Pubdate: Tue, 14 Oct 2003
Source: National Public Radio (US)
Program: All Things Considered
Copyright: 2003 National Public Radio
Contact: http://www.npr.org/contact/
Website: http://www.npr.org/
Details: http://www.mapinc.org/media/1296
Aauthor: Michele Norris, Anchor
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)
Bookmark: http://www.mapinc.org/topics/Conant (Walters v. Conant)
Note: Segment can be heard at 
http://discover.npr.org/rundowns/rundown.jhtml?prgDate=3D10/14/ 
2003&prgId=3D2
Note: Title by MAP Editor

ESTES REGARDING SUPREME COURT REFUSAL AND IMPLICATIONS FOR MEDICAL MARIJUANA

Dr. Milton Estes Discusses The Possible Implications Of The Refusal Of The 
Supreme Court To Hear A Case Regarding The Use Of Marijuana For Medical Reasons

MICHELE NORRIS, host: In the nine states that do allow the use of marijuana 
for medical reasons, doctors have still been barred from discussing it with 
their patients.  Under both the Clinton and Bush administrations, federal 
officials have threatened to prosecute doctors who did so.  Dr. Milton 
Estes is the medical director of the Forensic AIDS Project in one of those 
states, California.  He was a plaintiff in the case against the federal 
government, and until today, Dr. Estes said he's been circumspect about the 
topic.

Dr. MILTON ESTES (Medical Director, Forensic AIDS Project): We did it, but 
it became a frightening process, and certainly was something that we did a 
lot of self-censoring about and became increasingly reticent to do with 
patients.

NORRIS: How will this change your practice?

Dr. ESTES: Well, it's going to--after I take about 10 big sighs of relief, 
I think it'll make it much easier for patients to feel that they can come 
in and talk to me, and it's something that I will feel comfortable bringing 
up and talking with patients with whom I think it might be something that 
they should be thinking about doing.

NORRIS: How often would you speak to your patients about the possible use 
of marijuana therapy?

Dr. ESTES: I would guess--this is just an estimate--that it's something 
that might come up once or twice a week.

NORRIS: Once or twice a week it came up in the past, or do you think it 
will come up more often now that you feel more comfortable raising this topic?

Dr. ESTES: Oh, no.  In the recent--I don't remember how many years it is 
now, one or two or three years, since all of this happened, it's been 
uncommon for me to talk about it with my patients up until today.

NORRIS: Doctor, are there other therapies that are perhaps just as 
effective but less controversial?

Dr. ESTES: I think marijuana is one possible therapeutic agent in a wide 
armamentarium of therapeutic agents.  While other therapeutic agents are 
not as controversial, there is a unique place for inhaled medical marijuana 
that is often not met by other drugs or by other combinations of drugs.  So 
medical marijuana, I believe, has a place in the treatment of people with 
HIV/AIDS, in the treatment of people with severe debilitating pain, in the 
treatment of people with severe cancer and people who are on nauseating 
chemotherapeutic agents.  It's a part of what we as physicians have to 
offer our patients.

NORRIS: Doctor, you no doubt have heard from those who worry that this is 
the first step down a steep and slippery slope that could lead to the 
eventual legalization of marijuana.  What do you say to them?

Dr. ESTES: I'm not worried about a steep and slippery slope about the 
legalization of marijuana. What I am concerned about is taking care of my 
patients and giving them the tools that they need to make their lives 
livable and comfortable when they are struck with a very serious illness.

NORRIS: Because federal law still bans the use of marijuana, is it still 
possible for the federal government to investigate or to punish doctors in 
any way if they do have these discussions with their patients and they 
recommend marijuana use?

Dr. ESTES: I think that it certainly is not going to be possible for the 
federal government to do anything for a doctor who discusses medical 
marijuana with their patient.  A physician still cannot prescribe and 
furnish medical marijuana to a patient; that is furnishing or helping to 
furnish an illegal drug.  What we are doing with our patients is talking to 
them about the benefits and risks of marijuana.  It's up to our patients to 
find ways of obtaining the drug.

NORRIS: Dr. Estes, thank you very much.

Dr. ESTES: You're welcome.

NORRIS: Dr. Milton Estes is a family practitioner specializing in HIV and 
AIDS, and he's based in San Francisco.
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MAP posted-by: Beth Wehrman