Pubdate: Sun, 08 Aug 2004
Source: Hartford Courant (CT)
Copyright: 2004 The Hartford Courant
Author: Kim Kavin
Note: Freelance writer Kim Kavin is a former magazine and newspaper editor.
Cited: Marijuana Policy Project
Bookmark: (Cannabis - Medicinal)


Try to recall the last time a sweeping majority of Connecticut
residents agreed on anything. The war in Iraq? Fat chance. That
Connecticut's casinos play an important economic role? Only 65 percent
say that's true. How about the New York Yankees being better than the
Boston Red Sox? It's a 43-to-33-percent split.

Yet a new poll commissioned by Northeast and conducted by the UConn
Center for Survey and Research Analysis says that 83 percent of state
residents think adults should be allowed to use marijuana for medical
purposes if a doctor prescribes it.

Eighty-three percent. That's more than 10 percent higher than the
number who thought Gov. John Rowland should have resigned, and a solid
35 percent more than plan to vote for either President George W. Bush
or Democrat John F. Kerry in the upcoming election. It's a whopper of
a figure, 83 percent, one that would seem to make the legalization of
medical marijuana inevitable in Connecticut - through the sheer will
of the people.

Now exhale, and think the thing through. Sure, most people say their
loved ones with cancer, multiple sclerosis, AIDS and other crippling
diseases should be able to light up a joint if it eases their
symptoms, but how should they get the drug? Exactly how many ounces of
it should they be allowed to have in their home? Should they be able
to grow their own plants? If so, how many at once? And what will
happen to those plants - and all the buds they produce - after the
person's illness subsides?

These are the kinds of questions that derailed "An Act Concerning the
Medical Use of Marijuana," put forth in the last General Assembly
session by state Rep. James W. Abrams, D-Meriden, and state Rep. Penny
Bacchiochi, R-Somers. The 43-year-old Bacchiochi has become the human
face on the legislation, even admitting during a speech on the House
floor that she copped some pot for her terminally ill husband two
decades ago after a bone cancer operation left him a paraplegic.

"I remember the fear that I had as a caregiver," her written text
states. "I risked so much to obtain the marijuana: arrest, court
costs, incarceration, probation, criminal records. ... Thousands of
Connecticut residents are undergoing similar treatments and using
marijuana, and they are living in fear."

As the new poll says, most residents believe such legal fears should
be eliminated. But the same set of residents also said, by a 57-32
percent ratio in the poll, that marijuana should remain illegal in
general - and it is that number that is driving opposition to the
medical marijuana cause. Simply put, many lawmakers think making
medical marijuana legal would open the door to legalizing marijuana in
general, which in turn would lead to more use of harder drugs.

"Huge money, millions of dollars are being spent by groups that want
to legalize marijuana," says state Rep. Toni Boucher, R-Wilton, who is
leading the Connecticut opposition. "And they really feel that this is
a sympathetic way to get in the door."

Boucher is a longtime education advocate who sees keeping drugs out of
children's hands as the paramount issue. Legalizing the use of
marijuana for people who are sick, she says, is merely a step on the
slippery slope toward legalizing the drug altogether. She has one
constituent whose son died from drug abuse after trying marijuana and
then progressing to harder drugs. Some studies show that marijuana
does have this "gateway" effect, while other studies argue the
opposite, but Boucher is firmly in the camp of her constituent - who
begged her to fight the medical marijuana amendment to prevent more
children from experimenting with drugs until they die.

Boucher takes the cause seriously, even inviting Dr. Andrea Barthwell
to Hartford to speak. Barthwell made the trip between her other duties
as the adviser to President Bush on ways to reduce the demand for
drugs in America, and she is quite clear on what the administration
sees as the connection between the medical marijuana trend and the
broader war on drugs.

"Moving in that direction will make the drug problem in this country
larger," Barthwell said in an interview last month. Marijuana is not a
medicine, she emphasized. "There are some physicians who will gently
endorse a patient who is pushing toward this, but they may as well
offer the person alcohol or cocaine or heroin."

