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Mainers
for Medical Rights
44 Exchange Street
Suite 201
Portland, ME 04101
800.846.1039
207.780.0704
info@mainers.org
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March 18, 1999 |
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| Government
Study of Marijuana Sees Medical Benefits |
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By
SHERYL GAY STOLBERG
The active ingredients in marijuana appear to be useful for treating pain, nausea
and the severe weight loss associated with AIDS, according to a new study commissioned
by the Government that is inflaming the contentious debate over whether doctors
should be permitted to prescribe the drug.
The report, the most comprehensive analysis to date of the medical literature
about marijuana, said there was no evidence that giving the drug to sick people
would increase illicit use in the general population. Nor is marijuana a ''gateway
drug'' that prompts patients to use harder drugs like cocaine and heroin, the
study said.
The authors of the study, a panel of 11 independent experts at the Institute of
Medicine, a branch of the National Academy of Sciences, cautioned that the benefits
of smoking marijuana were limited because the smoke itself was so toxic. Yet at
the same time, they recommended that the drug be given, on a short-term basis
under close supervision, to patients who did not respond to other therapies.
The release of the delicately worded report, at a morning news conference here,
prompted a flurry of political maneuvering. Proponents of state initiatives to
legalize marijuana for medical purposes seized upon the findings as long-awaited
evidence that it had therapeutic value. They called on the Clinton Administration,
and in particular Gen. Barry R. McCaffrey, director of the Office of National
Drug Control Policy, which requested the study, to ease its steadfast opposition
to the initiatives.
''This report has proved McCaffrey wrong,'' said Chuck Thomas, a spokesman for
the Marijuana Policy Project, a nonprofit organization in Washington that lobbies
for the legalization of medical marijuana. ''We never said marijuana was a panacea
and a be-all or end-all. What we have said is there are some patients who don't
respond to existing medications, and this report confirms that.''
But the study is unlikely to change the Administration's position. The Department
of Health and Human Services, which is already financing some research involving
medical marijuana, issued a written statement noting simply that it would continue
to finance the work. And General McCaffrey, speaking in a telephone interview
from Los Angeles, said, ''This study seems to suggest that there is little future
in smoked marijuana.''
General McCaffrey politely praised the analysis as a ''superb piece of work''
and said he would take the recommendations under advisement. But he said there
was ''enormous confusion in law enforcement'' about how to handle the issue, and
added, ''We've got people with mischievous agendas at work.''
While the study's authors said they had been surprised to discover ''an explosion
of new scientific knowledge about how the active components of marijuana affect
the body,'' they added pointedly that the future of marijuana as a medicine did
not lie in smoking it. Marijuana smoke, they said, is even more toxic than tobacco
smoke, and can cause cancer, lung damage and complications during pregnancy.
The true benefits of marijuana, the experts said, would only be realized when
alternative methods, like capsules, patches and bronchial inhalers, were developed
to deliver its active components, called cannabinoids, to the body without the
harmful effects of smoke.
So far there is only one cannabinoid-based drug on the market, Marinol, manufactured
by Unimed of Somerville, N.J. It comes in pill form and was approved in May 1985
by the Food and Drug Administration for nausea and vomiting associated with chemotherapy,
as well as for anorexia and weight loss associated with AIDS. Some patients have
complained that Marinol is more expensive than marijuana and that they do not
feel its effects as quickly.
The researchers recommended that the Government pay for research that would speed
the development of more cannabinoid drugs, and were particularly keen on the promise
of inhalers. But, recognizing that such methods might take years to perfect, they
also recommended that people who did not respond to other therapy be permitted
to smoke marijuana in the interim.
''Marijuana should only be smoked in circumstances where the long-term risks are
not of great concern, such as for terminally ill patients or those with debilitating
symptoms that do not respond to approved medications,'' said Dr. John A. Benson
Jr., former dean of the Oregon Health Sciences University School of Medicine and
one of the study's two lead authors. ''Even in these cases, smoking should be
limited to carefully controlled situations.''
Dr. Benson and his co-author, Dr. Stanley J. Watson Jr. of the Mental Health Research
Institute of the University of Michigan, announced their findings in a wood-paneled
lecture hall at the Institute of Medicine here. As the two scientists spoke, a
handful of people sat quietly in the audience, wearing fire-engine red T-shirts
with white block lettering that blared: ''Medical Marijuana Patient.''
Among them was Jim Hardin, a 48-year-old Virginia man who testified before the
panel and whose story was among several personal anecdotes included in the report.
Mr. Hardin suffers from Hepatitis C, a disease that is destroying his liver, and
uses a wheelchair. He said smoking marijuana helped him cope with the intense
nausea and rapid weight loss the disease has caused.
''I lost 95 pounds,'' Mr. Hardin said. ''I tried everything: 35 different pills.
Finally, doctors told me to go to Europe and try marijuana.'' He did just that,
in November 1997, visiting the Netherlands, where a doctor prescribed one to two
grams of marijuana per day. Here in the United States, Mr. Hardin said, he obtains
the drug ''from a network of care providers that are willing to grow a safe and
clean cannabis.''
Also in the audience was Joyce Nalepka of America Cares, a parents' anti-drug
group based in Maryland that has been critical of efforts to legalize marijuana
for medical use.
''I'm concerned about the message we are sending,'' Ms. Nalepka said. ''Kids interpret
things differently than adults. What they're going to hear is, 'Marijuana is good
for something.'''
The report contained some surprising findings. It concluded that, despite popular
belief, marijuana was not useful in treating glaucoma. While the drug can reduce
some of the eye pressure associated with glaucoma, the effects were short-lived,
the report found, and did not outweigh the long-term hazards of using the drug.
In addition, the study found that there was little evidence for marijuana's potential
in treating movement disorders like Parkinson's disease or Huntington's disease,
but that it was effective in combating the muscle spasms associated with multiple
sclerosis.
So far, voters in seven states -- California, Alaska, Arizona, Colorado, Nevada,
Oregon and Washington -- have approved initiatives intended to make marijuana
legal for medical purposes. But doctors are often afraid to write prescriptions
because the Federal Government has threatened to prosecute them, and patients
often have difficulty obtaining the drug, in part because the Government has moved
to shut the marijuana buyers' clubs that had been distributing it. In the District
of Columbia, meanwhile, the November ballot contained a proposal to legalize medical
marijuana, but Congress intervened and prevented the vote from being counted.
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