Pubdate: Mon, 10 Jul 2000
Source: St. Petersburg Times (FL)
Copyright: 2000 St. Petersburg Times
Contact:  http://www.sptimes.com/
Forum: http://www.sptimes.com/Interact.html
Author: James R. McDonough
Note: James R McDonough Is Director Of The Florida Office Of Drug Control.

RESPONSE TO MEDICAL MARIJUANA

I read with interest the St. Petersburg Times editorial, "Reefer
madness remains," (June 24) which argues for more research on the
potential benefits of so-called "medical marijuana." Madness is the
appropriate word to describe the current trend of state ballot
initiatives that puts seriously ill people at risk of getting even
sicker by advocating the smoke of burning leaves as medicine.

To advocate a liberalization of policy on marijuana research, the
Times has trotted out the tired myth that the federal government is
blocking research on the possible medicinal benefits of marijuana. In
fact, the opposite is true. The Institute of Medicine study, which
recognized that cannabinoids - the active components in marijuana -
have potential medical use and was cited in the editorial was funded
with federal dollars. The conclusions of its expert panel were very
skeptical about the promise of smoked marijuana as medicine. Indeed,
analysis of the marijuana research submissions to the National
Institute on Drug Abuse during the past decade shows that almost none
were able to pass peer review, an indication that medical experts -
not government bureaucrats - could not see the validity in the
proposed studies.

The Food and Drug Administration's approval of Dronabinol, an oral
medication that contains a synthetic form of THC, the relevant
chemical in marijuana, dispels the notion that the federal government
is opposed to researching the plant. What the government does oppose -
and rightfully so - is the idea of smoked marijuana. There is strong
evidence that smoking marijuana has detrimental health effects to the
degree that it is unlikely ever to be approved by the FDA as a
medicine. Unrefined marijuana contains approximately 400 chemicals
that become combustible when smoked, producing in turn more than 2,000
impure chemicals. The IOM report states that, when used chronicalIy,
"marijuana smoking is associated with abnormalities of cells lining
the human respiratory tract. Marijuana smoke, like tobacco smoke, is
associated with increased risk of cancer, lung damage, and poor
pregnancy outcomes."

The IOM report concluded that cannabinoid drugs have potential for
therapeutic use. It specifically named pain, nausea, vomiting, and
lack of appetite as symptoms that might be alleviated. According to
the report, cannabinoids are "moderately well suited" to combat AIDS
wasting and chemotherapy-induced nausea and "probably have a natural
role in pain modulation, control of movement, and memory."

Another report, by the National Institutes of Health, recognized the
potential benefit of marijuana to help with appetite stimulation and
AIDS wasting. These studies present a consistent theme: Cannabinoids
in marijuana do show potential for symptom management of several
conditions. But the finding most important to the debate is that the
studies did not advocate smoked marijuana as medicine. To the
contrary, the NIH report called for a non-smoked alternative as a
focus of further research. The IOM report recommended smoking
marijuana as medicine only in the most extreme cases, and then only
under medical supervision.

Unfortunately, many who advocate smoked marijuana as medicine do so
only as a ruse in order to enable the legalization of marijuana. They
reject scientific findings indicating that smoking a burning leaf does
not measure up to modem standards of medicine. And they ignore the
safeguards provided by established drug-approval procedures.

This debate should be driven by science, not the ballot box. I agree
with the Times that marijuana research be kept within the parameters
of medical science. I disagree with the Times that this has not been
done.
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