Pubdate: Fri, 17 Sep 1999
Source: Bangor Daily News (ME)
Copyright: 1999, Bangor Daily News Inc.
Author: Shawn O'Leary, Of the NEWS Staff


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.

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