With those kinds of comments reverberating throughout Hartford's
halls, state lawmakers ended their recent session and left the medical
marijuana legislation stalled. While a state law passed in 1980
remains on the books - allowing physicians to provide marijuana and
patients to possess it - its wording makes it nothing more than
symbolic in the face of the federal marijuana prohibition. Connecticut
is now like many other states where voters overwhelmingly say they
want workable medical marijuana legislation, but where the
nuts-and-bolts creation of it pits people like Bacchiochi, who watched
a loved one suffer and die, against people like Boucher, who wants to
keep kids off drugs. All around them are legislators looking to vote
without seeming indifferent to the very real concerns each side raises.

"There are legislators like Toni Boucher who really believe in their
heart that they're doing the right thing," Bacchiochi says. "I respect
that. But then there are legislators who get into the technical
aspects: 'Where do you get the first seed?' 'How do you prosecute
that?' And I'm saying that every day, people are suffering and dying
because we can't get past the technical hurdles."

Boucher doesn't agree that the question is one of medicine and legal
language. "In my heart of hearts, I don't believe that," she says.
"I'm doing this for the kids."

And that - no matter what the poll says - is just the beginning of
trying to answer the bigger question surrounding Connecticut's medical
marijuana standoff: Why is this so hard?

Trying to determine whether marijuana is an effective natural remedy
or a dangerous gateway drug is like trying to determine whether
abortion laws should protect mothers or babies. Most advocates are
entrenched in dogma. They speak unequivocally in favor of their own
statistics. They're akin to talking heads on cable television news
programs, hurling data like javelins into the arguments of their
opposition. For every doctor who calls the current law misguided,
heavy-handed and inhumane toward ailing adults, there is a doctor
ready to discuss drug addiction as a widespread, pediatrically
acquired disease.

"It is sharply divided in the public debate because there is an
essential question here," Barthwell says. "Is this really an essential
medicine for the treatment of almost a hundred ailments? Is it really
the first magic bullet in a smoke form, or is it a cruel hoax?"

The one thing both sides agree upon is that marijuana is a plant - an
absurdly basic fact from which the most serious of arguments stem. In
the context of modern medicine, a plant is the opposite of a pill. It
is grown instead of manufactured. It offers unending supply instead of
controllable dosages. It exists in nature and thus cannot be patented
by a pharmaceutical company - nor can it ever be as concentrated as
what such companies can extract from it and repackage in a bottle of

Neither side argues that marijuana's active ingredient, THC, can have
a beneficial effect for people suffering from pain, nausea, vomiting
and other symptoms caused by serious illnesses. Marijuana's medicinal
use dates back nearly 5,000 years. It was legal in America until just
before World War II. The question today's argument focuses on is not
whether THC can be helpful, but whether smoking a joint is the best
way to deliver that key ingredient into the body.

"There is tremendous promise with the plant," Barthwell admits. "But
the way we bring medications to the marketplace in the 21st century is
by taking the crude botanical, isolating [the active ingredient], then
manipulating it to see if you can increase the speed of its onset of
action, increase its affinity of binding to the receptor." In the case
of marijuana, the discussion is about delivering THC while reducing
the side effects that some studies say can come from smoking the
plant, such as coughs, lung infection and cancer.

The only drug that has achieved this is Marinol, whose active
ingredient is a synthetic form of THC. The federal Food and Drug
Administration approved Marinol for treatment of nausea and vomiting
associated with cancer chemotherapy in 1985, and for the treatment of
anorexia in AIDS patients in 1992, according to Georgia-based Unimed
Pharmaceuticals, which markets, manufactures and distributes the drug.
Unimed is a subsidiary of Belgium-based Solvay S.A., whose 2003 annual
report lists sales of Marinol in the United States up 32 percent from
2002 to 70 million euros (over $84 million at current exchange rates).
The drug's launch is currently being prepared in Europe.

Marinol is the escape hatch that legislators like Boucher look to
first in the medical marijuana debate. Smoking makes people sick in
ways that pills don't, they say. Because Marinol exists, there's no
need to discuss legalizing marijuana itself. They insist it's not the
THC they're against; it's the act of growing it and smoking it.

"Is it right to say that even though this method is less effective
medically, we should allow people to grow plants in their homes
without control?" Boucher asked. "We have such potent drugs right now
that alleviate people's pain. Who's going to be held liable for cancer
if we approve this smoking?"

