CONTROVERSIAL HERBAL REMEDY

Every day Redmond resident Shaun Heuston is greeted by 18 pills, large and
small, green and white, in a tin canister that he keeps on the shelf next
to the window in his mobile home.

He takes six or seven of them before breakfast, lunch, dinner and before he
goes to bed. The pills numb his lips, leave a copper taste in his mouth and
make him throw up.

But above all, the pills promise every day to shore up Heuston's immune
system and battle HIV/AIDS, which would eventually allow another illness to
kill the 42-year-old.

Heuston uses medical marijuana through a state program to quell his nausea
and boost his appetite. More than 140 Central Oregonians participate in the
program, which voters placed into law in 1998.

"Half the battle is just keeping the medication inside of you," said
Heuston, who was diagnosed in 1997 with the virus. "You have to do whatever
helps you to keep that medication in your system, because it keeps you alive."

Local medical marijuana patients say they use the drug as part of their
daily medical routine to lessen side effects from other medications, stop
painful muscle spasms or replace other prescription drugs.

Patients interviewed said they were thankful the law allows them to legally
use marijuana as medicine, but also pointed to holes in the program that
can make access to the drug difficult.

Oregon is one of nine states that has legalized marijuana for medical use,
with others including California, Washington, Maine and Alaska. About 6,000
people participate in Oregon's program.

Under the voter-approved law, Oregonians "suffering from debilitating
medical conditions should be allowed to use small amounts of marijuana
without fear of civil or criminal penalties when their doctors advise that
such use may provide a medical benefit."

Those debilitating medical conditions include cancer, glaucoma, HIV/AIDS
and Cachexia, which is severe malnutrition or wasting. Severe pain, severe
nausea and seizures, including those caused by epilepsy and muscle spasms,
are also on the list.

Whether marijuana does have medical benefits has been much debated.

It's been difficult to conduct many clinical studies on the drug because of
various federal regulations, according to a 1999 report from the Institute
of Medicine titled "Marijuana and Medicine: Assessing the Science Base."

"Scientific data indicate the potential therapeutic value of
(cannabis-derivative) drugs, primarily THC (the active ingredient in
marijuana), for pain relief, control of nausea and vomiting and appetite
stimulation," a summary of the report states. "Smoked marijuana, however,
is a crude THC delivery system that also delivers harmful substances."

The Oregon Medical Association remains neutral on the subject, leaving it
up to individual physicians to decide whether they would recommend
marijuana for medical use.

The Federal Drug Administration has approved Marinol pills, which contain
synthetic THC, and is used for patients with anorexia, AIDS or cancer
patients who have chemotherapy-induced nausea and vomiting, according to
the Marinol Web site.

Heuston had tried Marinol, but said it didn't help with the nausea caused
by his other medications.

Increasingly health conscious, Heuston started exercising and stopped
smoking cigarettes years ago because of his health. He said the smoke from
his medical marijuana does bother him.

Both Heuston and his partner, Charles King, 37, also diagnosed with
HIV/AIDS, are on disability and have a fixed income.

Other patients said they used medical marijuana because they didn't like
the side effects of other prescribed drugs.

Martin Halsey, 47, a quadriplegic, uses medical marijuana to control muscle
spasms in his arms and legs. The Bend man said he broke his back almost 20
years ago after falling while skiing at Mount Bachelor.

His muscle spasms are particularly bad when it's cold.

"(My arms) get really tight," he said. "Sometimes I can't drive because I
can't even move the steering wheel."

He's tried muscle relaxant and prescription pain medications. But they
leave him tired and unable to think clearly, he said.

"I get zombified," Halsey said.

Though he had smoked marijuana before, Halsey applied for a medical
marijuana card soon after the law went into effect.

To participate in the program, the state requires people to send
documentation from their attending physician of their qualifying medical
condition and, if it's their first application, documentation that the
physician said marijuana may be a helpful medicine.

The program costs $150 the first year and then $100 each year to renew the
application. Beginning this summer, the program lowered the cost to $50 if
a person is on the Oregon Health Plan or receiving supplemental security
benefits.

"We estimate about 35 percent of the participants qualify for that lower
amount," said Mary Leverette, program manager of the Oregon Medical
Marijuana Program. The program is administered by the Department of Human
Services.

As of March 2002, the laws are more restrictive about who is considered a
patient's attending physician. Physicians must have an established
relationship with the patient, be primarily responsible for the patient's
care and have reviewed the patient's medical charts.

The changes followed the Board of Medical Examiners investigation of a
Molalla physician, Dr. Phillip Leveque. Leveque, according to an Associated
Press report in 2001, had signed more than 40 percent of approved
applications for the state's medical marijuana program.

"The primary way abuse (of the law) is supposed to be avoided is that it's
a decision made between a patient and his attending physician," said Dr.
Grant Higginson, the Department of Human Services public health officer.

