MR. STUART HOFFMAN

A Top Doctor at a Major Drug Testing Company Refutes the Efficacy of
Medical Marijuana

Stuart Hoffman does not believe in the medical use of marijuana -- at
least, not the kind you grow in your backyard or buy off the street. And
he'd feel that way, he says, even if he wasn't the chief medical review
officer for the drug testing services at ChoicePoint, with clients ranging
from the U.S. Government to large national retail chains. Born and educated
in Minnesota, he was a private oncologist -- a cancer doctor -- with a
thriving practice in Downey, California, for 35 years, and had plenty of
patients who used pot to relieve symptoms. And while he agrees marijuana
does relieve symptoms -- dulling chronic pain, reducing seizures,
stimulating the appetite, controlling nausea -- he's seen it surpassed by
better drugs.

And that, he says, is where the pro-medical marijuana people go wrong. It's
not that the feds don't want to relieve suffering of people like Angel
Raich, the 38-year-old with a plethora of chronic conditions who has taken
her case to the U.S. Supreme Court. It's that the medical establishment has
studied pot and found it lacking. "Angel Raich is being used by a group of
people, in my opinion, who are struggling to make marijuana legal across
the board," says Hoffman, "and they use all sorts of arguments that are
sort of half-truths." He spoke to CityBeat not in his capacity as an
officer of ChoicePoint -- he cannot speak officially for the company -- but
as a doctor who couldn't let those "half-truths" lie.

- -Dean Kuipers

CityBeat: At ChoicePoint, do you test people who use medical marijuana?

Dr. Stuart Hoffman: Constantly. We do about four million drug tests a year
here. Approximately five percent are positive for all sorts of things, and
marijuana is probably 75-80 percent of those. A few people have
prescriptions for Marinol, pure marijuana: perfectly legitimate, recognized
by the federal government. People who are on medical marijuana present a
very different problem for us because there are only about 10 or 11 states
that currently accept medical marijuana. And it is the employer's
individual policy which determines whether we make it a positive or negative.

So a Wal-Mart store in California will fire someone for using medical
marijuana?

A Wal-Mart store anywhere in the world will not recognize medical
marijuana, even though some states say that it's legal. It's their
decision. It's title 49, part 40, U.S. Department of Transportation.
[Hoffman pulls out thick printed book of regulations.] That's the bible for
the federally regulated tests, and it's been challenged in court many
times. Nobody's ever beaten this thing.

As an oncologist, you treated people who used marijuana. Have your
attitudes about it changed?

No, my attitudes about it have always been the same. I treated many people
with chemotherapy who became very nauseated, who were dying of cancer,
losing weight and couldn't eat. Before it was legal, many of my patients
would go out and get street marijuana. At the time, there were drugs called
Compazine and Thorazine, which were also tranquilizers but had a fair
anti-nausea effect. These drugs were on a par with marijuana, and none of
them was very good, but they were better than nothing. About seven or eight
years ago, a whole new class of drugs came in including things like
Ondansetron and two-to-three others, which were anti-nausea medicines that
just revolutionized chemotherapy. These were superb. There was no question,
it was better. There were still a few people who would request marijuana
because it was the mystique of the forbidden fruit.

Yes, but Ondansetron is expensive, and homegrown pot is free.

Sure. It's not cheap. But Ondansetron is given intravenously at the time of
the chemotherapy, so insurance covers it 100 percent. Uninsured people
don't get chemotherapy, because they can't afford it -- so cost isn't
really a factor.

What about appetite stimulation?

It's been known for years that marijuana will stimulate your appetite a
little bit. But they've found that massive doses of progesterone, one of
the female hormones -- the substance is marketed under a trade name of
Megestrol -- is a superb appetite stimulant. Far better than marijuana.

Why not give seriously ill people whatever they want? Isn't it a societal
goal to relieve suffering?

There's a lot of things that the general public does out of guilt or what
they feel is compassion, but which really doesn't jive with reality for the
people actually on the stuff. I had a huge cross-section of the population
in my practice -- they didn't want it. Any more than they wanted opium or
opiates for pain relief. They fought it. But, nonetheless -- if they did
want it, that's fine. When it comes to pain relief, the right dose of
morphine is enough. Whatever that is. The first goal is to prolong life.
The next goal is to relieve suffering.

Sounds like you agree that marijuana could be good for that.

They can have Marinol. Now, there are many physicians in the state of
California, particularly in Northern California, who have marijuana
practices. We see the medical marijuana prescriptions coming in here. I
called one of these physicians and talked to her at some length. She told
me that she has limited her practice to the treatment of conditions that
require marijuana. She has about 500-600 patients. I asked, "Well, what
kind of diseases are you treating?" I thought: HIV, cancers, and things.
[She said,] "I treat chronic anxiety, low back strains, tension headaches,
degenerative arthritis." A bunch of things that the preponderance of
physicians in this country would not treat with marijuana. I said, "Well,
do you monitor them?" "Oh, yes. If these patients don't come in to see me
once a month, I don't refill their prescription." This, to my mind, is immoral.

Why? She's relieving their suffering in some way. But she could prescribe
it for 90 days. She's doing this for the money.

Isn't that true of all doctors? People take drugs for arthritis or back
pain or depression and never stop. Every time they go in to see the doctor,
the doctor gets paid.

Sure, there are doctors who do that. Valium, Vicodin. But, in these areas,
the state Medical Board of Quality Assurance does step in. I told them
about this doctor, and they said she was doing nothing illegal. But there
are people getting thrown out of the profession every single month for
doing that.

You've given me a pile of photocopies showing that the government still
allows research on the medical effects of marijuana. But the FDA and DEA
have claimed for years that they cannot reschedule marijuana to allow for
medical use because there's no research. Are they just ignoring it?

No. There's no research supporting street marijuana as medicine. If you
listen to Americans for Safe Access, it says: These people are dying
because they can't get access to marijuana. That's baloney. They can have
Marinol. Your body can't tell the difference if you take it in that form or
whether you smoke a joint. The federal government recognizes that there is
a medical purpose for marijuana and a use. What they don't recognize is a
medical purpose for marijuana grown in your back yard or bought off the
street, because it conflicts with the societal objective of keeping the
community safer by allowing less people to be impaired by it.

So you disagree with the idea that people ought to be able to medicate
themselves. That's true: That I disagree with, because you are taking a
substance that can impair you and there's not some medical oversight. I'm
not a policeman. I'm not a judge. I really believe that society is better
off without medical marijuana. Sure, some people are going to benefit --
poor people who cannot afford health insurance, for example. I have heard
some very cogent arguments stating that we should completely decriminalize
drug abuse and make it an illness. But sometimes when you get conflicting
benefits and non-benefits to society, you say, okay, which is the greatest
good for the greatest number?