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Forbidden Medicine

Laws and medicine clash over medicinal marijuana use.

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Still, the Institute of Medicine report acknowledged problems with some legal drugs. Both oral THC and megestrol acetate, a synthetic derivative of progesterone sold as Megace, can stimulate appetite in AIDS patients, but they can also cause dizziness, lethargy, and other more serious side effects. In addition, some patients say inhaling marijuana smoke gives them more control over the effects than a pill containing THC. Yet, even if researchers eventually do develop safer forms of the drug such as inhalers, the authors observed, terminally ill patients currently in severe pain "will find little comfort in a promise of a better drug ten years from now."

On that last point many Americans would seem to agree: In a nationwide Gallup poll conducted after the report was issued, 73% of respondents favored making it legal for doctors to prescribe marijuana to suffering patients. The issue has also been cropping up repeatedly on the campaign trail. In an October debate in Hanover, NH, Republican presidential contender John McCain was asked how he reconciles society's tolerance for alcohol with the obstacles to medicinal marijuana. "That is an excellent question," said McCain. "Which I'd prefer to duck." GOP front-runner George W. Bush has said that while he personally does not support medical marijuana use, states should have the right to allow it.

Gore, responding to questions from a December town hall audience in Derry, NH, recalled his late sister's struggle with cancer in the mid-1980s and said some people "ought to have the option" of marijuana use: "We have not given doctors enough flexibility to help patients who are going through acute pain." In another New Hampshire forum his chief Democratic rival, Bill Bradley, said he opposes medical marijuana use for now, but believes it is "something we have to study more."

So far the federal government has approved a handful of studies. In one, researchers at the University of California-San Francisco are looking at the effects of the drug for patients with HIV. But even if scientists eventually establish such safety, ultimately factors besides science are bound to come into play. As the Institute of Medicine report concluded, this debate "presents a policy issue that must weigh -- at least temporarily -- the needs of individual patients against broader social issues."

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