WHY NOT POT?

Some Elderly Patients Use Marijuana to Ease Their Pain

Seattle -- Betty Hiatt's morning wake-up call comes with the purr and
persistent kneading of the cat atop her bedspread. Under predawn gray,
Hiatt blinks awake. It is 6 a.m., and Kato, an opinionated Siamese who
Hiatt swears can tell time, wants to be fed.

Reaching for a cane, the frail grandmother pads with uncertain steps
to the tiny alcove kitchen in her two-room flat. Her feline alarm
clock gets his grub, then Hiatt turns to her own needs.

She is, at 81, both a medical train wreck and a miracle, surviving
cancer, Crohn's disease and the onset of Parkinson's. Each morning
Hiatt takes more than a dozen pills. But first she turns to a
translucent orange prescription bottle stuffed with a drug not found
on her pharmacist's shelf -- marijuana.

Peering through owlish glasses, Hiatt fires up a cannabis cigarette
with a wood-stem match. She inhales. The little apartment - a cozy
place of knickknacks and needlepoint - takes on the odor of a rock
concert.

"It's like any other medicine for me," Hiatt says, blowing out a
cumulus of unmistakable fragrance. "But I don't know that I'd be alive
without it."

With the U.S. Supreme Court poised to soon rule on whether medical
marijuana laws in California and nine other states are subject to
federal prohibitions, elderly patients like Hiatt are emerging as a
potentially potent force in the roiling debate over health, personal
choice and states' rights.

No one knows exactly how many old folks use cannabis to address their
ills, but activists and physicians say they probably number in the
thousands. And unlike medical marijuana's younger and more militant
true believers, the elderly are difficult for doubters to castigate as
stoners.

Their pains are unassailable. Their needs for relief are real. Most
never touched pot before. As parents in the counterculture '60s, many
waged a generation-gap war with children getting high on the stuff.

Now some of those same parents consider the long-demonized herb a
blessing.

Patients contend cannabis helps ease the effects of multiple
sclerosis, glaucoma and rheumatoid arthritis. It can calm nausea
during chemotherapy. Research has found that cannabinoids, marijuana's
active components, show promise for treating symptoms of Parkinson's
disease and Alzheimer's, perhaps even as anti-cancer agents.

A recent AARP poll found 72 percent of people age 45 or older believe
adults should be allowed to use cannabis with a physician's
recommendation. (The poll found a similar proportion staunchly opposed
to legalizing recreational pot.) Even conservative elders such as
commentator William F. Buckley and former Secretary of State George
Shultz have supported marijuana as medicine.

Betty Hiatt and those like her are "more and more the face of the
marijuana smoker," said Ethan Nadelmann of the Drug Policy Alliance,
which advocates treating cannabis like alcohol: regulated, taxed and
off-limits to teens.

"There's this sense that when you get old enough, you've earned the
right to live your own life," Nadelmann said. "The mantra of the drug
war has been to protect our kids. But the notion of a drug war to
protect the elderly? That's ludicrous."

Stories of suffering elders are not lost on John Walters, President
Bush's point man for the war on illegal narcotics. But as he beats the
drum for psychotropic abstinence, the drug czar doesn't mince words.

"The standard of simply feeling different or feeling better" does not
make pot safe and effective medicine, said Walters, director of the
White House Office of National Drug Control Policy. People who abuse
illegal drugs such as crack cocaine feel a similar burst of euphoria,
he noted, "but that doesn't make crack medicine."

Congress and federal drug regulators have repeatedly rebuffed pleas to
legalize medical use of cannabis, which is classified as a dangerous
Schedule I drug, along with heroin and LSD. Walters argues there is
not a whiff of clinical proof qualifying smoked pot as medicine. Any
beneficial compounds that do exist in the leafy plant, he said, should
be synthesized, sent through the rigors of the regulatory process and
packaged as a pharmaceutical, not smoked like black-market weed.

"This is not like growing a rosebush in your yard," Walters said.
"This is a plant the products of which are used for serious and
expensive abuse among illegal drugs."

Hiatt isn't seeking a recreational high at this early hour, with much
of Seattle asleep.

She recieved a diagnosis of breast cancer in 2001. Chemotherapy left
her a wreck. She threw up anti-nausea drugs, so her oncologist
suggested cannabis, legal for medical purposes in the state of Washington.

"I thought he was a little off track," she recalls. "I had never done
anything like that. I was very uneasy."

A few puffs of pot smoke each morning help quell the nausea caused by
her prescription drugs, she said. Her appetite is restored and she
never gets high.

Her two granddaughters, ages 18 and 20, display a ho-hum attitude
about Granny toking up.

"It's just totally the norm," said Jessica, the older of the
two.

Hiatt's son Doug, a defense attorney, endorses his mother's use of
medical pot, picking up her cannabis every few weeks from a collective
not far from home.

Her other son doesn't share that unfettered faith. Dan Hiatt, an
assistant district attorney in Atlanta, was shocked to learn his
mother was seeking relief from a drug that has landed many a pusher
behind bars, his mother recalled. (Dan Hiatt declined to be
interviewed.)

But he never tried to talk her out of it, Betty Hiatt said. "I don't
think he likes it, but he accepts it. He loves me. He knows I wouldn't
be doing it for fun."

Hal Margolin, 73, claims the same dependency.

Pain drove the Santa Cruz resident to the drug. It began a decade ago,
as the cervical vertebrae at the top of Margolin's back calcified,
strangling a bundle of nerves and producing a searing sensation in his
extremities. His feet can feel as if scalded by boiling water.

