Pubdate: Sun, 15 Jul 2012
Source: Arkansas Democrat-Gazette (Little Rock, AR)
Copyright: 2012 Arkansas Democrat-Gazette, Inc.
Contact: http://www2.arkansasonline.com/contact/voicesform/
Website: http://www2.arkansasonline.com/
Details: http://www.mapinc.org/media/25
Note: Accepts letters to the editor from Arkansas residents only
Author: Tracie Dungan

MEDICAL PROFESSION GIVES MARIJUANA MIXED REVIEWS

Prominent Local Cancer Patient a Reluctant User

Cancer patient Emily Williams initially resisted the idea of using 
marijuana for the severe nausea and pain that came along with her 
chemotherapy two years ago.

"Before I did my first treatment, I had someone offer to get some ' 
pot' for me, and I said no," Williams, 55, of Fayetteville said 
recently. "For all the obvious reasons."

One of them was the mere thought of using an illegal drug in the home 
she shares with her husband, Kit Williams, the city attorney for Fayetteville.

Now Emily Williams finds herself a somewhat reluctant advocate for 
the movement in Arkansas to get medical marijuana before voters. The 
Arkansas Medical Marijuana Act would legalize cannabis for treatment 
of a list of a dozen diseases, including cancer, as well as 
conditions that produce certain debilitating symptoms.

A group called Arkansans for Compassionate Care submitted 67,883 
signatures to the state July 5 to get the petition submitted for the 
November ballot. Williams is listed as a featured patient on the 
group's website, arcompassion.org. Only 36,495 of the signatures 
submitted belong to registered voters, the secretary of state's 
office said Friday. The group was given 30 days to collect 28,918 
additional signatures.

Diagnosed with stage 3 lymphoma in 2010, Williams experienced 
cancer-related pain in her lungs and back.

Her chemotherapy brought severe nausea, headaches and pain in her 
muscles and joints.

A medication that triggers white-blood-cell production caused further 
pain in her bones, she said.

In the hours after the first of her six chemo treatments, she was 
determined to rely on medicines doctors had given her to relieve her symptoms.

"I tried to tough it out," Williams said.

After one oral medication didn't work for pain, she tried a second 
the doctor had given her. By early evening, she was throwing up.

"The headache was so blinding," she said. "I couldn't get off the couch."

Williams stuck it out until 9:30 p.m., then called the person who'd 
earlier offered her marijuana.

After she smoked it, the relief was almost immediate.

"Within 10 to 15 minutes, my headache was gone. My nausea was gone," 
Williams said. "I wasn't hurting. And really for me, the remarkable 
thing was I went to bed and was able to sleep for four hours.

"And that was the most I'd been able to sleep for probably two months."

Though she continued to try to use pain medication the oncologists 
gave her, "I ended up using [ marijuana] throughout my entire chemo," 
Williams said.

LACK OF STUDIES

Gov. Mike Beebe has recently said that he will not vote in favor of 
legalizing marijuana for medical use, should the issue make it to the 
ballot. But he won't campaign against it either, said Beebe spokesman 
Matt DeCample.

"He said he had concerns that the law would be abused," DeCample said Thursday.

Alan J. Budney, who left the psychiatry faculty at the University of 
Arkansas for Medical Sciences in Little Rock in June, said he can 
understand why cancer patients try marijuana when prescription 
medicines fail them.

The lack of sufficient studies on its use, however, means he cannot 
be swayed to supporting it.

While the cannabis plant and its cannabinoids have demonstrated "lots 
of possibilities" for medicine - particularly in settling people's 
stomachs - long-term clinical trials involving hundreds of patients 
from wide demographic groups haven't been done, he said.

"There's just very, very little literature that is clinical, and 
there are no definitive studies that are clinical," said Budney, who 
worked in UAMS' Center for Addiction Research.

He's now at the Geisel School of Medicine at Dartmouth College in New 
Hampshire.

