized medical marijuana.

About 300,000 sick people in Tennessee are living with conditions
that could qualify them for the proposed access program, proponents
of the bill say.

Mr. Donovan might be able to qualify to use medical marijuana under
the category of chronic, debilitating pain, bill supporters say.

Historical Use

Marijuana has been used therapeutically for at least 5,000 years,
first recorded in ancient China. The mild hallucinogen was a part of
the U.S. pharmacological list from the late-1800s to 1942, according
to a 1999 Institute of Medicine report exploring the therapeutic uses
of the drug.

Under a federal law passed in 1970, marijuana today is classified
alongside drugs such as heroin and LSD as a Schedule I drug. That
classification indicates marijuana has high potential for abuse and
no known medical benefits.

The American Medical Association and American College of Physicians
have requested a reassessment of marijuana's classification, since it
hinders future research into the drug's medical benefits. The
Institute of Medicine reported in 1999 that a range of biological
studies show a number of therapeutic potentials for marijuana-based
drugs but that clinical data is scarce due to legal constraints.

Marijuana's medical uses already documented range from an appetite
stimulant and nausea suppressant for cancer patients to recent
findings that the chemicals in cannabis can inhibit the growth of
tumors in prostate cancer patients, according to a 2009 British
Journal of Cancer article.

Based on patient surveys, it's likely that 25,000 patients in
Tennessee with cancer, AIDS-HIV, hepatitis-C or multiple sclerosis
already are using marijuana illegally, often with the quiet consent
of their medical providers, said Bernard Ellis, a former National
Institutes of Health official and public health epidemiologist, who
wrote the Tennessee legislation.

For years Mr. Ellis grew cannabis on his farm outside Santa Fe,
Tenn., to ease his pain from fibromyalgia, and he said he also
quietly provided marijuana to a network of cancer and AIDS/HIV
patients. In 2002, he faced federal prosecution and was put on
probation after he refused to sell marijuana to a local drug dealer,
who reported him to the authorities, he said.

Programs Proliferating

Supporters of the legislation in Tennessee say the momentum toward
legalization of marijuana for medical uses is growing nationwide.

Despite federal law prohibiting the use of marijuana, 14 states allow
medical marijuana use, and at least 14, including Tennessee, are
considering legislation to do so, Rep. Richardson said.

"This is no longer a fringe issue," Rep. Richardson said when
introducing the bill last week to the House health and human
resources committee.

Medical marijuana is not about "Cheech and Chong smoking a bong. That
is not what we're talking about here. We're talking about
compassion," she told legislators.

About 81 percent of Americans support legalizing the use of marijuana
for medical purposes, according to a recent ABC News/Washington Post poll.

Dr. Gene Huffstutter, a local rheumatologist, said the medical data
for the drugs' benefits for arthritic patients such as Mr. Donovan is
very limited. But the drug's classification as a Schedule I drug is a
barrier to more research, he said.

"There are some potential legitimate uses for it and, unless we're
allowed to study it and capture that data, we won't know," Dr.
Huffstutter said.

Mr. Donovan says he feels compelled to take a stand on the issue of
medical marijuana.

"If it were just me, I probably would continue to just use illegally,
because I can get the product," he said. "But it does affect so many
people, so many lives."

The Legislation

Under the House bill, H.B. 2562, patients could be eligible for a
doctor's recommendation to use medical marijuana if they have one of
the following conditions: cancer, Hepatitis-C, multiple sclerosis,
epilepsy, glaucoma, severe debilitating chronic pain, severe nausea,
Crohn's disease, Alzheimer's, Lou Gehrig's disease, wasting syndrome
or if they are enrolled in end-of-life care through hospice.

Any Tennessee farmer could apply to be licensed and overseen by the
state Department of Agriculture as a supplier. The state Board of
Pharmacy would regulate processors who package the drug, and the
Tennessee Department of Health would license and oversee
dispensaries. Patients and caregivers would not be permitted to grow
their own marijuana.

The bill could make an ounce of pot available to patients for as
little as $60 an ounce, supporters say. Within five years, proponents
say the program could bring an estimated $450 million in revenues
annually, $85 million of which would be excess revenues for the state.

Possession

In Tennessee, possession of an ounce or less of marijuana is a
misdemeanor offense punishable by up to 11 months and 29 days in jail
or a fine of $250. Any amount over half an ounce is presumed as a
"resale" quantity and can be classified as felony possession,
punishable by a $2,000 fine and between one and six years in jail,
depending on one's prior record. Possession of 20 to 99 marijuana
plants also is considered a felony.

Source: Jerry Sloan, assistant district attorney, Hamilton County

Fast Fact

This year an ABC News poll found that 81 percent of Americans support
legalizing use of marijuana for medical purposes. A 2004 AARP poll
found that almost three-quarters of 1,706 adults 45 and older
surveyed said they believe adults should be allowed to use marijuana
legally if a physician recommends it.