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TO MANY OLDER PATIENTS IN PAIN, MARIJUANA ISN'T EVIL

Today's topic: Medical Marijuana

SEATTLE - Betty Hiatt's morning wake-up call comes with the purr and persistent kneading of the cat atop her bedspread.  Under predawn gray, Hiatt blinks awake.  It is 6 a.m., and Kato, an opinionated Siamese who Hiatt swears can tell time, wants to be fed. 

Reaching for a cane, the grandmother pads with uncertain steps to the tiny alcove kitchen in her two-room flat.  After Kato gets his grub, Hiatt turns to her own needs. 

She is, at 81, both a medical train wreck and a miracle: surviving cancer, Crohn's disease and the onset of Parkinson's.  Each morning Hiatt takes more than a dozen pills.  But first she turns to a translucent orange prescription bottle stuffed with a drug not found on her pharmacist's shelf -- marijuana. 

Peering through owlish glasses, she fires up a cannabis cigarette with a wood-stem match.  She inhales.  The little apartment -- a cozy place of knickknacks and needlepoint -- takes on the odor of a rock concert. 

"It's like any other medicine for me," Hiatt says, blowing out a cumulus of unmistakable fragrance.  "But I don't know that I'd be alive without it."

With the U.S.  Supreme Court poised to soon rule on whether medical marijuana laws in 10 states are subject to federal prohibitions, elderly patients such as-Hiatt are emerging as a potentially potent force in the roiling debate over health, personal choice and states' rights. 

No one knows exactly how many old folks use cannabis to address their ills, but activists and physicians say they probably number in the thousands.  And unlike medical marijuana's younger and more militant true believers, the elderly are difficult for doubters to castigate as stoners. 

Their pains are unassailable.  Their needs for relief are real.  Most never touched pot before.  As parents in the counterculture '60s, many waged a generation-gap war with children who were getting high on the stuff. 

Now some of those same parents consider the long-demonized herb a blessing. 

Patients contend cannabis helps ease the effects of multiple sclerosis, glaucoma and rheumatoid arthritis.  It can calm nausea during chemotherapy.  Research has found that cannabinoids, marijuana's active components, show promise for treating symptoms of Parkinson's disease and Alzheimer's, perhaps even as anti-cancer agents. 

A recent AARP poll found that 72 percent of people 45 or older think adults should be allowed to use cannabis with a physician's recommendation.  ( The poll found a similar proportion staunchly opposed to legalizing recreational pot.  )

Even conservative elders such as commentator William F.  Buckley and former Secretary of State George Shultz have supported marijuana as medicine. 

People like Hiatt are "more and more the face of the marijuana smoker," said Ethan Nadelmann of the Drug Policy Alli-ance.  His group advocates treating cannabis like alcohol: regulated, taxed and off-limits to teens. 

"There's this sense that when you get old enough, you've earned the right to live your own life," Nadelmann said.  "The mantra of the drug war has been to protect our kids.  But the notion of a drug war to protect the elderly? That's ludicrous."

'Not Like Growing a Rosebush'

Stories of suffering elders are not lost on John Walters, President Bush's point man for the war on illegal narcotics.  But as he beats the drum for psycho-tropic abstinence, the drug czar doesn't mince words. 

"The standard of simply feeling different or feeling better" does not make pot safe and effective medicine, said Walters, director of the White House Office of National Drug Control Policy.  People who abuse illegal drugs such as crack cocaine feel a similar burst of euphoria, he noted, "but that doesn't make crack medicine."

Congress and federal drug regulators have repeatedly rebuffed pleas to legalize medical use of cannabis, which is classified as a dangerous Schedule I drug, along with heroin and LSD.  Walters argues there is not a whiff of clinical proof qualifying smoked pot as medicine. 

Any beneficial compounds that do exist in the leafy plant, he said, should be synthesized, sent through the rigors of the regulatory process and packaged as a pharmaceutical, not smoked like black-market weed. 

"This is not like growing a rosebush in your yard," Walters said.  "This is a plant the products of which are used for serious and expensive abuse among illegal drugs."

Cannabis Mouth Spray

Although it was part of the U.S.  pharmacopeia early in the 20th century, cannabis was outlawed during the Depression.  In recent decades, advocates have repeatedly failed to gain federal approval for doctors to prescribe the herb. 

An exhaustive 1999 study by the National Academy of Science's Institute of Medicine concluded that marijuana can help curb pain, nausea and AIDS-related weight loss.  The study warned against the smoke's toxic effects, but said cannabis could be given under doctors' close supervision to patients who don't respond to other therapies. 

Now several small drug companies are pressing forward with prescription forms of the drug, such as a cannabis mouth spray that G.W.  Pharmaceuticals of Britain is expected to soon begin marketing in Canada. 

During the buildup to prescription forms, the raw plant shouldn't be ignored, said Dr.  Raphael Mechoulam, a pioneer in cannabinoid chemistry at Hebrew University of Jerusalem.  If it helps the elderly fight pain until prescription drugs are available, he said, "then why not?"

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