What studies there are haven't distinguished between street 
marijuana, research marijuana grown by the government for such 
studies and the active ingredient in the plant known as THC, he said.

It takes comprehensive trials to determine effectiveness, dosage, 
side effects and overall safety, he said.

"You know, alcohol is helpful for pain, too," he said. "Ever have a 
few drinks and your pain is gone?"

While smoking and intravenous needles are "superdelivery systems" 
that get a drug to the brain quickly, most prescription drugs are not 
smoked or injected, Budney said.

With smoking, it's virtually impossible to have a doctor instruct a 
patient on how to inhale and get the right dose.

ALTERNATIVE DELIVERIES

For her part, Williams said, the smoking hurt, but not nearly as much 
as the pain.

She went online, then asked around, and discovered a better way to 
take marijuana, and that also lasted longer.

"Just melt butter in a pan, throw in your crumpled-up 'pot' in the 
butter, and cook it for about 30 or 40 minutes," she said.

She refrigerated it and spread it on crackers or toast.

Budney said other delivery systems are being researched globally but 
in the U.S., any kind of marijuana as-medicine research seems to be a 
harder sell.

"Does a drug company want to spend $ 10 million researching an 
illegal drug?" he said.

Elsewhere, "There are people working on this as an aerosol, where you 
squirt it," he said.

In Canada and some other countries, Sativex, which contains THC, has 
been approved as a mouth spray, he said.

In January, the New York Daily News reported that the British drug 
maker GW Pharma was in advanced clinical trials for what it touts as 
the world's first drug developed from raw marijuana rather than 
synthetically derived equivalents, and that it hoped for U.S. 
approval for cancer pain treatment by late 2013.

Dr. Joe McSherry, a neurologist at the University of Vermont College 
of Medicine who's followed cannabis research closely since 2000, said 
he favors medical marijuana use, though he agrees with Budney on the 
lack of studies in this country.

"Doctors haven't been educated on this," McSherry said. "There have 
been literally thousands of articles since 2000, research articles, 
mostly done in Europe."

Studies on mice show that cannabis "reduces the toxic input of pain 
signals" at the spinal cord level, he said. But marijuana works on a 
second level as well, affecting separate pain pathways from the brain 
to the spinal cord, inhibiting transmission.

"Pain is a complicated thing," McSherry said.

It's a combination of what you actually feel and your emotional 
response to that feeling, he said.

The cannabis works on both: "It makes it so you're not so afraid, or 
not so anxious, about the pain."

Unlike opiates, which can put someone to sleep, marijuana can control 
pain without the intoxication that disrupts someone's daily 
activities, he said.

According to ProCon.org, which says it is an independent, nonprofit 
public charity, 17 states and Washington D.C. have legalized medical 
marijuana as of June 1.

McSherry and a Fayetteville nephrologist, Dr. David Crittenden, said 
medical use of marijuana is good public policy.

"It's a useful drug from what I've read," Crittenden said, referring 
to the treatment of certain conditions and chronic pain.

"The reason there hasn't been more study of the use of the drug in 
the United States [is because] the government who funds most research 
either directly or indirectly hasn't let people study it," Crittenden 
said. "And it's illegal to give it to people."

McSherry added that the U.S. Drug Enforcement Administration won't 
allow cannabis research unless it's approved by the National 
Institutes of Health's National Institute on Drug Abuse.

The drug abuse institute's leader has said its mission statement 
doesn't cover "finding beneficial use of drugs of abuse."

In Arkansas, the group that submitted signatures to put the issue on 
the ballot said it is continuing to collect them even as the state 
continues verifying the first petitions submitted.

Ryan Denham, campaign director for Arkansans for Compassionate Care, 
said that while the group needed only 62,507 signatures, it wanted to 
collect substantially more.

Without the extended effort: "We're definitely going to be short," Denham said.
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MAP posted-by: Jay Bergstrom