I-692: Medical Marijuana - Agent Of Terror Or Compassion
by Lorraine Marie

October 29, 1998 - Statesman - Examiner - ccowbroughse@plix.com

Drugs like morphine are legal for pain relief, and medical marijuana will also become an option someday if voters pass Initiative 692 this November.

The initiative allows' physicians to advise patients about using medical marijuana for terminal or debilitating conditions.

Those opposing I-692 claim marijuana is addictive, lacks medical research, and therefore is not a compassionate way to address pain. They also say that an American Medical Association report finds marijuana to have "very limited or no effectiveness" in treating ailments related to chemotherapy, multiple sclerosis, AIDS, glaucoma or other afflictions.

That stance, according to November Coalition Director Nora Callahan, of Colville, has a number of problems. The Coalition is a fast-growing national organization engaged in educating the public about drug policy reform.

As a Coalition speaker who tours the United States, Callahan has met with people who have effectively used marijuana for things like the reduction of AIDS symptoms, and she says it is "already known" that marijuana can be and has been used for glaucoma, epilepsy, MS and a variety of ailments, and was also used back in Colonial Times.

"We are now learning that medical marijuana may even be beneficial for stroke patients," Callahan says.

She has found it instructive to `trace how marijuana developed a "bad boy' image. Industrial hemp (for clothing and paper) was grown by Colonists and through WWII. After WWII, on the heels of the "Hemp for Victory" campaign, the paper and cotton industries felt threatened. With media influence (a major owner and purchaser of paper) Callahan says a "Reefer Madness" documentary portrayed marijuana as more dangerous than heroin.

'The Congressional hearings that outlawed marijuana used no testimony from experts," Callahan points out. More recently, she adds, the government has not allowed any significant funding to determine finally just how addictive marijuana is, or whether addiction is related more to an individual's addictive tendencies.

Political hesitancy appears to be declining. Callahan says numerous organizations now endorse medical access to marijuana, including the American Academy of Family Physicians, the American Society of Addiction Medicine, Kaiser Permanente, The New England Journal of Medicine, the American Bar Assoc. and the British Medical Assoc.

As well, The Drug Enforcement Administration's Chief Administrative Law Judge, Francis L. Young, made a significant ruling in 1988 that Callahan offers: "Marijuana, in its natural form, is one of the safest therapeutically active substances known...It would be unreasonable, arbitrary and capricious for the DEA to continue to stand between those sufferers and the benefits of this substance."

Since 1978 Callahan says 35 states passed legislation admitting marijuana's health value, and over 90 published reports and studies show that "marijuana has medical efficacy." "Research rats don't suffer withdrawal from marijuana and don't go back for more like they do with cocaine or heroin," she has learned. "It appears that the main worry of 692 opponents is that legalization will come next. But we've legalized morphine for medical use, and that has not triggered instant addiction for those who have used it medicinally, such as to relieve the agonizing pain that accompanies cancer treatment." Opponents of medical marijuana say it is hazardous in the way tobacco is, since it can be smoked. "Medical marijuana can be eaten for relief," Callahan says, "but for those who have a difficult time keeping food down, smoking is the preferred treatment."

"What I find disturbing is that Congress--with no medical background, and law enforcement, with none--is dictating to doctors what they think is best for patients. These people have no training compared to doctors' 12 years.

"We need compassion before politics."

There are already a wide variety of pain-relieving options on the market, negating the need for medical marijuana, 692 opponents argue. But, "what works for one person may not work for another," Callahan points out. "We need more options."

"It still angers me to think how my father was forced to suffer before he died of bladder cancer. He used to throw up his dentures. That mortified him. Medical marijuana would have eased his suffering considerably."

How would it be determined what dose would have been good for her father? Callahan says that is a decision that should he relegated to one's' doctor, not to lawmakers, and that is one reason why the initiative does not make a dosage recommendation.

Dr. Susan Garcia-Swain is a Seattle area specialist who has treated addictions for the last 15 years. She has a number of concerns about I-692, such as the effect on the immune system, and the hazards of the smoke.

Marijuana depresses the immune system, the doctor says, which should be strongly considered in patients, such as those with AIDS, who are experiencing compromised immune responses.

As to marijuana smoke, Garcia-Swain claims there are 500 to 600 chemicals in marijuana, and one joint is equivalent to three-fourths to one pack of cigarettes. The risk is further extended, she believes, since it is typical for marijuana smokers to hold the smoke "deeper and longer." Callahan disagrees with Garcia-Swain's statement, and says there have been no tar studies that support her.

A third concern for the West Coast doctor is marijuana's affect on the reproductive system. She says the sex organs have a tendency to atrophy with the use of marijuana.

In speaking to the addictiveness of marijuana, Dr. Garcia-Smith admits there is a lot of confusion. Unfortunately, she says, people have a misguided image of addiction as "you try it once and you arc hopelessly hooked." But in reality, she says, addiction has three phases: increased tolerance; an increased desire to use the substance, and continued use despite negative consequences. Another factor contributing to addictiveness is an individual's personality, she noted.

Her own health concerns aside, Dr. Garcia-Swain suggests that I-692 might have been better presented if it had been rewritten. For example, she said hashish oil (higher in THC) taken on the tongue may be more desirable and safer than smoking marijuana. She also believes it would be better to have dosages standardized for record-keeping purposes, which would aid in identifying abuse of the substance.

As the initiative stands, Dr. Garcia-Swain says doctors would be vulnerable to malpractice by saying marijuana can be used for pain relief, but, "you go find your own and be careful." In her own experience as a doctor, Garcia-Swain says she has had patients come to her with tales of using marijuana for pain relief, only to find the pain had worsened.

"Marijuana is a hallucinogen," she said. "How it affects a person depends on their personality. There are antidotes for heroin if difficulties arise when it is used for pain relief, but there are no antidotes for marijuana."

Callahan says that with the approval of I-692 critic's distribution and dosage concerns will become a moot point.

"The federal government will not allow the medical use of marijuana," she says. "But 692 will work toward making it pharmaceutically available, and we will see progress toward offering pain relief for those unable to find it in other drugs."

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