We are beginning to encounter and read numerous articles in our newspapers and journals concerning the legalization of marijuana for medical use and eventually "recreational use" in South Carolina. This issue can and will create division and confusion, as it has in other states.

"Medical use" marijuana is now legal in 20 states and the District of Columbia, and "recreational use" in Colorado and Washington State. The group attempting to coordinate the introduction of marijuana is called NORML (National Organization for the Reform of Marijuana). This group was founded in 1970 by Keith Stroup with a grant from the Playboy Foundation.

More recently, much of NORML's support has come from the Soros Foundation. This is the same foundation that has been heavily financing many liberal politicians in the country.

The unofficial use of marijuana for medical purposes has been around for years but any real benefit has been elusive. A number of our cancer patients tried marijuana for prevention of chemotherapy-induced nausea and vomiting without success.

Many of these patients mixed the THC in with their brownies since most did not smoke. The only end result was discouraging them from ever using brownies again.

One of the problems in the medical use of marijuana is the inability to determine dosage, what part of the plant should be used and the mode of introduction ( i.e., oral or inhaled). When smoked, it gets into the system faster, but ingesting gives one a double effect.

There is the initial effect of the drug itself, and then when THC is processed in the liver, an additional psychoactive effect is produced.

Therefore, it makes little sense to smoke marijuana when for "medical purposes," the ingested drug is more quantifiable and with possibly more added effect.

Regardless of any perceived or real medical benefit of marijuana, there are alternatives with equivalent or better efficacy profiles in our existing formularies.

There are numerous articles from the National Cancer Insitute and the American Cancer Society discussing the above issues and other studies, without any of the scrutinity of the average FDA-approved medications.

Marijuana is being governmentally approved for use because of a perceived public groundswell.

It's an interesting conundrum that states are legalizing its use so that they can tax the sale of marijuana.

This appears to be a conflict of interest and especially troublesome, given data that show marijuana to be a gateway drug.

The FDA needs to step forward and require states and possiby medical insitutions to do controlled studies to prove or disprove the potential medical benefits of marijuana.

Robert L. Fening, M.D.

Belted Kingfisher Road

Kiawah Island