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Pandora’s Panacea

Virginia Lee Hunter

Four-star general and federal drug czar Barry McCaffrey claimed in 1996 that "There is not a shred of scientific evidence that shows that smoked marijuana is useful or needed." Over the two years since, researchers at the nonprofit national Institute of Medicine have conducted an exhaustive study intended to once and for all answer the burning, if you will, question: Is marijuana medicine?

The answer, delivered by McCaffrey at a press conference at the Community Coalition Center in South Los Angeles, was yes. And no. And further studies are needed.

Predictably, almost everyone claimed victory for their point of view, because the report, titled Marijuana and Medicine: Assessing the Science Base, has something for everyone. Yes, certain cannabinoids, the chemical compounds that make up cannabis, have been found to have therapeutic value. No, Marinol (or synthesized THC, which is currently prescriptively available), is not the only efficacious or desirable one for certain medical conditions. Yes, pot is effective for chemotherapy-induced nausea, pain management and AIDS wasting, but smoked marijuana is a "crude THC delivery system that also delivers harmful substances," e.g. smoke. But smoking aside, pot’s effects are "within the range" of other legal medications.

In fact, the report states that the anti-anxiety benefits of THC, i.e., getting mellow as a cello and/or ripped to the tits, depending on how one controls one’s anxiety, can be beneficial.

What has the legalizers, as well as strict medicinal advocates, taking celebratory bong hits, is the report’s debunking of two oft-repeated myths. Pot produces only mild symptoms of dependence and withdrawal (if any), and it found "no conclusive evidence" for pot’s reputation as a pharmacologic "gateway" drug (those youths who start on weed are not necessarily going to end up tooting Peruvian marching powder). Moreover, the report holds that these questions are immaterial for sick people.

The study concludes by arguing against making marijuana available in pharmacies, but then states, "Until a non-smoked, rapid-onset cannabinoid-drug delivery system becomes available, we acknowledge that there is no clear alternative for people suffering from chronic [their emphasis] conditions that might be relieved by smoking marijuana, such as pain or AIDS wasting." The use of the word clear is Solomon’s splitting of the baby or the report’s authors’ way of absolving themselves of any political stand.

The report’s authors reviewed all available scientific studies on the subject, held workshops, visited cannabis clubs (including L.A.’s) and AIDS clinics, and listened to both supporters and detractors. "We did hear a lot of uses that worried us in terms of two things," says Dr. John Benson, a physician and researcher at Oregon Health Sciences University and co-editor of the study. "Was the diagnosis correct and had everything possible in the way of approved, good drugs been used? For example, I remember a patient who told us his migraine headaches weren’t controlled by anything [other than pot]. But he’d never tried the currently most popular and effective drug, and he claimed he didn’t want to, because it was injectable. It also is available in other delivery systems. I, as a physician, would want to make sure everything had been done short of marijuana."

Scott Imler, director of the Los Angeles Cannabis Resource Center and co-author of Proposition 215, objects to the inherent systemic bias against pot. "No other drug is required to work better than every other available drug. There’s no requirement for Tylenol, in order for it to go on the market, that it be better than Bayer."

Smoked marijuana’s effect on the respiratory tract is the only real medical objection the report put forward. Trying to track the science is like looking through John Lennon’s proverbial glass onion. Dr. Donald Tashkin is the chief of pulmonary medicine at UCLA and, while he’s found no evidence that pot causes emphysema, has found cell abnormalities in the lungs of human study subjects. He’s embarking on a five-year study investigating any correlation between pot smoking and lung and upper-airway cancers. On the other hand, the 1995 Kaiser Permanente study Marijuana Use and Mortality — the largest of its kind, which tracked more than 65,000 potheads from 1979 through 1991 — showed "little if any effect of marijuana use on non-AIDS mortality in men and on totality mortality in women."


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