Legal Substitute Can Cost $1,000 A Month

THE CANNABIS DEBATE: SHOULD MEDICINAL MARIJUANA BE LEGAL?

The DEA recently approved research on medical uses of marijuana for
the first time in nearly 20 years.

There's no way to tell how many medical marijuana users are in the
Roanoke Valley.

Many patients keep to themselves. Some get their medicine from a
buyer's club in-state. Others take Marinol, the only legal
prescription drug that contains the same psychoactive ingredient in
cannabis, delta-9 tetrahydrocannabinol, or THC. Pharmacist James Black
at Medical Center Pharmacy in Roanoke said he dispenses 10 to 15
prescriptions for Marinol per month.

The argument repeatedly used against medical marijuana is lack of
scientific proof showing its medicinal value. The Drug Enforcement
Administration characterizes marijuana as a dangerous, addictive drug
that is among the most commonly used and readily available in the country.

In response, medical marijuana activists cite the 1999 Institute of
Medicine study, published as a book in layman's terms in 2000, which
said, "Scientific data indicate the potential therapeutic value of
cannabinoid drugs for pain relief, control of nausea and vomiting, and
appetite stimulation."

They also point to the ranking done by Dr. Jack Henningfield of the
Johns Hopkins University School of Medicine and Dr. Neal Benowitz of
the University of California at San Francisco. In 1994, the doctors
ranked the risks of six commonly used drugs - nicotine, heroin,
cocaine, alcohol, caffeine and marijuana. Marijuana was listed as one
of the least serious drugs for withdrawal, repeated use, tolerance and
addiction.

"They're all of serious concern - except coffee," Henningfield noted.
Marijuana "needs more study as a drug out there."

In May, the U.S. Supreme Court decided "there is no medical-necessity"
defense to charges of manufacturing and distributing marijuana.
Federal laws classify marijuana as a Schedule I drug, a substance that
has high potential for abuse and isn't accepted for medical purposes.

After the ruling, the Bush administration cracked down on California
marijuana buyers' clubs, widely accepted in the state after the
success of a 1996 proposition that decriminalized use of marijuana as
medicine.

More recently, on Nov. 28, the DEA approved research on medical uses
of marijuana for the first time in nearly 20 years.

But that doesn't help cannabis patients now.

Despite legal barriers, activists locally and nationally continue to
fight to legalize marijuana as medicine. Gary Reams, Libertarian
candidate for Virginia lieutenant governor in the November election,
ran on a platform with a single plank: reforming state marijuana laws,
or the "Reams Reeferendum." He received 28,783 votes. A total of
1,905,511 people cast ballots.

In Virginia, marijuana can be prescribed only to patients suffering
from cancer or glaucoma. But because the DEA hasn't declassified
marijuana as a Schedule I drug, the state law is only symbolic and
doesn't help patients in practice. It also isn't as functional as laws
in other states that allow for a doctor's recommendation, not a formal
prescription.

A recommendation gives medical marijuana patients more legal support
because a prescription for marijuana is illegal, except in rare cases
in which patients sued and petitioned the government to get it.

This program - the only legal way to get around federal prohibition -
is now defunct. In 1976, Robert Randall made history when a federal
court gave him access to government cannabis to treat his glaucoma and
won.

Irvin Rosenfeld, 49, originally from Portsmouth, was the second man to
get medical marijuana through the federal government. He suffers from
a rare disease that causes tumor growth at the end of long bones. He
now lives in Boca Raton, Fla.

In 1990, a Virginia man became the second AIDS patient in the United
States to receive government-approved marijuana with the help of
Alliance for Cannabis Therapeutics, an organization founded by Randall
and his wife.

Patients with everything from cancer and AIDS to glaucoma and bipolar
disorder have said marijuana has helped them. Some frequent the
buyer's club believed to be in Charlottesville. There may be other
clubs in the state, but they keep a low profile.

Although some of these patients take Marinol, many say it doesn't
provide the same relief marijuana does. Marinol also isn't easy to
get. Valley View and Lipes pharmacies don't carry it, and not all
doctors prescribe it. Carilion Roanoke Community Hospital's pharmacy
had only one bottle on hand for its patients. And the drug is
expensive: The standard industry price for 60 10mg pills is about
$1,000, or about $17 per pill. Pharmacist James Black said most people
take two pills per day. So it costs about $1,000 for a month's supply.

The best bet for Virginia medical marijuana patients is moving to one
of the nine states that have decriminalized medical marijuana within
their borders, said Mary Lynn Mathre, a clinic addictions consultant
nurse for the University of Virginia health
system. Despite federal laws, those states have practically barred
prosecution of the seriously ill for marijuana use with state drug
laws.

"Southwest Virginia isn't a bad place. A lot depends on local
authorities," Mathre added.

She said tens of thousands of people could easily benefit from taking
marijuana as a medicine.

Mathre is also president of Patients Out of Time, a national nonprofit
organization based in Howardsville in Albemarle County that educates
health care professionals and supports the legalization of medical
marijuana. She said she can only advise patients on how to keep
themselves safe when buying cannabis. She can't tell them where to get
it.

"It's a very scary thing to call us," she said. "We can't help them
any. All we can do is say, yes, this is illegal. It's great if a
doctor supports you. But the reality is it could be a patient calling
and sometimes a DEA person in hopes that we'll be providing cannabis."

Even advising patients can be difficult for a physician. Many are wary
of recommending cannabis to patients because it is an illegal drug -
even though a doctor's support can "help patients more than anything,"
Mathre said. "If you're arrested and can say it's a medical necessity,
at least you have a case."

"Clearly, the biggest danger of taking marijuana is getting arrested
or getting something that's contaminated," she said.

For more information about Patients Out of Time, go to
www.medicalcannabis.com. To read the Institute of Medicine's study, go
to http://www.nap.edu/books/0309065313/html