Pubdate: Thu, 18 Mar 1999
Source: NOW Magazine (Canada)
Page: 20
Copyright: 1999 NOW Communications Inc.
Contact:  http://www.now.com/
Forum: http://www.now.com/forum/index.html
Author: Colman Jones

FEDS SCREWED UP ON POT

Liberals Blowing Smoke On Medical Marijuana Study -- The Evidence Has Been
In For 25 Years

For many connoisseurs of altered reality, the pungent sweetness of the
marijuana plant heralds a gentle, spacy universe where time lingers
and reflection is a multilayered experiment.

But the much-maligned herb also offers less sublime possibilities.
Those who suffer physical torment talk of it as a salve -- a calming,
pain-easing medicine more important for its ability to make life
bearable than for its invitation to a fifth dimension.

Centuries after healers discovered the plant's therapeutic charms and
decades after scientists learned how to test it, our federal
government still refuses to legalize its use by thousands suffering
from cancer, AIDS and multiple sclerosis.

Despite an Ontario judge's recent decision that denying citizens
medical access to the substance is unconstitutional, and despite many
appeals, federal health minister Allan Rock has made no move to make
the situation easier for sick people.

While he suggested a year ago that he might allow access, last week he
derailed the legalization question by announcing the government's
intent to establish guidelines for clinical trials.

Cynical move

This move, seemingly dramatic and bold, is considered by many a
cynical manoeuvre to lend the appearance of sophistication and
compassion to a stalling operation.

Marie Andree Bertrand, a member of the government's famous Le Dain
commission that in the early 1970s recommended the decriminalization
of pot, says that to insist on more study of the plant before allowing
medical use is to "laugh in the face of the Canadian public."

The research, she says, was done and paid for 25 years
ago.

* * *

The bushy, hardy plant known as cannabis sativa has been used
medicinally across the globe for thousands of years. In 1971, the Le
Dain commission cited a series of classified U.S. army studies from
the 50s showing a number of potentially valuable therapeutic effects
from the use of synthetic cannabinoids for everything from fever and
epilepsy to high blood pressure.

Says the commission's Bertrand, "We spoke of all the symptoms that
would be alleviated by cannabis," contradicting what she calls "lies"
emanating from public health authorities.

"The minister is reinventing the wheel. This is full of
bullshit."

As well as Le Dain, a host of prestigious groups including the
American Public Health Association, the British Medical Association,
the Canadian AIDS Society, the Canadian Medical Association and the
Canadian Hemophilia Society have endorsed medical marijuana.

A 1997 editorial in the New England Journal Of Medicine even stated
that to demand evidence of therapeutic efficacy for pot is
"hypocritical."

Noxious feelings

"The noxious sensations that patients experience are extremely
difficult to quantify in controlled experiments," the journal stated.
"What really counts for a therapy with this kind of safety margin is
whether a seriously ill patient feels relief as a result of the
intervention, not whether a controlled trial proves its efficacy."

Most scientific research on pot has been limited to testing oral
tetrahydrocannabinol (THC), the ingredient that causes smokers to get
high, but THC is only one of the plant's many chemical
constituents.

The best evidence about smoking pot concerns its use in preventing
nausea among cancer patients undergoing chemotherapy.

A series of six studies conducted by American state health departments
in the 1980s, involving nearly 1,000 patients, showed that pot worked
better than conventional prescription anti-nausea drugs and oral THC
(marketed today as the synthetic pill Marinol) in alleviating chemo's
queasy downside.

Just last October, a study published in the New York State Journal Of
Medicine looked at 56 cancer patients receiving chemo for whom
conventional anti-nausea drugs were not working.

Smoking pot, it turns out, did the trick in nearly eight out of 10
cases, with no serious negative side effects. In light of this kind of
info, a good number of cancer doctors are now quietly recommending a
joint now and then to their patients, despite the drug's illegal status.

The list of uses for the much-beloved weed goes on. The problem is
that much of the evidence is anecdotal, so healing by weed hovers in
limbo -- good enough for doctors and a host of scientific
associations, but insufficient to sway regulators.

Its use in Canada thus remains strictly verboten under the Controlled
Drugs And Substances Act, which prescribes six months in prison and a
$1,000 fine for those caught taking a whiff to ease their aches and
pains. This despite December's ruling by Ontario judge Patrick
Sheppard in favour of Toronto's Terry Parker, an epileptic.

Benedikt Fischer, a scientist with the Addiction Research Foundation
(ARF), now part of the Centre for Addiction and Mental Health, is
surprised that Rock's announcement hasn't addressed the "legal
circumstances and regulation currently governing -- or not clearly
governing at all -- the issue of medicinal marijuana use."

He cautions that the timetable of any further research is going to be
long-range. "Rock hasn't specified what medical or health indications
they're looking at. Even if they started the trial process tomorrow,
it will take four or five years before we see any substantive results
or data coming out of it."

Doctor Andrew Weil, director of the University of Arizona's program of
integrative medicine and a renowned authority on psychoactive drugs,
allows that some clinical trials should be repeated but stresses that
"on the basis of what we know at the moment, marijuana could be
authorized for uses in medicine."

Non-toxic drug

Perhaps the most significant advantage weed offers, Weil says, is the
fact that its use entails no side effects. The effects of other,
conventional treatments are sometimes so serious that patients have to
stop taking them despite their suffering.

"It is so non-toxic -- relative to the pharmaceutical drugs that are
used routinely -- that you may as well look for ways to use it,
because we don't have anything else in medicine that is so non-toxic."

