Is Smoking Pot Good Medicine?by Richard C. Paddock
Cannabis has been used to treat pain and other ailments for at least 5,000 years, from ancient China to Victorian England. In this country, it was a battlefield painkiller during the Civil War and was added to patent medicines until the turn of the century. But whether marijuana is a safe and effective drug by modern American standards is the subject of growing debate in the medical community. Advocates cite anecdotal evidence that the plant can reduce nausea from chemotherapy, reverse the wasting syndrome associated with AIDS and ease muscle spasms in paralyzed people, among other things. In one survey by Harvard University researchers, more than 40% of cancer specialists questioned said they have advised chemotherapy patients to smoke marijuana. But other doctors and federal health officials say there is insufficient evidence to prove that hemp is beneficial; some suggest that smoking it could be harmful, particularly for AIDS patients vulnerable to lung ailments. Because of the controversy, the government has been slow to permit studies of its effects. "They can't approve medical use of marijuana because there isn't enough research, but then they aren't permitting the research," complained Rick Doblin, executive director of the Multidisciplinary Association for Psychedelic Studies in North Carolina. For nearly three years, respected AIDS researcher Donald Abrams of University of California San Francisco has sought federal approval to conduct a rigorous clinical trial to determine whether smoking marijuana can help patients overcome the deadly AIDS wasting syndrome. But amid opposition from the federal Drug Enforcement Administration and fears that approval of the study would undermine anti-drug efforts, the Food and Drug Administration has refused to authorize the research.
Despite the government's reluctance, it has been forced over the years to acknowledge that some individuals have a legitimate medical need for the drug. The use of marijuana is even more restricted than narcotics such as morphine, codeine and cocaine, which can be prescribed or administered by physicians for specific purposes. DEA spokesman Mike Heald said marijuana is strictly controlled because the public does not believe that smoking it is proper behavior. He said marijuana, like alcohol and tobacco, is a "gateway" substance that leads to the use of hard drugs such as heroin, cocaine and LSD - a contention disputed by marijuana advocates. Attacking the medicinal marijuana movement, the DEA spokesman also contended that efforts to make hemp available to patients are a smokescreen for the campaign to legalize cannabis. Heald said the DEA is not stalling medicinal marijuana research but rather is insisting on a high standard of research and limited access to the drug. Rayford Kytle, a spokesman for the Public Health Service, which oversees the FDA, said his agency is aware of the strong interest in using marijuana legally among some sick people. But he said, "we have to work with the DEA, and there are just a lot of problems that need to be worked out." Despite claims of beneficial effects, Kytle said, federal health officials doubt that its value exceeds its dangers, including potential damage from inhaling the smoke.
Once a common remedy, marijuana declined in use medicinally after 1900 with the advent of aspirin and barbiturates. When the federal government imposed a heavy tax on marijuana in 1937, doctors abandoned it. By 1941, it disappeared from the nation's pharmacopoeia. Now, marijuana must meet new drug standards to be accepted as a legitimate medicine. That means its effectiveness for specific ailments must be proved through controlled studies - a difficult proposition when test subjects can easily tell whether they are smoking a placebo. No one knows how cannabis acts on the body, how it eases pain or produces a high. Even research may not tell them - just as science cannot explain how long-used drugs such as digitalis and aspirin work. Federal health experts maintain that a variety of drugs can provide the same relief attributed to marijuana, including the synthetic form of pot's main active ingredient, THC, which is sold under the trade name Marinol. But many patients who have tried both say Marinol does not work as well. Swallowing a pill, they argue, is not an effective way to treat nausea. And, they say, smoking marijuana gives them immediate relief and they can better control consumption. Some advocates believe that the plant has not been approved as a medicine because no firm is likely to make much money on it. Typically, pharmaceutical companies spend $200 million or more to develop a drug and win FDA approval, then receive 17-year patent rights that allow them to recoup their investment and make a profit, said Lester Grinspoon, a Harvard professor of psychiatry and co-author of the 1993 book Marihuana, the Forbidden Medicine. But because marijuana is a plant, Grinspoon said, there can be no patent - and no big profit. Moreover, legal medicinal marijuana would be very cheap to produce, costing pennies per dose, and could cut into revenues from competing drugs.
Grinspoon argues that marijuana should be legally available to any patient who can benefit from it. In his book, Grinspoon cites the case of Harvard geology professor Stephen Jay Gould, who underwent chemotherapy for cancer. Gould disliked the marijuana high but found that the herb prevented nausea and improved his attitude.
In San Francisco, the Cannabis Buyers' Club - just a mile up Market Street from City Hall - has become an oasis for medicinal users. Since it opened in 1991, more than 3,000 people bearing notes from their doctors have flocked to the second-story speak-easy and joined the club. Hidden behind an unmarked door on the edge of the Castro district, the club is reminiscent of the 1960s, with its muted psychedelic decor and eclectic furnishings. Customers range in age from 18 to 75 and represent all races. At the Buyers' Club, members swear by its beneficial effects.
Hazel, who began searching for marijuana when she was diagnosed with glaucoma, volunteers at the club. The 75-year-old said she was referred there by county Supervisor Angela Alioto, whose late husband smoked marijuana when he was dying of cancer.
Another volunteer is "Brownie Mary" Rathbun, who became a Bay Area celebrity after she was arrested on suspicion of making marijuana brownies for AIDS patients. The charges were later dropped.
At the height of her baking operation, Rathun said, there were so many sick people asking for brownies she had to pull names from a cookie jar. "My kids are dying, some of them in the streets," she said, starting to cry. "Why marijuana is not allowed is something I will never, never understand." Richard C. Paddock is a staff writer for the Los Angeles Times. Condensed and reprinted with permission from Los Angeles Times, Sunday, February 26, 1995. ©1995 The Times Mirror Company.
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