'There Is Value in This Drug'

DEBATE CONTINUES WHETHER RISKS OF MEDICAL MARIJUANA OUTWEIGH THE BENEFITS

KALAMAZOO -- The chief medical officer of Kalamazoo County might use
marijuana to alleviate the pain of his glaucoma -- if it were legal.

In 2000, Richard Tooker, 54, was diagnosed with pigmentary glaucoma,
a rare eye disease where fluid buildup inside the eye can lead to
intense pain. Blindness is also possible.

"I would consider taking it, if it were legal, for medical use," he
said. "I want to keep my vision."

Studies have shown marijuana can lessen pressure in the eyes of those
with glaucoma.

Tooker said he would have to consult with legal counsel before he
used the drug. That's because, even if Michigan voters in November
decide to allow medical marijuana use by seriously ill patients, it
still would be illegal under federal law.

Users of medical marijuana, as well as others who support its use,
say the drug offers relief to those suffering debilitating
conditions. They also say it would be cheaper than buying the drug
off the street and that use and production can be controlled if
properly regulated.

But questions remain.

How would the appropriate dose be established for those who are
deemed eligible users? Are there possible negative health effects
from using the drug for medical reasons? Do alternatives to medical
marijuana already exist?

"On the balance, it's a good thing," Tooker said of medical
marijuana. "And if we're going to legalize marijuana for medical use
in Michigan, let's legalize it across the country. It's a dicey,
difficult issue."

State Sen. Tom George, R-Texas Township, worked for Hospice of
Greater Kalamazoo and sometimes prescribed a synthetic -- and legal
- -- form of marijuana called Marinol.

But the drug is not cheap.

Ninety Marinol pills at the middle dosage strength of 5 milligrams
cost $1,140 at www.drugstore.com, an online pharmacy. The amount and
strength of Marinol taken by a patient depends on their needs. The
average cost of an ounce of marijuana on the street is between $125
and $150, said Joseph Taylor, commander of the Kalamazoo Valley
Enforcement Team, which targets illegal drug use in Kalamazoo County.

Smoking Risks

George, an anesthesiologist, opposes the ballot initiative because of
the availability of Marinol and the possible health risks of medical marijuana.

"Marinol is better than smokeable marijuana because Marinol does not
contain the additional chemicals, impurities and hazards associated
with smoke," George said in a statement this month to the Senate.
"Also, the resulting THC (tetrahydrocannabinol) blood levels and
hence, the effects, are more predictable with Marinol than smokeable
marijuana."

George said other drugs being developed would include THC, the main
active component of marijuana. One drug is called Sativex, which if
approved by the U.S. Food and Drug Administration, could be used as a
treatment for patients with advanced cancers.

Approved in November by the FDA for clinical testing, the drug would
be administered as an oral spray.

"I'm telling you, as a former hospice physician, it is of no benefit
to legalize smokeable marijuana," George said.

The FDA agrees.

"There are alternative FDA-approved medications in existence for
treatment of many of the proposed uses of smoked marijuana," the
agency said in a statement in 2006.

But Marinol, available since 1986, has its problems, said Ruth Hoppe,
head of the Michigan chapter of the American College of Physicians,
the nation's second largest physicians group.

Marinol is absorbed slowly into the body, she said, and a patient
experiencing extreme nausea might not be able to use it because the
pill must be swallowed to be effective.

"We need to look at other routes of delivery," Hoppe said.

Potential for Abuse?

Smoking anything is harmful to one's health, Hoppe said. But that
doesn't mean marijuana doesn't have its place as a legitimate medical
treatment or supplement to other medications.

The American College of Physicians recently released a position paper
on medical marijuana. It concluded that, although more research needs
to be done, "reports suggest numerous potential medical uses for marijuana."

"For patients with AIDS or those undergoing chemotherapy, who suffer
severe pain, nausea and appetite loss, cannabinoid drugs may provide
symptom relief not found in any other medication," the position paper said.

The federal government, however, puts marijuana in the same class as
LSD, heroin, mescaline, psychedelic mushrooms and ecstasy.

"Marijuana has a high potential for abuse, has no currently accepted
medical use in treatment in the United States, and has a lack of
accepted safety for use under medical supervision," the 2006 FDA report said.

The government's classification of marijuana hinders study of the
drug for medical use, Hoppe said. The American College of Physicians
is recommending reclassifying the drug to allow for more study.

"I can see a day when marijuana is seen as a legitimate medical
treatment, especially in conjunction with other medications," Hoppe
said. "There is value in this drug."

'Trial and Error' Doses

Marinol comes in doses of 2.5 milligrams, 5 milligrams and 10
milligrams. Determining the proper dose of marijuana from plants is
less scientific because it can be smoked, drunk, eaten or inhaled
through a vaporizer.

Tooker, who is open to the medical uses for marijuana, said he
opposes smoking it. He said "trial and error" would be the only way
to determine what the appropriate dose of marijuana would be for a patient.

Dianne Byrum, a former state legislator and spokeswoman for the
Michigan Coalition for Compassionate Care, said the dose level would
depend on the patient's needs and symptoms.

"This would be a recommendation, not a prescription," she said.

She also said smoking marijuana would not be harmful, especially for
patients with terminal conditions.

Drug of Choice

For about 40 years, Eva Myrick, 62, has had multiple sclerosis, a
disease that sometimes has made it difficult for her to speak, see and walk.

Shortly after her diagnosis, she used marijuana to ease her symptoms.

"It makes it so you can live with what you've got," she said. "It's
like a cushion."

Myrick, of Kalamazoo, takes four other prescription drugs, many of
which have side effects like constipation. Marijuana, she said, would
help make the side effects more tolerable.

"If marijuana was legal (for medical use), I'd definitely try to get
rid of some of my pills," she said.

Myrick said her husband, Bruce, also used marijuana prior to dying of
cancer in 1997.

"Now it's a risk to try to find it," she said. "I don't (understand)
it, though, because we're not hurting anybody."