Bacchiochi looks at Marinol from a more personal perspective, one that
many advocates on her side of the debate share. Her husband was in his
early 20s when he was diagnosed with bone cancer, and the surgery to
remove the tumor did nothing beyond leaving him immobile. She watched
him drop 60 pounds before he died. He tried Marinol, but couldn't keep
it down. He was simply vomiting too much.

One day at the Veterans Affairs hospital in Boston, Bacchiochi says,
she left her husband's room to get a vending machine snack. A doctor
approached. He asked her not to tell anyone they had spoken, then
suggested that she get her husband some marijuana.

"This is a terminally ill man," Bacchiochi recalls. "You just want
some relief. I knew people who smoked pot, and so I got some joints.
It was a night and day difference. He could control the intake."

Bacchiochi says the alleviation began almost immediately, a benefit
that pills don't offer. They take time to digest and work their way
through the bloodstream, whereas taking a few puffs causes a much
faster reaction. It's another common argument on the side seeking
legalization for medical use, one that was articulated in a recent
editorial in the Providence Journal by former U.S. Surgeon General Dr.
Joycelyn Elders. She wrote that some patients avoid the hazards of
smoking by using simple devices called vaporizers, then added: "For
many who only need a small amount - like cancer patients trying to get
through a few months of chemotherapy - the risks of smoking are minor."

Barthwell, whose degree is in addiction medicine, counters that such
arguments are more about support for smoking pot than they are about
alleviating symptoms. "Anyone who's ever treated pain knows that you
don't wait for the pain to get out of control, then bring it back
under control through medication."

So the debate swirls, with Connecticut's 83 percent public opinion
figure trapped in the eye of this tornado that feeds on points and
counterpoints. While national polls also consistently show public
support for medical marijuana use, only nine other states have
actually found a path out of the stormy debate to the passage of
effective laws.

And in most of them, it wasn't elected officials who got the job

Seven of the nine states that have workable medical marijuana laws
achieved them through ballot measures, not through legislation. With
the exception of Hawaii and Vermont, where lawmakers passed bills,
regular citizens have had to build up grass-roots support for
referendums in order to make medical marijuana legal. California was
the first state to do this, in 1996, and was pretty much the last
state to do it without major influence from national special-interest
groups. Ever since advocates for medical marijuana saw the game plan
that worked in Sacramento, they have worked to recreate it with
referendums in targeted states across the country.

Since referendum is not an option available to Connecticut citizens,
what's happening here seems to be most closely in line with what
happened in Maryland, where lawmakers enacted the best law they could
get enough votes to support. It does not make medical marijuana legal,
but limits the penalties that can be imposed on people who are
arrested and charged with possession.

"Maryland is a textbook example of why it's so difficult to go through
legislatures," says Bruce Mirken, director of communications at the
Washington, D.C.-based Marijuana Policy Project, a group that aims to
reform marijuana laws and remove criminal penalties for its use. "It
was a three-or four-year process after which we got this hideous
compromise. It's better than nothing, but it still leaves terribly ill
patients having to go through being arrested and spending thousands of
dollars in legal fees."

The problem his group has learned to expect with lawmakers is that
they see the war on drugs as a sacred cow. "It's one of those things
like mom, apple pie and the pledge of allegiance that they are simply
scared to touch," Mirken says. In the early 1980s, some lawmakers were
voted out of office for being considered too soft on drugs. That
message has stuck, Mirken says, even though polls consistently show
that the majority of citizens are all right with medical marijuana as
an exception to the federal prohibition.

When lawmakers block something that 83 percent of the people say they
want, he says, the only course for change is the ballot box.

"Eighty-three percent, that's a number out of Soviet elections." he
says. "It's higher than average. With that sort of popularity, it's
the sort of thing that in other cases politicians jump on. The only
way to shift the legislative landscape is for a few people to get
voted out of office who are opposed. The lesson needs to be relearned.
I really think that unless they start to understand that there is
strong support and that it's an issue that at least some people will
vote on, it's going to be a struggle."