Margolin tried to address the unrelenting agony the standard way,
buying maxi-packs of Advil and Aleve. An operation made things worse.
He lost the feeling in his fingers and soles of his feet, and at times
was reduced to crawling to the bathroom. Despite a prosperous
retirement, a good marriage and two happy grown children, Margolin
contemplated suicide.

He tried pot at a friend's urging. A few tokes and the pain seemed to
recede to the background, Margolin said. "I was no longer obsessing"
about it.

Finding marijuana early on was no easy task. At times, the bald and
bespectacled retiree turned to the streets to score his weed.

Dressed in a cardigan sweater against the coastal cool, he would amble
along the ramshackle blocks adjacent to the town's beachfront
Boardwalk. Mustering his courage, Margolin would approach one of the
street kids he figured was dealing. Most of the time they scoffed.

"They thought I was some kind of undercover cop," he
says.

Now he gets his cannabis from a Santa Cruz dispensary serving 200
patients, many terminally ill. In a decade of operation, the cannabis
cooperative has lost more than 150 clients to cancer, AIDS and other
ills. A woman who used pot to tame the painful aftereffects of polio
died last year at 93. Margolin now is among the oldest.

For him, marijuana has been "the difference between clinical
depression from the pain, and carrying on with my life."

Alhough it was part of the U.S. pharmacopeia early in the 20th
century, cannabis was outlawed during the Depression. In recent
decades, advocates have repeatedly failed to gain federal approval for
doctors to prescribe the herb.

An exhaustive 1999 study by the National Academy of Science's
Institute of Medicine concluded that marijuana can help curb pain,
nausea and AIDS-related weight loss. The study warned against the
toxic effects of the smoke, but said cannabis could be given under
close doctor supervision to patients who don't respond to other therapies.

Now several small drug companies are pressing forward with
prescription forms of the drug, such as the cannabis mouth spray that
G.W. Pharmaceuticals of Britain is expected to soon begin marketing in
Canada.

During the buildup to prescription forms, the raw plant shouldn't be
ignored, said Dr. Raphael Mechoulam, a pioneer in cannabinoid
chemistry at Hebrew University of Jerusalem. If it helps the elderly
fight pain until prescription drugs are available, he said, "then why
not?"

Some have already found ways around lighting up.

Catherine Ballinger, 94, saw a busy retirement undercut by infirmity.
A fiercely independent woman who worked for years as a technical
illustrator during the heyday of Southern California's aerospace
industry, Ballinger lives in pain. Her right hip and knee grind bone
on bone and arthritis bedevils her. She can hardly walk. Pain forced
the Torrance woman to give up a beloved hobby, painting seascapes
while perched on the Pacific bluffs.

She was never a smoker, so Ballinger's doctor recommended trying
cannabis baked into brownies. Her agony shrank, Ballinger says,
allowing her to sleep. Although no miracle cure, the brownies made
life tolerable.

"If those guys in Washington had the pain I suffer," she said, "they
wouldn't put up all these legal barriers for patients to obtain
medical marijuana."

Although controversial even in states that have approved it, medical
marijuana remains illegal in most of the U.S. But even outside safe
havens such as California and Washington, a few marijuana patients
have enjoyed a free pass.

For nearly three decades the U.S. has provided cannabis grown on a
University of Mississippi farm to a tiny sampling of seriously ill
people in a special federal program. The effort, launched in the
mid-1970s to settle a "medical necessity" lawsuit brought by glaucoma
patient Robert Randall, was shut to newcomers in 1992 as a flood of
AIDS patients sought entry. Over the last decade, others have sued to
get in but failed. All that remain are seven survivors, many pushing
their golden years.

Randall died in 2001, but Elvy Musikka of Sacramento is a feisty 65.
The oldest is Corinne Millet, 73, a Nebraska grandmother suffering
glaucoma. The wife of a surgeon, Millet credits the government
marijuana with saving her sight.

Irvin Rosenfeld calls their little band the nation's most exclusive
club aside from living ex-presidents. At 52, Rosenfeld is the youngest
- - and he expects to be smoking pot as medicine for decades to come. A
dozen joints a day curb riveting pain from a rare disorder that causes
bony protrusions to poke like cattle prods into his muscles.

Despite his copious marijuana consumption, Rosenfeld has prospered as
an investment banker in Fort Lauderdale, Fla. His longtime boss
marvels at his energy. Without marijuana, Rosenfeld said, "Instead of
being a productive member of society, I'd be a burden."

Among medical marijuana's biggest blocs are AIDS patients, including
many longtime survivors edging toward old age.

Keith Vines recieved his diagnosis of the disease in 1986. He nearly
died in 1993, as AIDS wasting stripped him of 60 pounds. When pills
didn't help, his physician recommended marijuana.

For years an assistant district attorney in San Francisco, Vines felt
like a "fish out of water" skulking into a medical marijuana
dispensary the first time. But pot increased his appetite. Nausea from
his medications ebbed. At 55, he has smoked it for a decade, limiting
use to a few times a week.

Now this law-and-order guy would love to sit down with John Walters or
the president, close the door and talk.

He'd tell them about losing friends and feeling despair. He would talk
about retiring early from a job he loved, after AIDS compromised his
short-term memory. He'd ask that they stop fighting the sick and elderly.

"Survival," Vines concluded, "is struggle enough."