Oct. 20 (Bloomberg) -- Madeline Martinez is in constant pain from a disease that is destroying her joints and the discs in her back. Marijuana relieves her discomfort, she said, and the Obama administration has ended her worries that she may someday be jailed for using the drug.

Martinez, 58, of Portland, Oregon, had previously been given Abbott Laboratories’ Vicodin and codeine for her pain. Use of those drugs led to stomach problems, and now she takes marijuana prescribed for her by a doctor. Medicinal marijuana is legal in Oregon, one of 14 states to allow so-called compassionate-care use.

The U.S. Department of Justice yesterday advised federal prosecutors not to seek criminal charges against those who use medical marijuana in accordance with state laws, reversing a Bush administration approach. Along with chronic pain, the American College of Physicians, the second-largest U.S. doctors group, has said marijuana can be used to treat glaucoma, multiple sclerosis and nausea.

“Having disabled people jailed for no reason, that’s terrifying,” said Martinez, who mostly uses a tincture of the drug rather than smoking it. “As a medical marijuana patient, it’s always good to have some stress and anxiety alleviated.”

Of 23,873 people in Oregon who hold cards allowing them to use marijuana legally, 21,087 are approved because of severe pain, according to the state’s public health division. Another 7,550 Oregonians take marijuana to relieve muscle spasms from conditions such as multiple sclerosis, and 3,997 use it for nausea. Patients may be approved for more than one condition.

6,000 Applications

Over 6,000 applications for the program are under review, either for initial treatment or renewal, according to the division’s Web site.

Marijuana, produced from the cannabis plant, is classified by the U.S. government as a Schedule I drug, which declares it has no accepted medical use. Possessing and using marijuana are crimes in most states.

“Our old Drug Enforcement Agency people thought it was a Cheech and Chong thing,” said Donald Abrams, the chief of oncology at San Francisco General Hospital, referring to the comedy team of Cheech Marin and Tommy Chong that made drug use a central part of their act in the late 1970s. “I see patients who have loss of appetite, nausea from chemotherapy, pain, depression, anxiety, insomnia, and I know I have one medicine I can recommend that takes care of all these symptoms.

“I hope this makes more patients ask their providers about marijuana,” said Abrams, who added that today he will be leading grand rounds entitled “Marijuana: Is it Medicine Yet?”

Waive Penalties

The Philadelphia-based College of Physicians, with 124,000 members, said in February 2008 that criminal penalties should be waived for doctors who prescribe marijuana and their patients.

Marijuana has been used for centuries as a medicine, and was marketed by companies such as Eli Lilly & Co. before the drug became illegal, according to the physician group.

Marijuana wasn’t sold as a prescription medicine. Rather, it was sold as an herbal extract, said Judy K. Moore, a Lilly spokeswoman. The Indianapolis, Indiana-based company deleted it from their price list in 1915, she said.

The drug is thought to work by attaching to areas in the brain called cannabinoid receptors. The active ingredient, tetrahydrocannabinol or THC, has been proven to be a pain reliever in animal studies. In humans, it has been shown in studies to reduce pain from nerve damage in AIDS patients.

A non-smoked form of THC called Marinol, marketed by Solvay Pharmaceuticals, of Brussels, is used to curb nausea.

Research Source

The science is difficult to define in part because the only legal source of marijuana for research in the U.S. is the Bethesda, Marilyn-based National Institute on Drug Abuse, said Abrams, who is also a professor of medicine at the University of California, San Francisco.

“It’s been difficult to generate evidence because NIDA only wants to provide it as a subject of research for abuse, not for treatment,” Abrams said. “There isn’t evidence because we don’t have the resources to generate it.”

Chronic use of marijuana may lead to lung damage, pneumonia, and poor pregnancy outcomes, according to the 2008 College of Physicians report. Smoking is generally unsafe, and the group doesn’t support the long-term use of smoked marijuana, the ACP said.

The National Drug Control Policy office in 1997 asked the Institute of Medicine, an independent scientific research group, to review evidence on the risks and benefits of marijuana. The drug has therapeutic properties for many ailments, the study concluded.

‘Not a Priority’

Yesterday’s Obama administration guidelines don’t legalize marijuana, said Attorney General Eric Holder in a statement.

“It will not be a priority to use federal resources to prosecute patients with serious illnesses or their caregivers who are complying with state laws,” he said. “But we will not tolerate drug traffickers who hide behind claims of compliance with state law to mask activities that are clearly illegal.”

The Justice Department will continue to focus resources on “serious drug traffickers, while taking into account state and local laws,” Holder said.

The Bush administration didn’t target patients and instead went after larger operations that were selling marijuana for recreational use, said Tom Riley, who was the spokesman for the Bush Office of National Drug Control Policy, in a telephone interview yesterday. The Obama Justice Department announcement will make it easier for criminal operations that claim to be medical marijuana producers, he said.

‘A Green Light’

“By announcing it this way, I’m almost positive it’s going to be sending a green light to people that medical pot is legal,” Riley said. “A very significant portion of the medical pot business is a fraud.”

California is among the states that has established medicinal marijuana dispensaries through a permitting process in a manner similar to other businesses. The clinics provide easier access to the drug for those with a prescription. Patients such as Martinez who live elsewhere must grow the drug on their own or find other suppliers.

“The impact of the Department of Justice decision is really interesting,” said Jeffrey Miron, an economist at Harvard University in Cambridge, Massachusetts, who has studied drug law. “This effectively legalizes marijuana not just for medicinal purposes but for all purposes.”

Many prescriptions for marijuana are for “vague” conditions such as back pain and anxiety, he said in a telephone interview yesterday.

‘Willy-Nilly’ Prescriptions

“It just takes a few doctors to write prescriptions willy- nilly, and marijuana’s legal,” Miron said.

Legalizing marijuana would result in savings of $12.9 billion per year, according to a December 2008 report from Miron. Taxing marijuana at a rate comparable to alcohol and tobacco would add $6.7 billion in annual revenue.

The city of Oakland has begun taxing marijuana at a higher rate than other local businesses, said Barbara Killey, an assistant to the city administrator.

Businesses classified in the “cannabis” sector are taxed $18 for each $1,000 of gross receipts. Previously, they had been taxed like other businesses, at a rate of $1.20 per $1,000 of gross receipts. Almost 80 percent of Oakland voters voted in favor of the proposition.

“This was a way for them to be more accepted by the community, and the city has experienced dramatic tax shortfalls with the recession,” Killey said in a telephone interview. “They were trying to help us resolve the shortfall.”

Grows Her Own

Martinez, who struggles with chronic pain from degenerative disc and joint disease, grows her own marijuana because Oregon doesn’t have official dispensaries, she said. She also participates in a collective to give away cuttings and medicine.

“We struggle with access,” Martinez said. “The black market mostly controls the marijuana in the country, and we need to grab it away from him and use it for our own economy, and to make it a priority for patients.”

To contact the reporter on this story: Elizabeth Lopatto in New York at elopatto@bloomberg.net.

Last Updated: October 20, 2009 00:00 EDT