Canada is perhaps the last industrialized western democracy to
officially recognize pot's medicinal benefits, even lagging behind our
neighbours to the south, where seven states and the District of
Columbia have approved such uses.

In Israel, revelations that police have provided an elderly asthma
sufferer with a monthly dose of dope for six years, with special
permission from the health ministry, led the government to form a
committee to establish guidelines for doctors prescribing marijuana.

Clinical tests are also under way in Britain, but in some other
European nations therapeutic use is already allowed.

Alan Young, a law professor at Osgoode Hall, attributes the logjam to
Canadian fear of American disapproval. "That's what holding things up,
because the rest of the industrialized world has more or less given up
on its quest to criminalize marijuana use."

Governments, he says, have not funded studies, so they are correct in
asserting that there are no really compelling, large-scale, valid
double-blind studies.

"It's by their own indifference and negligence that those studies
don't exist. For them to deny access to marijuana because of the
absence of valid, medically accepted studies is the height of
hypocrisy," says Young, who worked on the Parker case and represented
AIDS sufferer James Wakefield, who lost his suit against the feds to
get medical pot.

"What occurred on March 3 (Rock's announcement) was an exercise in
politics at its worst level, in the sense that it was an announcement
made simply to stall and to create the illusion that this government
does truly care about the plight of sick people.

"I see this as at least a five-year project, minimum. Cannabis sativa
is a very remarkable, very mysterious plant, and putting aside the 400
or so chemicals we have identified, there are 60 different
cannabinoids."

Replicating results

Certainly, marijuana research is not going to be straightforward.
Independently replicating results from clinical trials will be a
problem, since the precise chemical makeup of the drug varies greatly
from plant to plant.

Will the supply be handled by drug stores or street-corner
pushers?

"Those details are being worked out by officials who are working hard
on developing a plan, and as information becomes available we'll make
it public," says Rock spokesperson Derek Kent.

Umberto Iorfida, president of the National Organization for the Reform
of Marijuana Laws (NORML) in Canada, imagines that Rock's scheme will
probably allow for permits to be issued to both growers and dispensers
of medicinal pot.

This could take the form of existing buyers clubs like the B.C.
Compassion Club Society (a nonprofit group that provides cannabis to
650 members) or large drugstore chains, which could be provided with
permits that would enable them to purchase from growers. Perhaps there
would be a body akin to the wheat pool that would measure and label
THC content on packaging.

"Certainly, they (the government) are not going to grow it and
dispense it," suggests Iorfida, who has no doubt that existing growers
will end up supplying the weed.

Marijuana is currently being grown for medical use in greenhouses in
the Netherlands, though these are not licensed by the government. Then
there are a handful of other official growers, like a U.S. government
farm at the University of Mississippi and a British firm, GW
Pharmaceuticals.

"When it comes to cultivating marijuana, the underground community
knows more than the botanists and pharmacologists, and we should be
tapping into that information," says Young.

Weed licence

One private grower that may figure here is Brown Bear Medicinals, a
co-op organized by Brian Taylor, the mayor of Grand Forks, BC, one of
the first outfits in Canada to apply for an industrial hemp licence.
Taylor says the co-op is also applying to cultivate medicinal cannabis
for the Compassion Club and/or clinical trials.

"We'd like to be a supplier in the next little while to patients in
both the special access as well as trials and research," Taylor says.

"We have a vision of how access could happen over the next little
while, with controlled groups supplying through the medical community,
with either prescriptions or letters of recommendation or research
studies. I think there's a way we can include a whole bunch of people
who have been left out in the cold up until now."

Ottawa's plans to move on this issue come as little consolation to
people suffering from AIDS and other illnesses, who don't want to wait
four or five months before finding out whether they'll receive
compassionate access under rules already in force that allow certain
critically ill patients to obtain drugs that have not been approved.

As for Rock's clinical trials, Compassion Club founder Hilary Black
says, "The people who really need access now are not going to be alive
in a couple of years -- they're fading fast."

Health Canada's Kent, however, insists that the research plan "would
be flexible enough to ensure that those who require marijuana for
medicinal reasons would be accommodated."

But why can't people currently using pot for medicinal reasons be
granted an exemption?

Kent cautions, "We're working at determining where medicinal-quality
marijuana can be located, where it could be legally available. We're
looking at obtaining a product that's of good quality and originates
from a licit, licensed supplier. And we have to bear in mind that that
has to be used in a proper scientific context."

Young counters that there are by definition no licensed suppliers.
"They're the only institution that can license a manufacturer, so they
keep setting themselves up for failure by saying, 'We don't have the
clinical trials, we don't have a licensed manufacturer.' That's all a
product of our government's policy."

As for "proper scientific context," the ARF's Fischer notes that
clinical trials -- or science, if you will -- can't answer everything.
He says, "At the end of the day, we may have a few trials that
indicate no significant superior value of marijuana over other
existing conventional therapies, and we'll still have a huge list of
unanswered questions.

Awaiting studies

"At some point, the government will have to address the issue of
compassionate use, even in the lack of hard scientific evidence."

In the meantime, local organizations aren't waiting for the studies to
be mounted. Outfits like Black's Compassion Club and the for-profit
Medical Marijuana Resource Centre here in Toronto are openly selling
pot to medicinal users who show doctors' letters confirming they have
one of several life-threatening or debilitating conditions alleviated
by pot intake.

Black says the club's supply comes from 15 growers the club has
contracts with. "We can go see their grow rooms so we know it's being
done cleanly, without any chemicals.

"If Rock wanted to show good faith, he would put a stay on any
criminal proceeding right now that has anything to do with medical
use, and that would show that this is real and not just political fluff."
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MAP posted-by: Patrick Henry