MEDICAL VALUE STIRS DEBATE

While the limited legalization of medical marijuana has won widespread
approval from patients' advocacy groups, a cloud of controversy
remains over the efficacy of the medicine itself, which many still
view as a recreational drug with potentially dangerous side effects.

Doctors and medical groups across the nation stand on both sides of
the issue, at the heart of which lies the chemical composition of not
only the plant in question, but the human body.

Cannabis, which has been used medically for centuries, contains more
than 400 chemicals, 60 of which have been identified as cannabinoids.
The most widely recognized of the cannabinoids in marijuana are
tetrahydrocannabinol and cannabidiol, more commonly referred to as TCH
and CBD. Scientists and users have understood for some time that TCH
and CBD produce very specific reactions in the human body, but only in
the past few decades has science gathered enough information to
understand why marijuana produces such effects, according to the
Society for Neuroscience.

"Basically, cannabinoids in the blood sugar bind to the CB1 receptor
on the cells, which causes a cascade of reactions in the cell," said
John Kopta, chief science officer at Genovations Creations, a medical
marijuana research lab in Colorado Springs. "Depending on the
cannabinoids, that reaction can do several different things. Each
specific cannabinoid does a different thing to the body."

The key to marijuana use is the presence of the natural form of THC
occurring in the body, formally called endocannabinoids. Such
chemicals bind to cannabinoid receptors, CB1 and CB2, in the brain and
body to illicit a number of responses. In a sense, cannabinoids act as
regulators of various bodily function such as mood, hunger, pain and
anxiety.

"Endocannabinoids travel in the opposite direction of most brain
signals," stated a report from the Society for Neuroscience in
December 2007. "In this way, they play a part in regulating almost all
brain and body processes, making endocannabinoids prime targets for
treating many diseases and conditions."

When cannabinoids enter the body through the use of marijuana, TCH and
CBD essentially hijack cannabinoid receptors in the body, eliciting an
artificial response. Such responses can be manipulated to regulate
pain, ease body tremors associated with multiple sclerosis and
Parkinson's disease, and prompt hunger.

Joe Leininger, of Mancos, uses medicial marijuana to cope with pain
resulting from a herniated disk in his neck. Doctors prescribed
Leininger a combination of Fentanyl patches, Percocet, muscle
relaxants and antidepressants to manage his symptoms, but the
pharmaceuticals did not provide the same level of relief as marijuana.

Today, Leininger relies soley on cannabis for pain relief and says his
overall health has improved since ceasing use of traditional pain
medication.

"Not being on all the pharmaceuticals makes me feel a lot better
healthwise," Leininger said.

Leininger also cites the cost of medical marijuana as a side
benefit.

"It was like $700 a month for pain meds," he said. "For medical
marijuana, it's $50 to $100. It is drastically cheaper."

While much scientific study validates the benefits of
endocannabinoids, the specific use of marijuana for medical purposes
is still questioned by many in the medical community.

In April 2006, the Federal Drug Administration issued an interagency
advisory clarifying the federal government's position that "smoked
marijuana is harmful" and has not been approved "for any condition or
disease indication."

In a comprehensive study released in 1999 by the National Academy of
Sciences, Institute of Medicine, the institute determined that
"Although marijuana smoke delivers THC and other cannabinoids to the
body, it also delivers harmful substances, including most of those
found in tobacco smoke. In addition, plants contain a variable mixture
of biologically active compounds and cannot be expected to provide a
precisely defined drug effect."

Clinical trials of marijuana have yet to be completed at the same
level of traditional medicine as a results of the plant's
identification as a Schedule I drug.

"It is very difficult to do research with medical marijuana to
determine how it works and if it works because it is illegal to use
and dispense," said Lori Raney, a psychiatrist with Axis Health System
in Cortez and Durango. "Those are big issues limiting the ability to
see if it works."

Some medical organizations, such as the American Medical Association,
have called for the reduction of marijuana from a Schedule I to II
drug so well-controlled studies can be completed. So far, the FDA has
rebuffed any attempts to declassify marijuana as Schedule I.

While acknowledging the benefits of marijuana use for chronic wasting
syndrome, pain associated with HIV infections and the relief of
nausea, Raney also cautioned that the negative impacts of marijuana
use might counteract any positive effect.

"The problem is, in these conditions people are already so physically
compromised," Raney said. "If on top of that you smoke (marijuana), it
may actually lead to more physical complications because of the toxins
that are in marijuana itself."

A study conducted by the federal Drug Enforcement Administration
concluded that most of the hazardous chemicals found in tobacco smoke
are also present in the 400-plus chemicals in smoked marijuana. The
study stated: "The harmful chemicals and carcinogens that are
byproducts of smoking create entirely new health problems. There are
four times the level of tar in a marijuana cigarette, for example,
than in a tobacco cigarette."

Such facts give Raney pause when it comes to the overall benefits of
smoked marijuana.

"As a physician, I have seen so much more harm than good," Raney said.
"I cannot be in favor of reducing it to a Schedule II drug to do the
studies. There may be others that might think that is the right thing
to do, but in my particular field there is nothing that I can see that
marijuana would be helpful for. I don't want to see it in clinical
studies."