MARINOL VS. MARIJUANA

John Flynn's May 22 letter criticizing J.R. Labbe for advocating legalizing
marijuana use for medical purposes was based on a common misunderstanding
of the value of smoked marijuana vs. synthetic Marinol.

First of all, the authors of the report issued by the National Academy of
Sciences (via the Institute of Medicine) specifically said: "We acknowledge
that there is no clear alternative for people suffering from chronic
conditions that might be relieved by smoking marijuana such as pain or AIDS
wasting."

Some of the reasons why smoking is often better:

At the simplest level, patients say it works when the pill doesn't. This is
not surprising, since a synthetic of one ingredient (THC) of 60 or so is a
bit like making a stew of synthetic meat with no onions, carrots, potatoes,
salt, pepper, etc., and expecting it to taste the same as the real thing.

The pill is concentrated and often too strong for users, producing unwanted
side effects. Smoking allows "titration" - the user controls the dose
according to need. Moreover, the response to smoke is rapid as opposed to
the long delay in pill form.

Quelling nausea is a common use, and a pill is often vomited.

Marinol is very expensive, a boon to pharmaceutical companies' profits but
a plague on patients' pocketbooks.

Doctors are not going to jeopardize their careers by giving false
certification of need. And it is not the Food and Drug Administration that
is now in charge of marijuana's medical use, but the Drug Enforcement
Administration - a police group - via foolish legislation.

Jerry Epstein, president Drug Policy Forum of Texas