Pubdate: Tue, 09 Oct 2012
Source: Valley Advocate (Easthampton, MA)
Copyright: 2012 New Mass Media
Contact:  http://www.valleyadvocate.com/
Details: http://www.mapinc.org/media/1520
Author: Maureen Turner

WHAT I SAW WITH MY SON

On November 6 the people of Massachusetts will have their say about 
medical marijuana.

Silas "Sy" Bennett was a 28-year-old returning college student 
studying journalism at Keene State when he was diagnosed with Stage 4 
lung cancer in the fall of 2007.

Initially, Bennett thought the pain he was feeling was caused by a 
pinched nerve, an injury from a house painting job, said his mother, 
Lorraine Kerz of Greenfield. Then one day, the pain was so bad that 
he couldn't get out of bed. Bennett ended up at the emergency room, 
where an X-ray revealed the cancer, which had by then spread to his 
bones. Doctors needed to operate on his spine, to make sure his 
damaged vertebrae didn't collapse and paralyze him, before beginning 
him on a difficult course of chemotherapy.

"It was brutal. He was in terrific pain," Kerz recalled. "I'm 
watching my son-he was throwing up nonstop for days and days. He was 
so sick he couldn't keep anything down."

Kerz searched for ways to relieve his suffering. "For me, as his mom, 
I was thinking about anything, including anything outside the box, if 
you will," she said. That included alternative therapies, like reiki 
and reflexology. It also included marijuana.

Sometimes Bennett would ingest the marijuana in food-for instance, to 
prepare for a chemo treatment. Other times, when he needed more 
immediate relief, or couldn't keep down any food, he would smoke it. 
"It helped him almost immediately," Kerz said. The marijuana quelled 
his nausea, eased his anxiety ("He knew he was looking at his own 
mortality-that's difficult.") and helped him regain some of the 
weight he'd lost. And it did so, she added, without the negative side 
effects of some of the legal drugs doctors put him on.

"There was a quality of life piece that was huge for us," Kerz said. 
"It really almost stabilized Silas in ways that he was able to be 
himself, to get outside the cancer a bit. That was absolutely one of 
the most positive things that came out of this for us."

In the months before his death in May of 2008, Bennett found the 
energy to document, in photos and on video, his battle with cancer. 
After his death, Kerz used the footage to make a documentary about 
her son that she uses to promote "Sy's Fund," a non-profit she 
established that gives grants to young people with cancer.

She's also lent her support to the campaign to legalize the medical 
use of marijuana in Massachusetts. On Nov. 6, voters here will have 
the opportunity to weigh in on a ballot question that, if passed, 
would allow patients with qualifying medical conditions to obtain 
marijuana with a written recommendation from a doctor. The measure 
has the support of the Mass. Bar Association, the Mass. Public Health 
Association, the ALCU and the Mass. Nurses' Association, among other groups.

On the other side of the issue are a number of anti-drug groups, 
including the Mass. Prevention Alliance, which argues that the 
program would be ripe for abuse and that the measure is actually 
about advancing full legalization of pot. The state's Police Chiefs' 
Association also opposes Question 3, as does the Mass. Medical 
Society, which says there's not adequate research showing the medical 
benefits of marijuana.

Kerz believes that opponents conflate social pot smoking with its 
medical use, and that patients and doctors should have the right to 
consider marijuana as one possible way to ease suffering like that 
her son experienced, without worrying about legal repercussions. (She 
declined to say how she obtained marijuana for her son.)

"As a mom I would have done absolutely anything for my son. I would 
take any risk, and I did take the risk," Kerz said. But as long as 
medical use of marijuana remains illegal, she added, plenty of people 
who are in pain will suffer needlessly.

