DOCTORS DIVIDED ON MEDICAL POT

Opinions Vary On Marijuana As Treatment Option

EDITOR'S NOTE: This is the second in a two-part series regarding
pending legislation on the legalization of medical marijuana in Illinois.

Some medical professionals are at odds as to whether medical
marijuana would offer a viable treatment option for patients with
extreme pain and nausea.

Others say working with the drug would be more of a moral or comfort issue.

Doctors in oncology and infectious diseases have access to a drug
called Marinol, or synthetic THC, to help cancer and AIDS patients
with extreme pain and symptoms consistent with "wasting syndrome."

The THC, the psychoactive ingredient in marijuana, is meant to help
with pain and/or stimulate a patient's appetite and encourage weight
gain. Some doctors swear by it, and others say it's not always the answer.

"This (legislation) is critically important for the simple fact that
it gives options to people," said Dr. Eric Christoff, an internist
and HIV specialist in the Chicago area. "The point is, people will
have strikingly different reactions that are expected and not
expected with certain drugs."

Christoff did not travel to Springfield in person but submitted
written testimony supporting Senate Bill 1381, which is waiting to
come to a vote in the Illinois House.

He said he believes his peers in Northern Illinois generally would be
receptive to the legalization of marijuana for medical purposes,
although not all would be comfortable personally prescribing it.

Having heard from patients who have used marijuana on their own and
becoming familiar with the effects, Christoff said he wouldn't have a
problem looking to medical marijuana as an option for his patients.

"I actually prescribe Marinol quite a bit in my practice. Marinol is
usually used to stimulate appetite in some patients," he said. "It
works in some people. For the people it doesn't work for, it causes
nausea or can also make people sleepy, tired, sluggish, which can
also happen with marijuana."

Dr. Mark Woodson with Hematology-Oncology Consultants in Alton and
St. Louis agreed that expanded treatment options would be a plus.

"There are medications out there now to help with pain and nausea,
all which have potential side effects," Woodson said. "I've used
Marinol. I've seen mixed results. For select patients with careful
monitoring, (medical marijuana) could be quite beneficial in my
cancer patients."

In patients who marijuana helped and Marinol did not, Woodson said
inhalation of the drug may have played a part in feeling the effects faster.

Should medical marijuana become legal, Woodson said while the drug
would not be his first option, he would include it in a list of
options given to his patients.

A lot comes down to whether a physician feels comfortable prescribing
marijuana or whether a patient feels comfortable taking the drug, he said.

"A lot of elderly patients would probably be more reluctant, due to
the stigma of marijuana," he said. "I think, for the most part,
people are waiting to see what happens. I foresee that use in the
Alton area would be very small - oncologists, infectious disease specialists."

Dr. J. William Campbell, an infectious disease specialist at St.
Luke's Hospital in St. Louis who uses Marinol with HIV patients, said
the issue of medical marijuana legalization raises a number of
questions, including whether smoked marijuana actually is better than
what's available currently or whether patients who are seeing results
simply are taking more.

He expressed concerns that dosage amounts aren't as easily measured
as with drugs like Marinol. A prescribed form of THC (Marinol) allows
doctors to control how many milligrams a patient is ingesting,
whereas patients growing their own plants would not.

Dr. John Hoelscher, a board-certified addictionologist in Alton, is
opposed to legalization.

"I think it's a terrible idea," he said. "The supposed medical
benefits of marijuana are mainly glaucoma treatment and nausea
treatment. There are far better treatments for glaucoma and nausea
than marijuana. There's no reason to have to resort to marijuana."

Hoelscher stands firm that medical marijuana is not a needed drug. He
said there are stronger, well-regulated, dependable medications that
can be used to treat patients instead.

He also said marijuana inhalation is "not a predictable way of
getting medicine."

Hoelscher said that especially now, while marijuana is illegal, there
is no way of telling how much THC is in the leaves or whether the
marijuana is contaminated with other drugs.

Government regulation would decrease that chance, he said, but every
plant still is different, so dosage would be difficult to tell.

"It's medically absurd to think you can have a medical prescription
when you don't know what dose you're giving," he said.

As with other drugs, Hoeslcher said marijuana has its own negative
side effects.

"It's not technically addictive, but certainly, there are some people
that are habitual users," he said. "It has detrimental effects on
their psychological function in some cases."

Jamie Clayton, an AIDS patient from Grafton, has been supporting the
bill as a private citizen and as a patient who would be affected by
medical marijuana legalization.

Clayton, who has participated in FDA-approved studies and appeared in
a documentary on the subject entitled "Waiting to Inhale"
(www.waitingtoinhale.org), can see that while some patients would be
willing to try the drug to get some relief, others would have a
problem crossing their own moral boundaries.

"Everyone has their own opinion," he said.

Clayton stresses the importance of education on the matter and making
one's own decisions, rather than persuading people to think one way or another.

In previous interviews, he has expressed the importance of giving
options to patients such as himself.

"It may not be the magic bullet, (but) I would like to be able to use
cannabis," he said in a previous interview. "If it's out there, and
it's therapeutic, then I want to be able to include it in my therapy."

Both Clayton and state Sen. William Haine, D-Alton, the sponsor of SB
1381, are pleased with the bill's progress so far.

"Everybody's talking about it," Clayton said. "If we weren't hearing
about it, I would be afraid."

"It shows that Illinois is a civilized, compassionate and mature
state," Haine said.

Opponents are appalled.

"It appears that the medical marijuana bill is going to be run
through the House in an unusual manner," Judy Kreamer of Educating
Voices Inc. wrote in an e-mail to fellow opponents, asking them to
voice their displeasure to House members.

Kreamer wrote that a vote was expected on Sunday.

Should the bill become law, Illinois would join 13 other states that
have such measures in place.

With a doctor's prescription and identification card from the
Illinois Department of Public Health, eligible patients would be
allowed a small number of plants or two ounces of the dried drug.

"This is a popular and sensible thing to do. There's just not a lot
of reason to oppose it," said advocate Bruce Mirken with the
Marijuana Policy Project.