Medical Marijuana? Don't Do It, D.C.

By Barry R. McCaffrey

Tuesday, September 9, 1997; Page A19
The Washington Post

As the recipient of Harvard University's Zinberg Award this past
spring, I reviewed what the late Dr. Norman Zinberg, a pioneer in
drugrelated research, had to say about illegal drugs some three
decades ago. Zinberg argued that "set and setting" which is to say
"text and context" are pretty much the whole show. To assess the
cultural meaning of alcohol or tobacco, for example, you have to
consider how it is used by whom. Wine, for instance, is different when
framed by a religious ritual in church than when drunk in the street
by a "wino" holding a bottle in a bag.

What has changed in drug use over the past 30 years is both set and
setting a younger set has adopted the habit, and children are using
a wide range of drugs in settings where they spend most of their time:
schools, playgrounds and cars. The new survey conducted by the
National Center on Addiction and Substance Abuse (CASA) indicates that
a halfmillion eighthgraders say they began using marijuana in the
sixth and seventh grades. If we picture the 22yearold coed of the
1960s smoking pot at a rock concert, her counterpart in the '90s is 12
years old and stoned during thirdperiod English.

The joke has been told: "If you remember the '60s, you probably
weren't there." Today's teens are missing their education or the turn
on Highway 95, not a political rally or jam session. The stakes have
changed along with the drugs. With marijuana being the second leading
cause of car crashes among young people (after alcohol) and with a
hundred thousand teenagers moving on to heroin, life itself is at risk
for American kids.

The context for today's drug abuse is homelessness and hopelessness.
With broken families becoming the rule rather than the exception, and
with communities racked by violent crime, too many youngsters no
longer have the proverbial kitchen table where parents can tell them
not to use drugs. Teen pregnancy, venereal disease, delinquency,
domestic abuse and rising school dropout rates are other features of
the setting in which illicit drugs are located. Many proponents of
legalizing drugs fail to notice the new terrain where polydrug use is
likely to include crack cocaine, dangerous hallucinogens, socalled
"designer" drugs, and potent chemicals with purity levels that promote
addiction. The shortlived flower children have been replaced by gangs
with guns. What may have begun with pleasureseeking ends up with
paincontrol.

Signatures are now being gathered in the District of Columbia for 1997
Initiative 57, the legalization of "medical marijuana." If
approximately 17,000 names can be collected (a figure determined by a
percentage of each ward) and submitted to the D.C. Board of Elections,
the petition will be put on the ballot, possibly this November. Were
this measure approved by a majority of voters, Washingtonians would be
able to grow, use, and distribute marijuana with a physician's
recommendation. (No written prescription is required.)

The loosely structured initiative, which allows up to four "friends"
to grow or otherwise provide marijuana for any "patient," would permit
residents of D.C. to organize and operate marijuana corporations
ostensibly for the sick. In Arizona, a similar marijuana ballot was
passed it also legalized LSD for medical purposes despite the
absence of any proven medical benefit only to be repealed by the
state legislature after careful consideration.

If pot is such a wonderful medicine, why haven't more doctors
prescribed Marinol, the real "medical marijuana"? The active
ingredient in the cannabis leaf, THC, is synthesized in measured
dosages as Marinol, a prescription drug that has been available for 15
years. The argument that this chemical needs to be smoked, exposing
patients to carcinogenic agents that damage the lungs, doesn't make
sense. No one argues that in place of penicillin capsules, people
should revert to moldy bread.

Crude marijuana, unlike Marinol, would evade the testing process of
the Federal Drug Administration that has made American medicine among
the safest in the world. The current scientific process for approving
medications, which entails peer review by researchers and physicians,
should not be supplanted by a nonmedical, political process. Advocates
of drug legalization admit that they have couched the question in
medical terms to camouflage the issue.

The latest research suggests that marijuana relies upon the same
mechanism of chemical reinforcement in the dopamine pathways that is
utilized by addictive drugs such as heroin and cocaine. By hijacking
the body's pleasure system, drugs produce counterfeit highs that
substitute for life's genuine rewards.

In the Netherlands, where marijuana technically has been legalized for
personal use, "medical marijuana" was prohibited by the Dutch minister
of health. Holland has no reason to distort the scientific process in
order to represent therapeutic applications for pot. In the United
States, a medical blanket has been thrown over marijuana, obscuring
debate. We should not accept a substance with minimal medical efficacy
and maximal psychotropic effects.

The setting for marijuana typically has been in classrooms, where it
interferes with learning; automobiles, where it interferes with
driving, and the workplace, where it interferes with productivity
not in hospitals contributing to healing. Our nation's capital has
been inundated by waves of drugs, as have other U.S. cities. D.C.
voters should say "yes" to themselves and to our country by voting
"no" on drugs.

The writer is director of the White House Office of National Drug
Control Policy.

_Copyright 1997 The Washington Post Company