Question 3 would allow a patient with a "debilitating medical 
condition"-defined in the law as cancer, glaucoma, HIV, AIDS, 
hepatitis C, ALS, Crohn's disease, Parkinson's, multiple sclerosis 
and "other conditions as determined in writing by a qualifying 
patient's physician"-to obtain marijuana for personal use at a 
medical marijuana treatment center. The patient would need a written 
recommendation from a licensed physician, granted "only in the course 
of a bona fide physician-patient relationship," and could obtain no 
more than a 60-day supply at a time.

The treatment centers would be overseen by the Mass. Department of 
Public Health. The law allows a maximum of 35 treatment centers 
across the state, with at least one in each of the commonwealth's 14 
counties, but no more than five in any one county. After one year, 
the DPH could increase the number of centers if it determines a need.

In addition, the law includes a provision that would allow a patient 
who demonstrates that he can't access a treatment center due to 
financial hardship, physical incapacity or lack of proximity, to grow 
his own 60-day supply of marijuana. It would protect patients and 
caregivers from state prosecution for possession of marijuana for 
medical use if they meet the conditions of the law, and would protect 
doctors who write valid recommendations for patient use from prosecution.

The Massachusetts Legislature has considered several 
medical-marijuana bills in the past, but never acted on them. After 
the most recent bill-sponsored, on the Senate side, by Amherst 
Democrat Stan Rosenberg-failed to come to a vote before a May 
deadline, proponents gathered enough petition signatures to put the 
matter before voters on the November ballot. According to an August 
poll, 58 percent of likely voters said they favored the question, 
while 27 percent were opposed.

If the question passes, Massachusetts would join 17 other 
states-including, in New England, Connecticut, Maine, Vermont and 
Rhode Island-and the District of Columbia in legalizing medical 
marijuana. A similar question will appear on the ballot in Arkansas. 
Medical marijuana bills are also pending before several state legislatures.

California was the first state to legalize medical marijuana, after 
voters approved a ballot proposition in 1996. Sixteen years later, it 
remains a contentious issue there; over the past year, federal agents 
have shut down hundreds of dispensaries in the state as part of a 
campaign to crack down on commercial enterprises where so-called 
patients can easily obtain the drug for recreational use.

"We're not concerned with prosecuting patients or people who are 
legitimate caregivers for ill people, who are in good faith complying 
with state law," Benjamin B. Wagner, a United States attorney in 
California, told the New York Times this summer. "But we are 
concerned about large commercial operations that are generating huge 
amounts of money by selling marijuana in this essentially unregulated 
free-for-all that exists in California."

Other cities have also attempted to crack down on illegal 
distributors; this summer, the City Council in Los Angeles-described 
in a recent NPR report as a "mecca for medical marijuana 
dispensaries," where "anyone with a doctor's recommendation could 
stop in at chic storefronts offering cannabis-laced desserts"-passed 
a ban on dispensaries in the city. The Council recently reversed that 
decision in response to public pressure.

What's happening in California underscores the tension between state 
governments that have legalized medical marijuana and the federal 
government, which classifies it as an illegal controlled substance. 
In 2009, the Justice Department released a memo saying that, in order 
to "[make] efficient and rational use of its limited investigative 
and prosecutorial resources," it would not "focus federal resources 
in ... States on individuals whose actions are in clear and 
unambiguous compliance" with local medical-marijuana laws.

But critics say the feds have been overzealous in their efforts, 
leading to the shutdown of legal dispensaries and sending legitimate 
patients to find marijuana illegally.

Proponents say Massachusetts' Question 3 is written to avoid the 
abuses and excesses seen in other states. "This will be absolutely 
nothing like California," said Jennifer Manley, a spokesperson for 
the Committee for Compassionate Medicine, the group behind Question 
3. The drafters of the question, she said, looked at the experiences 
of other states, incorporating tight restrictions that will head off 
the problems seen elsewhere. That includes a requirement that the 
recommending doctor have a legitimate, established relationship with 
the patient; restrictions on the number of dispensaries; and DPH 
oversight of the program, she said.

In addition, Manley noted, the Massachusetts law includes penalties 
for those who commit fraud under the system, ranging from a $500 fine 
to up to five years in state prison.

