Pubdate: October 7, 1997 SOURCE: Chatelaine Magazine CONTACT: http://canoe2.canoe.ca/ChatelaineInfo/feedback.html Rx: marijuana People with MS, glaucoma, AIDS and cancer say smoking pot eases their symptoms. But is marijuana good medicine? By Katrina Onstad A year ago, Lynn Harichy, now 36, was a different person. Diagnosed at 18 with multiple sclerosis (MS), a chronic disease of the central nervous system, Harichy was rapidly succumbing to the disorder. Periods of blindness would come upon her; limbs would tingle and fall numb. The mother of four was confined to a wheelchair. "It felt like someone was breaking my bones," she recalls from her home in London, Ont. There is no cure for MS, only treatment in the form of drug therapy. At one of her lowest points, Harichy read a story in the local newspaper about a man facing charges for selling marijuana seeds. His defense revolved around marijuana as a pain reliever for the chronically ill. Harichy as intrigued. It had been years since she'd smoked pot, but when a friend gave her a joint as a gift and she lit up, the effects were immediate. Averaging a joint a day, Harichy found that the muscle spasms that racked her body ceased; the bouts of paralysis grew less frequent, finally vanishing. Most important for Harichy, her mental state shifted. "I could focus," she says, and in her life, that matters: Harichy has been on a disability pension and is training to become a lab assistant. "Suddenly, my thoughts were clear, more organized. I could concentrate in school because I wasn't in pain." But she didn't want to grow her own marijuana or use drug dealers. "I have kids. I don't want to put them in danger." So Harichy joined a Toronto group called CALM, Cannabis as Legitimate Medicine, an organization that provided marijuana for those who needed it for medicinal purposes. With a $15 registration fee and a letter of diagnosis, people with a range of health concerns suited to marijuana treatment from AIDS wasting syndrome to cancer to glaucoma could receive cheap clean marijuana in a safe officelike environment. There's only one catch: it's illegal. Like the Vancouverbased Compassion Club, CALM was based on the California model of "cannabis buying clubs." The difference is that in California, Proposition 215, passed last November, made marijuana use legal for certain illnesses. In Canada, it's illegal. Period. "Under the Controlled Drugs and Substances Act, marijuana can only be used in research situations," says Bruce Rowsell, director of the drug surveillance bureau at Health Canada. "But if you're caught cultivating or possessing marijuana in Canada, it doesn't matter if it's for medicinal use; you could still be charged." For people like Harichy, inaccessibility creates a logistical nightmare. She couldn't drive the hundreds of kilometres to Toronto to buy her marijuana through CALM, and delivery was often difficult. Canada Post sometimes intercepts suspected "drug shipments," and few marijuana proponents are willing to risk prosecution for trafficking. Harichy isn't alone in her frustration; though no one knows how many Canadians are relying on marijuana for pain relief, it is the mostused illegal psychoactive drug in North America. The question is: does marijuana really help? This is how marijuana works: we have receptors for delta9tetrahydrocannabinol (THC) the chief marijuana component responsible for the "high" in the parts of the brain responsible for memory, mood, motor activity and concentration. Smoking marijuana affects those functions, but because we don't have receptors in the parts of the brain that control basic life functions (consciousness and respiration), it can't kill us. For those with MS and epilepsy, marijuana is reported to reduce muscle spasms and to relieve accompanying bladder and bowel incontinence. Many people who suffer from glaucoma a condition usually resulting from excess pressure in the eye that, if left untreated, can lead to blindness also stand by marijuana for its effectiveness in reducing the pressure behind the eye. And the moodimproving qualities of marijuana are said to be useful treatment for a range of chronically ill patients. But marijuana is regarded as most medically viable in light of its most famous side effect: the munchies. Marijuana is an appetite stimulant, which can be key in the control of AIDS wasting syndrome, the result of HIV infection, which causes patients to lose 10 percent or more of their body weight. The nausea and inability to eat can contribute to early death, but marijuana has proven an effective antidote by making patients hungry and hence, better nourished. For cancer patients too, loss of appetite and an inability to keep food down can pose major problems. Dr. Eduardo Bruera of the Cross Cancer Institute in Edmonton has seen these effects firsthand with his chemotherapy patients: "I've had patients who are vomiting 30 times from the radiation. It can rip an esophagus apart or cause dehydration." In one U.S. survey, 78 percent of cancer patients felt that smoking marijuana reduced their nausea. But Dr. Bruera, like many doctors, isn't convinced marijuana is the best solution. "The problem with it is that it gets you high," he says. "A lot of our patients, especially the elderly, don't want that feeling." Also, little is known about the longterm effects of marijuana use, though the carcinogens produced by smoking any substance can be fatal. "Legalizing marijuana oversimplifies the care of the terminally ill," says Dr. Bruera. "Since the mid90s, plenty of effective medications for vomiting have been introduced, drugs that don't have the side effects of marijuana derivatives. Why would I tell an ill patient to smoke something when he can get better results elsewhere?" In the past few years, pharmaceutical versions of THC have appeared on the market. Dronabinol (brand name Marinol), a synthetic version of THC, is prescribed to AIDS patients and cancer patients with sever nausea. Advocates for legalizing marijuana aren't impressed. "Marinol is only one component of cannabis," says Umberto Iorfida, president of the National Organization for the Reform of Marijuana Laws in Canada (NORML). "Pot doesn't consist of THC exclusively; it has more than 400 ingredients." Hence, THC pills can cause patients to feel even more stoned than regular marijuana. "I've talked to people with AIDS who just don't want to take any more pills," says Iorfida. "They can't keep them down." Of late, the movement to legalize marijuana in Canada seems to be gaining momentum. In Vancouver, the Compassion Club has expanded its facilities. There, more than 100 clients regularly come by to purchase pot, discuss alternative treatments and talk to fellow smokers. According to founder Hilary Black, the club receives more than 15 calls a day from people across Canada who want to use the service (they send people information and will ship marijuana by mail to people in extreme need); at least a third of their clients are women. "A lot of women don't feel safe using the black market," says Black. "And if they have families, they might not be able to afford it." Yet according to Health Canada, we don't know enough about marijuana's effects to make it legal. "Most of the information out there is anecdotal," says Rowsell. "Only when good scientific studies come forward that say Yes, this drug may be useful for this disease, should we even consider legalizing it." In the meantime, however, Harichy is back to using the black market. After a couple of months in operation, CALM closed its doors in July. According to organizers, the HIV community they were targeting already had its own sources, and they couldn't attract enough clients. So where does that leave women like Harichy, who aren't connected to a marijuana subculture? For now, Harichy is relying on friends to get it for her. "They say we need more studies before it can be legalized, but what does that mean?" asks Harichy. "It makes me feel better, and I know that right now."