Pubdate: Saturday, 31 October 1998 Source: Arizona Daily Star (AZ) Contact: http://www.azstarnet.com/ Author: Jane Erikson FIGURING OUT DRUG INITIATIVES A TRICKY PROPOSITION Voters will make measure stick or let it drop Have Arizona voters followed Alice through the looking glass? ``A yes vote means no, a no vote means yes'' is the confusing take-home message on Propositions 300 and 301. But these measures aren't about Wonderland. They're about legislation voters approved by a two-thirds majority in the 1996 general election. The so-called Medical Marijuana Law said physicians should be allowed to prescribe marijuana and other illegal drugs - known as Schedule 1 drugs, under Food and Drug Administration classification - to relieve pain and nausea in patients with cancer, AIDS and other serious or terminal illnesses. The law also prescribed treatment rather than prison for first- and second-time drug offenders. Now here's where it gets confusing. A no vote on Propositions 300 and 301 would uphold the 1996 law as voters approved it. A yes vote would overturn the law, upholding instead the Legislature's 1997 vote to repeal the 1996 voters' decision. Proposition 300 says doctors should not be able to prescribe marijuana to seriously ill and dying patients - unless the federal Food and Drug Administration first allows such prescribing. The measure gets tougher on other Schedule 1 drugs such as heroin, LSD and PCP, which are generally considered more dangerous than marijuana. It says under no circumstances should doctors be able to prescribe those drugs. Proposition 301 would remove the portion of the 1996 law that precludes prison sentences for first- and second-time drug offenders. It would make it more difficult for those offenders to avoid jail time and get into treatment. But the debate over Propositions 300 and 301 focuses as much on voters' rights as it does on the pros and cons of the medicinal use of an illicit substance. It is the voters' rights aspect of the debate that has prompted Attorney General Grant Woods to oppose 300 and 301. ``The Legislature threw away the vote of 65.4 percent of the voters,'' said Sam Vagenas of The People Have Spoken, the group leading oppositionto 300 and 301. ``In 1996 we had a referendum on our failing war on drugs,'' Vagenas said. ``This year it's a referendum on our failing politicians.'' But groups supporting the propositions say Arizona's medical marijuana law sends the wrong message to children and threatens government anti-drug efforts. ``As medication experts, pharmacists know the dangers associated with prescribing Schedule I substances and the potential for forgery of signatures,'' said pharmacist Ken Cross, president of the Arizona Pharmacy Association. Both Arizona and California passed medical marijuana laws in 1996, sparking a huge national debate. California's somewhat tamer law allowed doctors to recommend the use of marijuana and other drugs, and patients to possess such drugs for their own use. But they were not the first states to legalize marijuana for medicinal purposes. Virginia passed a law in 1979 allowing doctors to prescribe marijuana for patients with cancer and glaucoma, an eye disease characterized by increased pressure within the eye; marijuana reduces the pressure. Connecticut passed a similar law in 1981. And according to the National Conference of State Legislatures, 23 states and the District of Columbia have laws that somehow authorize the medical use of marijuana. Early last year, the National Institutes of Health convened a panel of experts to review the scientific literature on possible therapeutic uses of marijuana. ``There are varying degrees of enthusiasm to pursue smoked marijuana for several indications,'' the panel noted. ``This enthusiasm was tempered by the fact that, for most of these disorders, effective alternative treatments are already available.'' The panel worried that prolonged use of marijuana could lead to lung and immune-system impairment. The panel concluded that more research was needed to evaluate marijuana's potential therapeutic use. But political pressures have prevented such studies from being conducted, said Dr. Kevin Carmichael, a Tucson family practice physician who specializes in HIV infection and AIDS. ``I think there's probably some medical use for marijuana, and I resent the fact that more research hasn't been done on it,'' Carmichael said. For AIDS patients who have no appetite, Carmichael prescribes an FDA-approved drug called Marinol, a synthetic version of the active ingredient in marijuana. The drug helps some patients improve their nutrition, but most don't like the drug, Carmichael said. ``It often just makes them feel strange,'' he said. Other experts, including Dr. Sydney Salmon, director of the Arizona Cancer Center, have noted that effective and legal - albeit expensive - treatments for cancer pain and chemotherapy-induced vomiting are available. A recent poll by Northern Arizona University's Social Research Laboratory showed that most Arizonans are confused about Propositions 300 and 301. But after having the measures explained to them, 56 percent of those surveyed said they would vote no on both propositions, upholding the 1996 voters' decision. Support for the 1996 law increases to 65 percent among those aged 36 to 55. ``We are seeing a generational effect,'' said Fred Solop, the survey's director. ``Baby boomers are more comfortable recognizing the medicinal effects of certain drugs.'' - --- Checked-by: Rolf Ernst