Marijuana on the ballot: should a menacing drug treat some chronically ill patients?

Should a menacing drug treat some chronically ill patients? Voters in two states say yes. Many health experts say no.

Ten times a day, Irvin Rosenfeld, 44, steps outside to smoke a marijuana cigarette. He's not puffing to get high. He's battling a bone disorder he's had since birth. After eight operations, Rosenfeld says marijuana is the only drug that offers relief from the tumors that tear through his muscles and veins.

"Nothing else," he says, "works as well to ease the pain."

Thousands of other chronically ill Americans would like to give marijuana a try--to see if it would alleviate their symptoms from diseases like cancer and AIDS. But Rosenfeld, a subject in a medical research program, is one of only eight people who can smoke the drug legally in the United States.

Voters in California and Arizona want to change that. Last November, they passed laws allowing all doctors to prescribe or recommend marijuana for their patients.

But the change won't come easily. Though 26 other states currently have similar laws, possessing, growing, and selling marijuana are still federal crimes. And the new state laws have triggered a strong response--especially from those concerned about drug use among teens.

Since 1991, the percentage of eighth graders who say they have smoked marijuana has nearly doubled, from 10.2 percent to 19.9 percent. Legalizing medical uses of marijuana could make the problem even worse, warns General Barry McCaffrey, head of drug policy for the Clinton administration. "Just when the nation is trying its hardest to educate teenagers not to use drugs, now they are being told that 'marijuana is medicine.' There could not be a worse message to young people," he says.

The Clinton administration says it plans to enforce the law--even if it means arresting doctors or patients. Still, the government recently agreed to spend $1 million to look into the possible medical benefits of the drug.

What do you think? Should "medical marijuana" be legalized? Read opinions on both sides, then debate and decide.

THE PROBLEMS WITH POT

"Smoking marijuana is more likely to cause new health problems than solve existing ones," says Donna Shalala, the U.S. Secretary of Health and Human Services.

There's no question that pot is a psychoactive (mind-altering) drug. Made from a plant called Cannabis saliva, it contains about 460 chemical ingredients. The one that affects the brain most is known as THC (delta-9 tetrahydrocannabinol).

THC molecules travel from the lungs through the bloodstream to the brain. There the drug binds with proteins called receptors on the surface of nerve cells. These cells then send sensations, including a feeling of intoxication, throughout the body.

Within a few minutes of smoking pot, a person might feel thirsty and, hungry. Blood pressure rises and the heart speeds up to twice its normal rate. With high doses of THC, a pot smoker might experience fear or anxiety and suffer paranoid thoughts.

Marijuana also blocks short-term memory and makes problem-solving difficult. So people using pot might forget things or perform poorly on tests. And because the drug interferes with balance and slows a person's reaction time, it can make driving a car or riding a bike especially dangerous.

Some drug researchers also argue that the long-term effects of pot will make sick people sicker. "Research shows that marijuana is harmful to the brain, heart, lungs, and immune system," Shalala says. Marijuana smoke contains more cancer-causing chemicals than cigarette smoke. And like cigarette smokers, people who regularly smoke pot suffer from chronic coughs and frequent colds. THC may even damage the immune cells that help fight diseases.

POSSIBLE BENEFITS

But many doctors say pot has positive effects, too. "More and more people are finding how useful marijuana is as a medicine," says Dr. Lester Grinspoon, a psychiatrist at Harvard Medical School. The main evidence comes from patient experience:

* In one study, 78 percent of cancer patients said that smoking marijuana --unlike other drugs--helped stop the nausea caused by chemotherapy (drug treatments used to kill cancer cells). A 1990 survey concluded that 44 percent of cancer doctors had already recommended marijuana to at least one of their patients.

* Many people with AIDS say that marijuana stimulates their appetite. That prevents "wasting syndrome," severe weight loss that can be fatal.

* Patients with glaucoma, an eye disease, say marijuana has prevented them from going blind by reducing fluid pressure in their eyes.

* Some people also say marijuana prevents epileptic seizures; reduces migraine headache pain; and alleviates the muscular tremors and paralysis of multiple sclerosis.

In 1985, the federal government recognized that marijuana might have some therapeutic effects, and approved the use of Marinol, a synthetic (human-made) version of THC. Patients can legally buy Marinol pills with a doctor's prescription.

But many patients say Marinol doesn't always work. "If you're vomiting every 15 minutes, like patients on chemotherapy or people with AIDS, you can't keep a pill down," says Allen St. Pierre, deputy director of the National Organization for the Reform of Marijuana Laws. And, as Rosenfeld says, "Marijuana contains more than 400 chemicals. Marinol is made of just one [THC]." Marinol can't possibly replicate all the effects of marijuana, he says.

The bottom line: Seriously ill people won't have legal access to the drug unless the government changes the law. Should "medical marijuana" be legal?

RELATED ARTICLE: MARIJUANA A HISTORY

~ 3000 B.C.-1790s A.D.

Marijuana used as a folk medicine to treat ailments in Central Asia, China, and Europe

1840-1900

More than 100 medical research papers recommend using marijuana to ease symptoms of rabies, rheumatism, epilepsy, and tetanus.

~ 1900

Marijuana is first used as a pleasure-inducing drug in the United States. No laws prohibit its use.

1937

The U.S. government makes growing, selling, or possessing marijuana illegal.

1941

Federal Bureau of Narcotics prohibits doctors from prescribing marijuana.

1960s

Recreational marijuana use spreads, making pot the second most prevalent drug in the U.S.--after alcohol.

1970

In passing the Controlled Substances Act, Congress classifies marijuana as a drug with no common, acceptance, medical use and a high potential for abuse

1976

The federal government grants the first of 12 patients the right to use "medical marijuana" as part of a research program.

1978

New Mexico becomes first state to legalize marijuana for medical use.

1985

The government approves synthetic THC (Marinol) as prescription medication.

1989-1991

People with serious illnesses (many with AIDS) flood the government with applications to join the medical marijuana program. The program is discontinued in 1992.

1996:

Eight patients still receive marijuana through the federal program. California and Arizona pass medical marijuana laws.

RELATED ARTICLE: Should marijuana be legalized for medical purpose?

NO Teens will get the wrong message. They might buy marijuana and abuse it. I don't want to see pot become more available. I have friends who smoke pot and I think it's pitiful.

Jessica Fajardo, 14 William Penn School Allentown, PA

YES Marijuana could help people who are sick, as long as they don't abuse it. They should stay at home and they shouldn't drive.

Dustin Gillum, 15 Greenup County High School Greenup, KY

NO Marijuana is a bad drug. Kids will start saying they're ill so they can get marijuana. They'll think they can get away with it.

Lindsay Gualario, 13 Gulfview Middle School Naples, FL

NO Marijuana doesn't cure people. It just relieves their symptoms. They should take the (THC) pill instead. It does the same thing and it's legal.

Christina Hammond, 12 Cary Junior High Cary, IL

RELATED ARTICLE: MARIJUANA FACTS

* In 1995, 20 percent of 8th graders, 34 percent of 10th graders and 42 percent of 12th graders said they had smoked marijuana.

* The number of teens who expect to try illegal drugs in their lifetime has doubled since 1995.

* In a recent poll, 58 percent of California voters said they support giving marijuana to people who are terminally ill.

* Sixty-eight percent of 17-year-olds say they can buy marijuana within a day.

* Some drugs that doctors can prescribe legally are highly addictive and potentially harmful (e.g., morphine and codeine, which are derived from opium, the same plant used to make heroin).

* Marijuana remains the most common illegal drug in the U.S.