If the federal government were right that medical marijuana has no
medicinal value, why have so many doctors risked their practices by
recommending its use for patients with cancer or AIDS?

Marcus Conant, the doctor who identified the first cases of Kaposi's
sarcoma among San Francisco AIDS patients, can answer that. Imagine you're
the doctor for a "40-year-old lady with breast cancer. They put her on
chemotherapy and every time she takes her therapy, she throws up." She
can't sleep; she's up sick all night. She has trouble caring for her
children. Medical marijuana can alleviate her nausea and give her an appetite.

Conant wouldn't write her a prescription for medical marijuana. He can't.
But he would write a note for her file recommending marijuana. Since his
patients have access to their files, they can present a copy of said note
to a marijuana club authorized by California's Proposition 215. If they use
the note, well, that's their business.

Conant sued the federal government to prevent federal law enforcement from
investigating or punishing doctors who exercise their First Amendment right
to recommend medical marijuana. Last month, a Ninth Circuit U.S. Court of
Appeals panel ruled in his favor. The feds had argued that recommending
marijuana was analogous to prescribing it, but the court agreed that this
advice entailed "dispensing of information." That distinction goes to the
heart of the matter - - the ability of doctors to give their best advice to
people who desperately need it.

Why not prescribe marinol, the legal pill form of marijuana? Conant said
that some patients don't respond well to it: It takes 45 minutes to work.
If they take too little, it doesn't work at all. If they take too much,
they fall asleep and don't eat.

My friend Julia, who is battling cancer, occasionally has used marijuana to
help her sleep, but not often. Too much pot makes her think about dying. Still,

Julia knows other cancer patients for whom cannabis is "the only thing that
stands between them and a complete inability to get down food."

Cancer patients can take as many as 12 medications a day. They juggle which
pills they can take with or without food, and with or without other drugs.
There's something to be said, Julia added, for a drug that you can smoke at
any time.

It's not clear if federal drug czar John P. Walters will appeal the decision.

My advice: Don't.

Walters also should reconsider his opposition to medical marijuana. Walters
complains that advocates use sick people's pain as a platform to legalize
pot for everyone. Legalize medical marijuana, however, and you take away
that high ground.

It won't happen, said Daniel Abrahamson of the Drug Policy Alliance,
because, "The drug czar's office can't abide the thought of losing any
ground or having any legitimacy given to the issue of medical marijuana."

Walters' spokesman Tom Riley resents "this caricature; it's very
frustrating. 'Oh, they're drug warriors. They don't care that people are
suffering and in pain.' "

Riley doesn't deny that marijuana can make patients feel better. A
cigarette, he said, can make an emphysema patient feel great. His bottom
line: The federal government doesn't make medical policy based on anecdotes.

But when the anecdotes are so plentiful, there's something missing in the
research. When nurses wear Prop. 215 pins, they surely know something that
the feds don't.

Conant, 66, has no use for a system that won't let him alleviate misery. He
closes his eyes, leans back in his chair and mutters, "To deny sick people
relief because of abuses is not humane."

Pubdate: Sun, 10 Nov 2002
Source: San Francisco Chronicle (CA)
Copyright: 2002 Hearst Communications Inc.
Contact: letters@sfchronicle.com
Website: http://www.sfgate.com/chronicle/