Pubdate: Tue, 13 Jan 2004
Source: Reporter, The (Fond du Lac, WI)
Copyright: 2004 Gannett Wisconsin Newspapers
Contact: 
http://www.wisinfo.com/thereporter/contactus/readerservices/letter_to_editor.shtml
Details: http://www.mapinc.org/media/2271
Website: http://www.wisinfo.com/thereporter/index.shtml
Author: Darold A. Treffert, M.D.
Note: Darold A. Treffert, M.D., of Fond du Lac, is past chairperson of the 
Controlled Substances Board and Medical Examining Board of Wisconsin.

LAW ALLOWS MEDICAL MARIJUANA IN CAPSULE FORM

The Reporter recently carried a story that Rep. Greg Underheim plans
to introduce legislation to make "medical marijuana" available for
treatment of some medical conditions. That legislation is premature,
and is not necessary.

First, medical marijuana is now already available by prescription in
Wisconsin. It is Marinol - (dronabinol) delta-9-THC, the active
ingredient in smoked marijuana - a Schedule II substance that any
Wisconsin physician can prescribe for several medical conditions
including nausea and vomiting from chemotherapy in cancer patients. It
is in capsule form, standardized as to quality and dose, and is taken
orally which is a much more reliable delivery system than smoking; no
other approved drug uses smoking as a delivery system.

The good news with respect to Marinol is that since the onset of
action is slow and gradual it is only weakly reinforcing, and it
produces dysphoria rather than euphoria, so abuse potential is very
low. While it is not always effective, Marinol is a beginning effort
to make alternatives available in otherwise refractory patients with
certain conditions.

Second, the research Mr. Underheim recommends is already underway. The
most respected and dispassionate recommendations regarding medical
marijuana appear in the 1999 National Academy of Science Institute of
Medicine report advocating research on cannabinoids, both synthetic
and plant derived, to determine which of those substances are possibly
effective for which conditions with the goal of developing, if
effective, a rapid onset, reliable and safe delivery system for those
substances.

The DEA agrees, stating that the question of whether marijuana has a
legitimate medical purpose should be determined by good science and
evidence-based, rather than belief-based, determinations. Centers have
now been established such as the University of California Center for
Medicinal Cannabis Research to seek reliable and dispassionate answers
to safety and efficacy of cannabis and its compounds to assess which
of those are possibly effective for which medical conditions. Similar
research is underway in a number of other settings as well so the $2
million in new money Mr. Underheim says is not available for research
here in Wisconsin is not necessary.

Regrettably, legitimate inquiry as to the possible role of
cannabinoids in the treatment of some medical conditions continues to
get "hijacked" in a bait-and-switch agenda toward legalization of
marijuana for recreational use with all of its accompanying risks. I
have seen too much damage in too many patients, particularly children
and adolescents, from use and abuse of marijuana to approach the
legalization question too casually lest we do the wrong thing for the
wrong reasons.

I support, as does the Wisconsin Medical Society, further research
into the possible role of cannibinoids in the treatment of some
medical conditions. The research Mr. Underheim says he can support, as
a compromise, is already underway and we should await those results -
objective, unbiased, non-political and with no hidden agendas--before
proceeding further, reasonably and rationally, in this important, but
conflicted, area.
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MAP posted-by: Richard Lake