INITIATIVE A REACTION TO DRACONIAN LAWS

Doctors Should Be Able To Prescribe Marijuana

In two recent columns, Robert Landauer has tackled the issue of marijuana's
medical uses, and how public policy should react to evidence of its
benefits. Oregon voters are likely to face this issue this fall as a
result of the Oregon Medical Marijuana Act.

Landauer concludes that the scientific evidence to date is too weak or
unreliable for marijuana to become a prescription medication. He rightly
chides the federal government's knee-jerk anti-marijuana policies for
blocking research that could have solved the question before now.

Still, his position -- increasingly common among medical professionals as
well -- begs the question: What do we do with patients who benefit from
marijuana now, but must break the law to use it?

Our initiative asks voters to end the risk of state criminal penalties
faced by these seriously and terminally ill patients in a sensible,
regulated way, brokering a peace of sorts while science continues its
investigations.

To reach a do-nothing position, Landauer and others tend to rely on an
understatement of the knowledge that exists about marijuana's medical
value. Wait for more research, they argue. Many share Landauer's fear
that "personal anecdotes will dominate the public discussion" of this
year's ballot initiative.

In fact, there's more value to these much-derided "anecdotes" than he
implies, and there's more scientific support for marijuana's value than
most people know. Good clinical doctors seek anecdotal evidence from
patients to help with diagnosis and treatment. This is especially true when
managing problems such as nausea and pain, which are almost totally
subjective. In fact, it would be impossible to evaluate any anti-nausea or
anti-pain medicine without the use of important anecdotal evidence. And,
when thousands of patients come forward, all describing the same phenomena,
it is time to put politics aside and accept the obvious truth that some
patients benefit from the medical use of marijuana.

Scientific data collected in studies of marijuana in the 1970s and early
1980s are also stronger than most people realize. The American Medical
Association's Council on Scientific Affairs summarized those findings in a
December 1997 report that Landauer quoted mainly for its more ambivalent
passages about marijuana's value. The report states:

[Both survey and data derived from placebo-controlled single dose studies
indicate that smoked marijuana stimulates appetite in normal subjects.

Smoked marijuana was comparable to or more effective than oral THC . . . in
reducing nausea and emesis (vomiting).

Anecdotal, survey, and clinical data support the view that smoked marijuana
and oral THC provide symptomatic relief in some patients with spasticity
associated with multiple sclerosis (MS) or trauma.

Smoked marijuana may allow individual patients to self-titrate their dosage
to the point of therapeutic benefit, while minimizing undesirable
psychoactive effects. It also provides a method of more rapid onset and
offset than oral THC.

The existence of Marinol, an imperfect substitute, and a tangle of federal
regulations and political opposition all get in the way of proving,
finally, whether and how marijuana works for some kinds of patients.

Currently, marijuana is classified federally as a Schedule I drug, meaning
doctors cannot prescribe it, even to dying and suffering patients. It is
time that the federal government moved marijuana to Schedule II, both to
expedite research into its medical uses and to allow patients to have
access to marijuana under medical supervision, just like morphine.

In the end, the debate over medical marijuana is about dying and suffering
patients. It's about providing these patients with effective means to
control the disabling symptoms they often face with terminal or chronic
debilitating illnesses.

We say, let us hear from the patients. If marijuana helps them, then they
should have access to it, under strict regulations, such as those in the
Oregon Medical Marijuana Act.

-
Rick Bayer, MD Chief Petitioner, Oregon Medical Marijuana Act 6800 SW
Canyon Drive Portland, OR - 97225 503-292-1035 (voice) - 503-297-0754
(fax) - ricbayer@teleport.com (email)