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The Debate Over Medical Marijuana

Politicians and patients are grappling with questions about the use of marijuana for medical treatment.

WebMD Feature

If it weren't for his few daily tokes from marijuana cigarettes, Kiyoshi Kuromiya believes he would no longer be alive.

The Philadelphia AIDS patient and activist had lost 40 pounds over a four-month period and spent most days nauseated before he began smoking pot in 1995 to boost an appetite suppressed by his disease.

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"Marijuana saved my life," says Kuromiya, 57, who was diagnosed with AIDS in 1988. "It's a great irony to me that I can buy cigarettes, which will kill me, anywhere. But marijuana, which has kept me breathing, is illegal."

Kuromiya and others with debilitating ailments have long argued that marijuana should be legally available when standard medical treatment can't relieve a patient's suffering and pain. They're now finding hope in the measured support that idea has received from some presidential candidates, including Vice President Al Gore. And some believe the November elections, which some political observers say could give control of the House back to the Democrats, may bring a change in attitude on the subject to Capitol Hill.

Voters in six states -- Maine, California, Alaska, Arizona, Oregon, and Washington -- have passed measures supporting medical marijuana use, and proposals in two other states -- Colorado and Nevada -- are pending. But under federal law the drug remains illegal. And while the government has rarely stepped in to prosecute medical users, the Clinton administration maintains that any change in marijuana's legal status should be based not on state politics, but scientific data.

In March the Institute of Medicine, an independent organization chartered by the National Academy of Sciences, issued a report examining just that topic. After a two-year review of the clinical research and literature available, the report concluded that marijuana cigarettes could help cancer and AIDS patients control nausea and pain, though there's still only rudimentary understanding of how the drug works. Findings were only "moderately promising" for treatment of spasticity diseases like multiple sclerosis, and less conclusive for glaucoma and seizure disorders like epilepsy. But the authors warned that smoking marijuana poses its own health hazards -- including possible lung damage and weakening of the immune system from impurities in plant material -- and should be recommended only as a last resort.

"Marijuana's future as a medicine does not involve smoking," says Stanley Watson, a neuroscientist and substance-abuse expert from the University of Michigan who cowrote the report. "It involves exploiting the potential in cannabinoids -- (chemical compounds that are the active ingredients in marijuana).

The best-known substance, THC, is already legally available as an oral prescription drug sold under the trade name Marinol -- a fact that those staunchly against medical marijuana use are quick to emphasize. "We already have good medicines out there for every ailment that marijuana is reported to help relieve the symptoms for, including cancer and AIDS," says Robert Maginnis, a senior director at the Family Research Council in Washington, DC. Maginnis and other opponents say legalizing marijuana for medical use sends the public the message that the drug is safe -- a sure prescription for increased illegal use by teenagers.

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