Regular readers know my position on drug legalization. While I admit that I do push the edge with that position, I am most adamant on the medical marijuana issue. Arnold agrees, as does this National Review writer. Terminator on Pot

The flash point in the marijuana wars at the moment is the fight over the medical use of the drug. Schwarzenegger is in favor of legalizing it, as are most Californians. The state passed a ballot initiative permitting the medical use of marijuana with 55 percent of the vote in 1996. Eight other states have legalized it as well, creating friction with the feds, who don’t want grievously ill patients to get relief if it means taking the untoward expedient of lighting a joint.

Of course, if the congressmen who maintain the federal prohibition on medical marijuana had to put their heads in toilet bowls several times a day to vomit from the effects of chemotherapy, they might be less categorical in condemning what some patients do to relieve their nausea. But the federal government has never been famous for its common sense or flexibility, so the war against medical marijuana lumbers on, even in the states that have legalized it.

Since the feds systematically suppress attempts to study the potential medical benefits of marijuana, the most important datum in the debate is simply this: Some patients say smoking marijuana is the best way that they can get relief from the nausea associated with chemotherapy and the wasting illness associated with HIV/AIDS. Smoking the drug works better for some patients than Marinol pills, which contain pure THC and have more side effects.

The New England Journal of Medicine has advocated the legalization of medical marijuana. In May, the journal Lancet Neurology reported that marijuana’s active components alleviate pain in almost every lab test, and called it potentially “the aspirin of the 21st century.” Earlier this year, the New York State Association of County Health Officials came out in favor of medical marijuana.

The ill health effects of marijuana come from inhaling the smoke into the lungs. This isn’t a problem if the use is only short-term, or if the user has a terminal disease. Consumer Reports (no less) writes “that for patients with advanced AIDS and terminal cancer, the apparent benefits some derive from smoking marijuana outweigh any substantiated or even suspected risks.”

Drug warriors worry that permitting medical marijuana “sends the wrong message” to teenagers. But the popularity of various drugs among youth moves in broad patterns that are not readily influenced by what federal “drug czar” John Walters says or does. And the fact is that ? God bless them ? cancer and AIDS patients aren’t glamorous, and are unlikely to prompt an epidemic of youth pot smoking.

Might medical marijuana be abused? Of course. That’s also true of a host of prescription drugs. But don’t tell Walters. Next he will be trying to deny patients the use of morphine and OxyContin.

What drug warriors really fear is that if medical marijuana is permitted, it will harm their effort to depict marijuana as utterly nefarious and create the opening for a more rational debate about the legal status of the drug. The drug warriors are already losing ground. The National Organization for the Reform of Marijuana Laws recently celebrated a vote in Congress that had 152 members voting to ease the federal crackdown on medical marijuana.

That’s progress, although the cause still needs a high-profile spokesman. If it happens to be a formerly swinging California bodybuilder who enjoyed the 1970s a little too much, so be it.

As a major advocate for palliative care, I worry that the governmental position (which has existed over several administrations) decrease the ability of some patients to achieve their best possible palliation. We have no compunction about prescribing high doses of morphine (or similar such drugs). In fact, we are appropriately criticized when we do not help these patients achieve adequate pain control Narcotics are drugs of abuse, but they are also drugs of palliation. We should all understand that medical marijuana fits in the same definition. We need brave politicians who understand this issue and champion doing the right thing. One can wish.

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