Possessing marijuana remains illegal under federal law, making some
physicians nervous about prescribing or even talking with their patients
about medical marijuana, according to the Oregon Medical Association (OMA).

Jim Kronenberg, OMA associate executive director, said in the past the
organization has advised its physicians to give patients inquiring about
medical marijuana a copy of their medical records, showing they discussed
the topic and that medical marijuana could help the patients' conditions.

The OMA advised physicians against signing the state application form or
writing a prescription for medical marijuana on a notepad.

"The main goal was staying out of trouble with the feds," Kronenberg said.

A recent decision by the United States Supreme Court now makes the previous
recommendations moot, he said. The high court rejected a request by the
Bush administration to consider whether the federal government can punish
physicians for talking about medical marijuana with their patients.

Upholding a previous decision by a California federal district court, the
decision allows physicians to talk about and even recommend the use of
medical marijuana as part of their freedom of speech.

The OMA has yet to revise its recommendations, but Kronenberg said they
will likely be brief.

"(The new recommendations) will probably be 'here's the provisions of the
Oregon law, here's what the courts said, and if you want to do it it's
nobody's business,' " he said.

Dr. Stephen Kornfeld, a Bend oncologist, said he feels the law makes it
irrelevant whether he believes in the medical benefits of marijuana or not.

"It just asks whether the patient has any of the following conditions and I
have to confirm that they have chronic pain or a cancer," he said. "I'm not
writing a prescription for marijuana and the state is allowing them to do it."

Kornfeld said the few of his patients who do use medical marijuana use it
as a last resort, after they've tried other medications to control their
nausea and increase their appetite. He estimated 1 percent to 2 percent of
his patients participate in the state program.

In Prineville, Dr. Michael Knower, medical director of Pioneer Memorial
Hospice, said he's recommended other prescription drugs as an alternative
to the few patients who have inquired about medical marijuana.

"We have medications that are more effective (for controlling nausea,
vomiting, etc.)," he said. "So why go with something that is not as effective?"

Dr. David Sandoval, a rheumatologist, said he hasn't encountered a
situation with his patients where conventional medications didn't work for
their arthritis pain.

Heuston, the medical marijuana patient, said problems with the state law
lie with the little amount of information the state can give medical
marijuana patients.

The state program is prohibited by law from referring patients to
physicians who will recommend medical marijuana, supplying the patients
with marijuana seeds or informing them where to buy the seeds or who else
is growing medical marijuana.

"We review applications and determine if people qualify, nothing allows us
to do anymore than that," said Leverette, the Oregon Medical Marijuana
Program manager.

The lack of information can leave patients in a bind.

Heuston said most people turn to the Internet for information and use word
of mouth for where to get marijuana. And many resort to the black market
for the drug.

"At some point in your participation you are going to have to (break the
law) if you want to have a constant supply," he said.

Halsey, of Bend, said he obtained his medical marijuana from the street for
the first six months he was in the program, while he was getting plants and
then waiting for them to grow.

Heuston said he and his partner have also had to do the same thing,
particularly if they end up harvesting less from their plants than they
anticipated or if more of their plants turn out to be males instead of
females. The leaves and flowers of both plants are useable, but the male
plants tend to have less THC and are usually discarded, he said.

Rick Szymanski, founder of Central Oregon Medical Marijuana Network
(COMMN), said the program works best when patients take care of themselves.
Szymanski is both a registered caregiver and medical marijuana patient. He
has chronic pain from several back and neck surgeries, he said.

"Those are the success stories," he said.

Becoming a care giver, or having a caregiver can also pose problems for
medical marijuana patients, patients said. Care givers are designated by
the state to grow marijuana for medical marijuana patients.

The state allows care givers or medical marijuana patients growing their
own to grow three mature plants and four immature plants at one time,
though the law does make room for exceptions. Both Halsey and Heuston said
the number of plants isn't enough to produce enough medicine for a year.

And those growing marijuana worry about thieves and have expensive security
systems in place to protect their crop. Szymanski said his former home in
Crook County was burglarized and people stole his marijuana plants.

Leverette, manager of the state's program, said the state's rules are
unlikely to change unless the law changes.

For now, patients are happy the law exists.

Sitting Tuesday in his small living room, surrounded by bookshelves stacked
with HIV/AIDS magazines and wooden furniture handmade by his partner, King,
Heuston packs a colorful glass pipe with his homegrown marijuana.

Lighting the pipe, he recalled how skinny and sick both he and King had
been before and shortly after each were diagnosed with HIV/AIDS. King had
weighed 97 pounds.

"I was at 124 pounds," said Heuston, still slim at 150 pounds.

It was few minutes before lunchtime.

The couple hits of marijuana will give both men an appetite for lunch.
Heuston will be able to keep down his next round of pills before heading
off to his doctor's appointment that afternoon.

The drug makes each day a little more tolerable.

"When you are looking at 20 years of medication, (medical marijuana) makes
looking down that road a little easier," Heuston said.