Pubdate: Thu, 11 Sep 1997 Source: The Olympian Contact: P.O. Box 407 Contact: Olympia WA 98507 Contact: As a physician I must dispute the exaggerated claims of marijuana's harmful effects put forth by Ms. Susan GarciaSwain in the 29 August 1997 "Other Voices" column. Let's do the balancing of cost, risk and benefits that she rightly cites as a requisite for responsible prescribing of marijuana for treatment of nausea and vomiting due to cancer chemotherapy. Benefits: Smoked marijuana relieves nausea and vomiting in 60 to 90 percent of chemotherapy patients in whom conventional anti nausea medications had failed to do so. (Studies carried out in six states: N.M., N.Y., Cal., Ga., Tenn., and Mich. in the 1980's, see "Marijuana, Medicine and the Law" Series, R.C. Randall, Ed., Galen Press, 1990). This allows patients to continue potentially lifesaving anticancer therapy. And once the nausea has started, Marinol (synthetic THC) pills are vomited up well within the one hour it takes to produce results. Smoked marijuana, on the other hand, bypasses the upset stomach and goes directly to the blood stream, producing nausea relief within minutes. The proper dosage is achieved when the patient starts to feel the "high." Listen to world renowned biologist Stephen Jay Gould, a cancer survivor: "Absolutely nothing in the available arsenal of antiemitics worked at all...I was reluctant to try [marijuana] because I have never smoked any substance habitually (and didn't even know how to inhale). Moreover, I had tried marijuana twice...and had hated it...Marijuana worked like a charm...The sheer bliss of not experiencing nausea...was the greatest boost I received in all my year of treatment, and surely the most important effect upon my eventual cure." (See the "NY Times," May 4, 1993, for Gould's entire story). Risks: The only conceivable significant risk to a cancer patient would be the irritation produced by smoking. Claims that marijuana might produce lung cancer are meaningless in this setting because lung cancers from smoking take 25 or more years to developwell beyond the life expectancy of most cancer patients at risk. Despite more than 30 years of marijuana use by large populations, no epidemic of lung cancers due to marijuana has occurred. Since the 60 million regular tobacco smokers develop 150,000 lung cancers annually, at similar rates we would expect the 1017 million regular marijuana smokers to develop 25 to 40,000 per year. I challenge Ms. GarciaSwain to show me evidence of any such epidemic. My review of the medical literature shows none. My reading of the above riskbenefit analysis overwhelmingly favors the beneficial medicinal use of marijuana. David L. Edwards, M.D. 2715 Schirm Loop N.W. Olympia WA 98502