"I think it's a well-crafted, solid measure. It avoids the kind of 
abuses we saw in California," said Dick Evans, a Northampton attorney 
who's fought for marijuana law reform for decades. "We're not going 
to see pot docs with sandwich boards on sidewalks."

The Mass. Prevention Alliance, a statewide group based in Acton, is 
leading the fight to defeat Question 3. Heidi Heilman, MAPA's chair, 
warns that if the question passes, it would create an infrastructure 
of easy access to marijuana and lead to crime, increased drug use and 
other problems in the areas near the dispensaries-which, she added, 
she expects to see concentrated in poor neighborhoods in cities like 
Springfield and Worcester. "It's going to be these vulnerable 
communities that have these pot shops," she said.

And with DPH underfunded and without leadership after the recent 
resignation of its director, Heilman questioned how prepared that 
department will be to oversee the new program.

Heilman believes that the law's wording is too vague, with no age 
limits for patients, no expiration dates for doctors' 
recommendations, and no limits on the number of refills. "It's a 
lifetime membership to smoke pot once you get a card," she said. "If 
this is medicine, then treat it like medicine. But this is about 
making [marijuana] more acceptable." Making medical decisions through 
the ballot box, she added, "puts our public health at risk."

Kevin Sabet, a former senior adviser at the White House Office of 
National Drug Control Policy who now directs the Policy Solutions 
Lab, a drug policy consulting firm in Cambridge, is a MAPA 
spokesperson. "The ballot question is not about compassion. It's not 
about medical marijuana. It's really about the legalization of 
marijuana, really, for anyone, for any reason," Sabet told the 
Advocate, noting that much of the support for the measure comes from 
legalization advocates. "That should tell you something," he said. 
(See sidebar for information on the ballot question's funding.)

Sabet disputes proponents' position that the Massachusetts law is 
written tightly enough to ensure that the state won't suffer the same 
problems as other states. "That's a good talking point for them," he 
said. "But the bottom line is, it would open up 35 medical marijuana 
dispensaries in the first year alone. That doesn't sound tight to me."

He also objected to the language of the law, which lists certain 
qualifying medical conditions but also unnamed "other conditions" as 
determined by a doctor-an open-ended phrase that would allow "any 
person with a hangnail" to access medical marijuana, he said.

"You're going to have a handful of unscrupulous doctors making a lot 
of money writing recommendations," Sabet predicted.

"We see there's obviously a lot of money coming from pro-legalization 
advocates to this initiative, so they're going to be able to tug on 
[voters'] heartstrings, so to speak," Sabet said. But he's confident 
voters will reject the measure: "I think Massachusetts voters are 
smart. They'll see this is not about compassion. It's about a pot 
shop in your neighborhood."

The cannabis plant has been used for medical purposes for thousands 
of years, across many cultures; the first recorded use was reportedly 
in 2737 B.C. in China, where it was used to treat gout, malaria and rheumatism.

While first embraced in Asia, the Middle East and Africa, cannabis 
became a commonly used painkiller in the West in the 19th century; 
the BBC reports that Queen Victoria used it to treat menstrual 
cramps. It first appeared in the U.S. Pharmacopoeia, which lists and 
set standards for medicines, in the middle of that century, and 
remained in the book until the 1940s. (Its removal came on the heels 
of the anti-marijuana campaign of the 1930s-the era of "Reefer 
Madness"-which some historians attribute to a concurrent campaign 
against Mexican immigrants, who were associated with pot use.)

Congress designated marijuana, under the Controlled Substance Act of 
1970, a Schedule 1 drug, defined as a drug with a high potential for 
abuse and no known medical benefit-a classification that places 
marijuana in the same category as heroin and LSD, among other drugs, 
and in a stricter category than cocaine, opium and methamphetamines, 
all of which are Schedule 2 drugs considered to have valid medical uses.

