'PROGRESS' IN A GLACIAL DEBATE

In addition to DEA Administrative Judge Mary Ellen Bittner's
non-binding recommendation that Professor Lyle Craker be allowed to
grow cannabis for research purposes ( see
http://www.doctortom.org/archives/2007/02/a_little_known.html ), a
second cannabis-related medical milestone was reached this week: a
paper from the University of California Medical School in San
Francisco reporting that inhaled cannabis significantly reduced
AIDS-related neuropathic pain in a small, but carefully controlled
series of human subjects, was published in the peer-reviewed journal,
Neurology ( see http://www.aidsmeds.com/articles/1667_11275.shtml
). Of the two events, the latter seems more likely to have both
immediate and lasting impact on drug policy. There is also a decent
possibility that the almost simultaneous announcement of the two
events might have a synergistic effect by deterring Bittner's DEA
superiors from rejecting her recommendation as they would otherwise
be certain to do.

My optimism stems from the historical impact of an earlier peer
reviewed paper which 'officially' established a medical benefit from
cannabis that could not be easily dismissed (see
http://www.jco.org/cgi/content/abstract/9/7/1314). It's significant
that by the time Proposition 215 made it to the ballot in 1996,
federal rhetoric had shifted from the dogmatic assertion that, as a
schedule one drug, pot couldn't possible have 'medical utility' to
the significantly different position that other medications worked
'better,' and without the 'undesirable' (code for immoral) effects of
'crude' marijuana. It was also certainly more than coincidence that
Marinol, a semisynthetic form of THC, was developed for oral use by
Unimed during the protracted DEA hearings that led to Judge Francis
Young's famous opinion and then approved for schedule two the same year.

More recently, the rhetorical argument with which Barry McCaffrey,
following cues within the report itself, minimized the impact of the
1999 IOM report by stating that anything 'smoked' couldn't be
'medicine' ( see
http://www.fda.gov/bbs/topics/NEWS/2006/NEW01362.html ), was adopted
by the FDA this past year as the main reason it would never be
approved for therapeutic use. Just coincidentally, vaporization, the
technic that the cannabis Professor Craker hopes to grow would be
used to study, is of interest primarily because it would obviate most
of the theoretical danger from inhaling the products of plant
combustion, a danger recent studies have unexpectedly failed to
confirm ( see
http://www.canorml.org/healthfacts/tashkinlungcancer.html ). Thus is
the glacial progress of the arcane, largely rhetorical, and
completely dishonest 'debate' that's been raging between the feds and
reform since 'medical use' was first raised as an issue in the early
Eighties. Sadly, that debate has been neither understood nor
accurately reported by the media and what my own experience
underscores is the enormous advantage the government has always
enjoyed from being able to use the criminal code to place millions of
self-medicating humans off limits for clinical research.

Of course, the insistence by most lobbyists for medical use that it's
only valid for the 'seriously' ill, and that their lifetime use has
been strictly 'recreational' hasn't helped to either clarify a murky
situation or advance their cause. Quite the opposite; it has tended
to validate the exaggerated Cheech and Chong image of the
Seventies. In that way, opinionated reformers have been more than a
little like the Congressional Democrats who painted themselves into a
corner by voting for a feckless war in Iraq.

Incidentally, neuropathic pain is a well known, but poorly
understood, medical problem which also tends to be undertreated; the
fact that cannabis can do so effectively wasn't news to me because
I'd been enlightened by several patients seeking recommendations;
unfortunately, that still isn't 'official,' because it has yet to be
published in a peer reviewed journal.

But I'm working on it...