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This allows them to retain strength and makes them better able to fight  
the cancer.  Psychologically, patients who can continue to eat even while 
receiving chemotherapy maintain a balanced outlook and are better able to 
cope with their disease and its treatment, doctors have found. 
         12.  Synthetic anti-emetic agents have been in existence and 
utilized for a number of years.  Since about 1980 some new synthetic  
agents have been developed which appear to be more effective in  
controlling and reducing chemotherapy-induced nausea and vomiting than  
were some of those available in the 1970's.  But marijuana still is found  
more effective for this purpose in some people than any of the synthetic  
agents, even the newer ones. 
         13.  By the late 1970's in the Washington, D.C. area there was a 
growing recognition among health care professionals and the public that 
marijuana had therapeutic value in reducing the adverse effects of some 
chemotherapy treatments.  With this increasing public awareness came 
increasing pressure from patients on doctors for information about 
marijuana and its therapeutic uses.  Many patients moved into forms of 
unsupervised self-treatment.  While such self-treatment often proved very 
effective, it has certain hazards, ranging from arrest for purchase or  
use of an illegal drug to possibly serious medical complications from 
contaminated sources or adulterated materials.  Yet, some patients are 
willing to run these risks to obtain relief from the debilitating nausea 
and vomiting caused by their chemotherapy treatments. 
         14.  Every oncologist known to one Washington, D.C. practicing 
internist and board-certified oncologist has had patients who used 
marijuana with great success to prevent or diminish chemotherapy-induced 
nausea and vomiting.  Chemotherapy patients reporting directly to that 
Washington doctor that they 
                                  - 13 - 
have smoked marijuana medicinally vomit less and eat better than patients 
who do not smoke it.  By gaining control over their severe nausea and 
vomiting these patients undergo a change of mood and have a better mental 
outlook than patients who, using the standard anti-emetic drugs, are  
unable to gain such control. 
         15.  The vomiting induced by chemotherapeutic drugs may last up  
to four days following the chemotherapy treatment.  The vomiting can be 
intense, protracted and, in some instances, is unendurable.  The nausea 
which follows such vomiting is also deep and prolonged.  Nausea may  
prevent a patient from taking regular food or even much water for periods  
of weeks at a time. 
         16.  Nausea and vomiting of this severity degrades the quality  
of life for these patients, weakening them physically, and destroying the  
will to fight the cancer.  A desire to end the chemotherapy treatment in  
order to escape the emesis can supersede the will to live.  Thus the  
emesis, itself, can truly be considered a life-threatening consequence of  
many cancer treatments.  Doctors have known such cases to occur.  Doctors  
have known other cases where marijuana smoking has enabled the patient to 
endure, and thus continue, chemotherapy treatments with the result that  
the cancer has gone into remission and the patient has returned to a  
full, active satisfying life. 
         17.  In San Francisco chemotherapy patients were surreptitiously 
using marijuana to control emesis by the early 1970's.  By 1976 virtually 
every young cancer patient receiving chemotherapy at the University of 
California in San Francisco was using marijuana to control emesis with 
great success.  The use of marijuana for this purpose had become  
generally accepted by the patients and increasingly by their physicians  
as a valid and effective form of treatment.  This was particularly true  
for younger cancer patients, somewhat less common for 
                                  - 14 - 
older ones.  By 1979 about 25% to 30% of the patients seen by one San 
Francisco oncologist were using marijuana to control emesis, about 45 to 
50 patients per year.  Such percentages and numbers vary from city to  
city.  A doctor in Kansas City who sees about 150 to 200 new cancer  
patients per year found that over the 15 years 1972 to 1987 about 5% of  
the patients he saw, or a total of about 75, used marijuana medicinally. 
         18.  By 1987 marijuana no longer generated the intense interest  
in the world of oncology that it had previously, but it remains a viable  
tool, commonly employed, in the medical treatment of chemotherapy  
patients.  There has evolved an unwritten but accepted standard of  
treatment within the community of oncologists in the San Francisco,  
California area which readily accepts the use of marijuana. 
         19.  As of the Spring of 1987 in the San Francisco area,  
patients receiving chemotherapy commonly smoked marijuana in hospitals  
during their treatments.  This in-hospital use, which takes place in  
rooms behind closed doors, does not bother staff, is expected by  
physicians and welcomed by nurses who, instead of having to run back and  
forth with containers of vomit, can treat patients whose emesis is better  
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