Nonetheless, some healthcare professionals maintain that marijuana 
offers valid medical benefits while posing minimal risks. Among the 
higher-profile proponents is Lester Grinspoon, professor emeritus of 
psychiatry at Harvard Medical School, who has written several books 
on the topic.

"Cannabis is remarkably safe," Grinspoon testified before a 
Congressional hearing in 1997. "Although not harmless, it is surely 
less toxic than most of the conventional medicines it could replace 
if it were legally available. Despite its use by millions of people 
over thousands of years, cannabis has never caused an overdose death."

In states where medical marijuana is legal-and extralegally in many 
other places-the drug is used to treat nausea in patients with 
cancer, AIDS and other diseases; to relieve ocular pressure in people 
with glaucoma; to control seizures in patients with epilepsy and 
similar conditions; and to address pain caused by a long list of 
conditions. But doctors remain split on the drug's effectiveness and 
safety. At a Statehouse hearing last April, Karen Munkacy, an 
anesthesiologist, testified that marijuana works on brain receptors 
to "decrease pain, decrease muscle spasms, and decrease nausea and 
vomiting" and also increases appetite. Her testimony was countered by 
that of Louis Fazen, chair of the Mass. Medical Society's Committee 
on Public Health, who told legislators he's concerned about the lack 
of research into the drug. "It is very difficult for physicians to 
prescribe something they don't have any information on," Fazen testified.

In May, the MMS' House of Delegates passed a resolution opposing the 
legalization of medical marijuana. "We're a proponent of 
evidence-based medicine," MMS President Richard Aghababian told the 
Advocate. While supporters offer anecdotal evidence of the plant's 
medical benefits, "that alone is not enough," he said. "We would want 
that to be verified by science, by carefully documented clinical 
trials, as with any other drug or intervention. ... We're not going 
to get ahead of the science."

And therein lies a problem: because the federal government classifies 
marijuana as a Schedule 1 drug, "that prohibits us not only from 
prescribing it, but also people from doing the studies," Aghababian said.

To that end, the MMS passed at its May meeting a resolution calling 
on the Drug Enforcement Agency to reclassify marijuana "so that its 
potential medicinal use by humans may be further studied and 
potentially regulated by the U.S. Food and Drug Administration." The 
group also voiced support for "the development of non-smoked, 
reliable delivery systems for cannabis-derived and cannabinoid 
medications for research purposes." (As Aghababian explained: "We 
don't think anyone should smoke anything. Smoking is bad.")

But getting the government to reclassify marijuana is a hard battle, 
as Lyle Craker knows all too well.

Craker, a professor in the Department of Plant, Soil and Insect 
Sciences at UMass Amherst, has spent 11 years fighting for permission 
to grow marijuana for research purposes, to no avail. The DEA has 
refused his application, saying a government-run lab at the 
University of Mississippi-the only facility with permission to grow 
marijuana for research purposes-can provide the plant to researchers. 
Craker says that facility doesn't produce enough of the drug for 
researchers and that the plant it does produce is not strong enough 
for use in research.

Like any other plant with potential health benefits, marijuana should 
be subject to scientific investigation, Craker maintains. "We need to 
have honest clinical trials to determine whether this is a good 
medicine. The people deserve that," he said. And, as a professor at a 
public university, he added, it's part of his job to do research for 
the public good.

Since he first took up his fight, Craker has heard from many people 
who say that marijuana helped them or a loved one with a medical 
condition. While he's not unsympathetic to their stories, he told the 
Advocate, "As a scientist, lay evidence is almost worthless. This is 
not to say it doesn't work; this is not to say they're not telling 
the truth. But science is built on replicated trials with adequate 
controls. ...

"I think that if you ask anyone-well, not anyone-but probably the 
vast majority of scientists would say this should be investigated 
like anything else. If it turns out it's bad for people, let's really 
ban the material," Craker continued. "But if it has any medical 
benefits, we should try to develop it into medical materials, as we 
do with many other plants."

