I-692: MEDICAL MARIJUANA - AGENT OF TERROR OR COMPASSION?

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."

Checked-by: Patrick Henry