Pubdate: Fri, 17 Sep 1999 Source: Bangor Daily News (ME) Copyright: 1999, Bangor Daily News Inc. Contact: http://www.bangornews.com/ Author: Shawn O'Leary, Of the NEWS Staff MAINE DOCTORS' GROUP NEARS VOTE ON MEDICAL MARIJUANA BAR HARBOR - A professional association of Maine doctors expects to decide today whether it will oppose a measure on November's statewide ballot that would legalize medical use of marijuana. A four-doctor panel wrestled with the issue Thursday, the first day of the Maine Medical Association's annual meeting. The panel debated a proposed resolution that would put the association squarely at odds with the November citizen initiative. Results of the panel's deliberations will be presented to the association's House of Delegates this morning. The delegates will then have the opportunity to amend, accept or deny the resolution. Mainers will vote this fall on an initiative, sponsored by Mainers for Medical Rights, that would allow physicians to discuss and recommend the drug for the treatment of five specific diseases: AIDS, glaucoma, cancer, multiple sclerosis and epilepsy. A resolution to publicly oppose the citizen initiative was proposed by Dr. John Garofalo, chairman of the association's public health committee. His resolution contends that a scientific basis for the use of marijuana as a medicine is lacking, and that marijuana is an addictive "gateway drug" to other drugs such as cocaine and heroin. If adopted, the resolution would allow the association to publicly rally against the initiative through news releases, commentaries and other ways of addressing Maine voters. Gordon Smith, executive vice president of the Maine Medical Association, said Thursday that while his organization has never come out for or against the wholesale use of marijuana as a medication, it has testified on two occasions before the Maine Legislature on the use of the drugs for "two limited purposes": treatment of AIDS and chemotherapy. Those afflicted with AIDS can suffer from prolonged and drastic weight loss known as "wasting syndrome." Chemotherapy patients may suffer from nausea and vomiting - conditions marijuana has been said to prevent. Smith said that "anecdotal evidence" has supported use of marijuana as a treatment for both conditions. Yet the association hasn't supported use of marijuana for treatment of other diseases. Should voters approve of the initiative, doctors would have the right to recommend the drug's use - shielding the patient from prosecution for possessing 1.25 ounces of dry marijuana and from growing six of the plants for personal use. Smith said that association members have expressed concern with the role of the physician within the initiative, largely because doctors are accustomed to prescribing FDA-approved drugs. While FDA-approved drugs administered at pharmacies come with known toxicity levels, concentrations and ingredients, Garofalo told the doctors' panel Thursday that those factors may vary with marijuana cultivated at home or bought on the street. Those variations, he said, represent a margin of error that could translate into consequences ranging from an inadequate dose of medication to the possible death of the patient. Garofalo also expressed concern that the delivery of marijuana's active substances may not be adequate or constant while smoked. He favors synthetic forms of the drug that can be administered in controlled amounts - and regulated by the FDA. "There are drugs that are available as a prescription," Garofalo told the panel. "Why the necessity for permitting the use of marijuana?" Those sentiments were disputed by Elizabeth Bean, a clinical social worker affiliated with the group that wrote the ballot initiative. Bean, who said she has never smoked marijuana, told the panel that the group hasn't been influenced by people with sinister or hidden agendas. "We are not being duped by potheads," Bean said. "We're educated people and we can assess the scientific basis" for the drug's use. She said patients should be given the option of smoking marijuana because it allows patients to administer a dose to accommodate their own needs. Prescription forms of marijuana's active ingredients, Bean said, can put patients into a debilitating high as the drug is administered orally in one dosage. She also said that the orally prescribed drug may not be suitable for patients suffering from vomiting, and that it can take an hour or more to take effect while smoking provides an immediate effect. She said the initiative would allow doctors who were not comfortable with recommending marijuana as a medicine to rule out the drug as an option for treatment. Moreover, the drug could only be available from a patient's declared doctor, and only after the doctor has determined that the drug would be used to treat one of the five declared illnesses. - --- MAP posted-by: Don Beck