But that scientific impulse has been thwarted by competing political 
interests. "The government has demonized [marijuana], very much so, 
by its campaigns and its war on drugs and all these type of things, 
which makes people sensitive to this whole concept that it's 
worthless," Craker said. "And then by not allowing any research to be 
done on it, that can be perpetuated."

Craker dismisses the government's arguments that marijuana is a 
"gateway" drug-"I don't know of any real evidence that's true, 
either"-and that legalizing its medical use will "open up the gate, 
and we'll be a drugged-out nation-if we're not already," he added, 
pointing to studies showing that about half of all Americans take at 
least one prescription drug every day.

Craker says he's never smoked pot and opposes its recreational use. 
"I don't want my airplane pilot under the influence of marijuana," he 
said. But, he added, "with all the things to worry about in the 
world, this is not one them. I can't see how scientifically testing 
this material is going to create a big revolution in marijuana use 
for recreational reasons."

Craker's case with the DEA is now before a federal appeals court, 
where he doesn't expect to prevail. He suspects the DEA is looking at 
his age-he's 71-and hoping to wait him out. But even if he never wins 
his case, the pressure on the DEA to relent will increase as medical 
marijuana is legalized in more and more states, he said: "I don't 
know when common sense will prevail."

Evans, the Northampton attorney and activist, believes it's up to 
citizens to reform marijuana laws. He points to state legislators' 
refusal to consider the medicalmarijuana bill co-sponsored by Sen. 
Rosenberg even in the face of earlier, non-binding public-policy 
ballot questions showing that their constituents supported it. "They 
ducked it entirely," Evans said.

Lawmakers, like the general public, have long been fed the message 
that marijuana not only has no medical utility (a position Evans 
called "disingenuous"), but also that any use of the drug amounts to 
abuse (a claim, he said, that "is not only incorrect, it's almost 
delusional"). "A lot of people just can't accept the idea of 
marijuana as medicine because it runs directly counter to 
prohibitionist dogma," he said.

But public opinion is swinging the other way, Evans believes. "I'm of 
the view that most people have an opinion on this subject already and 
don't really need to be educated," he said. "They need to be 
liberated, so to speak, or given the opportunity to express their 
opinion, and the only time they can express that opinion truthfully 
and safely, without risk, is in the privacy of the voting booth."

One elected official who openly backs Question 3: Rosenberg, who 
contends that the law would provide access to more healthcare 
options. (Rosenberg has recently undergone treatment for skin cancer, 
although he's said that his personal experience has not influenced 
his position on the issue.)

With medical marijuana already legal in 17 other states and D.C., it 
makes sense for Massachusetts to follow, Rosenberg told the Advocate. 
"We've learned a lot from the mistakes of the early states. We're not 
repeating those mistakes," he said.

Which is not to say that Rosenberg considers the ballot question 
perfect. He preferred the bill he co-sponsored to the ballot measure; 
the latter, he said, is too broad on the question of which patients 
and medical conditions qualify, which could lead to abuse. Rosenberg 
would like to see the law include a clearly defined list of 
qualifying conditions, with the possibility of adding other 
conditions "through a reasonable public process using the best 
science." If the law passes, the Legislature could rewrite portions 
of it, "although that can be controversial," Rosenberg noted.

His misgivings about portions of the ballot question aside, Rosenberg 
believes its time has come. "Given that the Legislature is reluctant 
to act on the bill, I don't want it to languish session after session 
after session. ... I'd be very happy now to have it become law 
through the ballot question," he said.

"Drugs are a third-rail issue in the Legislature," Rosenberg added. 
"My personal opinion is, it's an irrational fear on the part of 
legislators. But it's a fear nonetheless."

To Lorraine Kerz, arguments over legalizing marijuana and other broad 
drug policy issues distract from the purpose of Question 3. "I'm not 
involved in any of those politics. But I have to stand by what I saw 
with my son," she said. "I saw a young man who was quickly losing his 
life. ... This is something that helped him, and helped him tremendously."
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MAP posted-by: Jay Bergstrom