Part of that relearning includes looking at what has happened to drug
use rates among children in states that have passed medical marijuana
laws. California has the longest track record by which to judge, and
the state's attorney general publishes a study every two years called
the California Student Survey. The most recent data, compiled in
2001-02, regards more than 8,000 students in the seventh, ninth and
11th grades at 113 schools. It found no increase in marijuana use
among high-schoolers and a notable decline among seventh-graders.
Eleventh-graders said marijuana was almost as readily available as
alcohol and about as dangerous, and most students in all age groups
said friends were their most likely source of pot.

"If you go back to the early '90s, you see that adolescent marijuana
use in California was rising up until 1996, the year they passed Prop
215," Mirken says. "Since then, it has gone down - as much as 40
percent in some age groups. And yet people like [Bush adviser]
Barthwell keep making these utterly ridiculous claims."

The only thing consistently rising, it seems, is public opinion in
favor of medical marijuana use. In Connecticut, according to the poll,
it has risen even higher than elsewhere in the nation.

At the end of June, the U.S. Supreme Court announced it will hear
arguments this winter that are likely the most important to reach the
bench on this issue. The appeal is from the Bush administration, which
lost a case last year involving two California women who smoke pot to
alleviate chronic pain and other problems. The court will consider
whether federal marijuana prohibition trumps state medical marijuana

If the administration loses, federal officers will no longer be
allowed to arrest patients in states where medical marijuana is legal.
If the administration wins, the status quo will continue, with
residents of states with workable laws being protected at the state
level, but not from federal prosecution. (State laws offer decent
protection, since the federal Drug Enforcement Agency does not have
the staff to scour every state looking for cancer and AIDS patients.)

The debate will thus continue at the state level either way. In
Connecticut, assuming their re-election this fall, that means Boucher
and Bacchiochi will take up sides again. The two Republican women
could not be more different in appearance - Boucher is a short
brunette tucked into a navy blue suit with a gold pin on the lapel,
while Bacchiochi is a tall blonde who favors a pink sleeveless dress
with open sandals that reveal a toe ring - but both are on the same
page in stating their commitment to move the issue forward.

Boucher said in an interview in June that she thought she could summon
enough bipartisan support for a Connecticut law that would allow
terminally ill people to use medical marijuana under a doctor's orders
provided the drug was distributed to patients instead of grown by
them. Her thinking is that such a law would eliminate concerns about
cancer and other negative smoking consequences (eligible patients
would already be on their deathbeds) and would eliminate the problem
of plants being grown without supervision across the state. "I want
them to show me that there's not another way to skin this," she said,
emphasizing that in no case should patients be allowed to grow their
own plants. "Why can't we in Connecticut test something where it is
distributed over a counter, when they're terminally ill, and then you
don't worry about the caregivers and what's going to happen to the

Bacchiochi doesn't favor that compromise; she says lawmakers are not
doctors and should not be in the business of deciding who qualifies as
needing certain types of drugs. "As far as the distribution of
marijuana, if we could find a way to distribute it without it being
grown that would be great, but because of its [federal]
classification, that's not possible," she said. "I'm all for
compromise, but the more educated you become, you realize that many of
the compromises will not work."

When told of the recent poll that showed 83 percent of state voters
want a medical marijuana law, Boucher said her position had not
changed. "The way that the question was stated, it was very easy to
agree with it," she said. "The legislation being proposed in Hartford
on this is dramatically different. That is a very simplistic question
not at all reflecting the legislation that has been proposed."

One might expect Bacchiochi to celebrate the poll's results, but she
did not do so immediately. "My initial reaction is that it's just so
sad," she said. "Because I had such a personal experience with this,
it's not political for me. I get choked up when I hear those numbers.
It's a painful reminder that people are suffering and that we have to
do something to help them."

At the end of the day, Bacchiochi said, whatever the lawmakers do
won't make much difference. Marijuana - despite the federal
prohibition - is easy to acquire in virtually every town and city.
Nobody wants kids getting hooked on it, but desperate adults will buy
it whether it's legal or not. She just wishes it didn't have to be
that way for those watching a loved one suffer.

"My suspicion is that people aren't even going to grow marijuana," she
said. "The people who are smoking pot are going to continue smoking
pot. The ones who aren't, who want to be law-abiding, are the ones
this is meant for."
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