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: Richard Lake