Subject: Sometimes Marijuana Is the Best Medicine Date: Published: 1/28/93 (119 lines) Source: Wall Street Journal. Copyright Dow Jones & Co. Inc. Counterpoint: Sometimes Marijuana Is the Best Medicine ---- By Doug Bandow Advances in medical research and technology have allowed doctors to increasingly extend the lives of many terminally ill patients and ultimately save others. Unfortunately, there is often little that doctors can do to preserve the quality of their patients' lives. What has proved to be of value to some of the very ill, however, is marijuana. Before she died in early 1991, Barbara Jenks, desperately sick not only from AIDS but also from heavy doses of AZT to combat AIDS, explained that "I've got to smoke marijuana. I've got to, or I'll die." But the Bush administration terminated the program under which Ms. Jenks, her husband, Kenneth, a hemophiliac who contracted AIDS from a blood transfusion, and roughly a dozen other patients acquired marijuana legally through the federal government. Although the Public Health Service is continuing to supply current recipients, no new patients are being accepted. Explained Bill Grigg, a Public Health Service spokesman, the government was afraid that marijuana might sicken the dying, proving to "be harmful to people with compromised immune systems." The agency's decision was bizarre. In June 1991, Public Health Service head James Mason, a political appointee, announced that he was going to review the government's policy of providing marijuana to people suffering from AIDS, cancer, glaucoma and other illnesses. After concluding that "existing evidence does not support recommending smoked marijuana as a treatment of choice," explained Mr. Grigg, Dr. Mason canceled the program. The agency's decision, which should be reversed by President Clinton, left out in the cold the 28 patients whose applications had already been approved by the Food and Drug Administration. The Public Health Service said not to worry: It would provide Marinol, a synthetic form of marijuana's active component. However, many users report that Marinol is inferior to marijuana -- being less effective, having more side-effects, and failing to stimulate the appetite, a particularly important benefit for AIDS sufferers. The Public Health Service is "giving me a death sentence," complained Tim Braun, a 44-year-old AIDS patient whose application had been approved by the FDA. Mr. Braun, who died in May, said that when he found marijuana unavailable, his weight dropped by one-third in a single month. While the Public Health Service provided a pile of "fact sheets" to back up its decision, it did not dispute marijuana's benefits for many patients. Instead, the agency complained that, for instance, marijuana's effectiveness varies by patient in controlling cancer-chemotherapy-induced nausea and vomiting and that the drug causes side-effects in glaucoma patients. As for pain control, the Public Health Service even admitted that "there may well be some patients for whom marijuana is a moderately effective pain reliever when no other treatment is of benefit, but this has not been rigorously studied." One wonders: Why didn't the government conduct such research before cutting off desperate patients? In short, it appears that the Public Health Service made a political rather than a medical judgment, one predetermined before the review even started. For Dr. Mason had previously complained, "If it's perceived that the Public Health Service is going around giving marijuana to folks, there would be a perception that this stuff can't be so bad." But there is an obvious difference between someone smoking a joint to get high and using marijuana under the guidance of a doctor to relieve suffering from a serious illness. The public obviously sees the distinction: In 1991 San Francisco's electorate and Massachusetts' Legislature approved measures allowing doctors to prescribe marijuana for those who are seriously ill. While the latter two laws have little effect, since only the federal government now provides the drug legally, more significant is legislation passed in 1992 by Maine's Legislature. The measure, ultimately vetoed by the governor, would have exempted from prosecution those cultivating marijuana for medical use -- effectively legalizing the drug for this purpose. Even Herbert Kleber of the Bush administration's drug policy office called the Public Health Service's marijuana program a "compassionate" option for the sick. Moreover, the medical profession sees an important treatment role for marijuana. More than 70% of cancer specialists in a recent Harvard University survey stated that they would prescribe marijuana if it were available legally; nearly half said that they have advised patients to break the law, if necessary, to obtain the drug. And break it many do. Joe Hutchins, who suffers from a rare skin disease, is facing prison in Massachusetts after having exhausted his appeal of a 1984 marijuana conviction. The Jenkses, too, were prosecuted for growing their own marijuana before they were admitted into the now discontinued federal program. The point is not that marijuana should be the preferred treatment for every patient. Rather, a physician and his or her patient should be able to choose marijuana if it is the best medicine in that case. The best solution would be for the Drug Enforcement Administration to stop classifying marijuana as a Schedule I drug, which makes it unavailable even for medical use. In 1989 a DEA administrative law judge declared the DEA's stance to be "unreasonable, arbitrary and capricious," but, despite several challenges in federal court, the agency has so far refused to reconsider its position. Unfortunately, a Clinton spokesman says that the president, perhaps afraid to address the issue because of criticism over his student marijuana supports current law. He could nevertheless direct the Public Health Service to provide marijuana when prescribed by a doctor for a seriously ill patient. In fact, Mr. Clinton's nominee for surgeon general, Joycelyn Elders, says that the drug "should be available" in such cases. By allowing the medical use of marijuana, the government would simultaneously help those with a fighting chance to survive and ease the pain of those who are dying. What better opportunity could there be for the new president to demonstrate his commitment to change than to stop treating AIDS and cancer patients as the enemy? --- Mr. Bandow is a Cato Institute fellow and a former special assistant to President Reagan. [This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.]