Pubdate: Sun, 5 Oct 2008
Source: Livingston County Daily Press & Argus (MI)
Copyright: 2008 Livingston Daily Press & Argus
Contact: http://drugsense.org/url/23S0e9bz
Website: http://www.livingstondaily.com
Details: http://www.mapinc.org/media/4265
Author: Jim Totten, Daily Press & Argus
Cited: Proposal 1 http://stoparrestingpatients.org/
Bookmark: http://www.mapinc.org/mmj.htm (Marijuana - Medicinal)
Bookmark http://www.mapinc.org/topic/Marinol

DOC SAYS POT PILL NO GOOD

There's a key reason why some groups want to make it legal for some 
seriously ill patients to smoke marijuana to ease vomiting and nausea.

Although there is a pharmaceutical version of marijuana called 
Marinol that comes in pill form, it doesn't work, according to Dr. 
Elaine Chottiner. She serves as section head of hematology and 
oncology at Saint Joseph Mercy Health System, which runs the Saint 
Joseph Mercy Woodland Center in Genoa Township.

"If Marinol worked, nobody would care about legalizing marijuana," 
Chottiner said.

On Nov. 4, Michigan voters will decide the fate of the medical use of 
marijuana ballot question. Under Proposal 1, there would be specific 
guidelines to using marijuana. A physician would need to approve 
marijuana use for a patient with a debilitating medical condition, 
and patients would receive an identification card. Patients would 
only have protected use in their home and could not smoke it in public places.

Chottiner said Marinol was approved because it was shown in clinical 
trials to alleviate vomiting and nausea caused by certain kinds of 
chemotherapy. It contains a synthetic form of THC, the major active 
substance in marijuana, which helps relieve nausea and vomiting from 
chemotherapy and stimulates appetite for AIDS patients.

However, Chottiner said few patients have found the pill to be 
effective and usually don't seek refills. She said absorption is 
probably one reason the drug doesn't work as well, since it takes 
longer to digest something than smoke it. Also, Marinol contains only 
one of marijuana's 66 compounds.

Chottiner said a few people have asked her about smoking marijuana to 
ease their symptoms, and a few patients have told her they're smoking 
marijuana to ease their nausea and vomiting. In general, Chottiner 
said only a very small percentage of patients have chronic nausea and 
vomiting from chemotherapy. She said most chemotherapy does not cause 
those symptoms. She also said there are excellent medications 
available -- and that work -- to prevent those symptoms.

Chottiner, who indicated she was neutral on the ballot question, said 
there are pros and cons with the proposal.

She said the most important issue is helping patients.

"We want to do everything we can for our patients and alleviate their 
suffering," she said. "If this is something that can be used for this 
purpose, it would be helpful to find a way to provide it."

However, Chottiner said she feels much more comfortable prescribing 
drugs that have gone through the U.S. Food and Drug Administration 
approval process. She said the FDA conducts rigorous clinical trials 
so doctors know what's in a drug, a proper schedule and dosage for a 
particular drug. She said it would be difficult to prescribe 
marijuana because there are no standards.

Chottiner said she doesn't prescribe herbs because "you never know 
what you're getting." 
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