Medicinal pot, Yes. Legal pot, bad idea

Wafting around California these days is a lot of rhetoric about legalizing marijuana, a proposition (#19) that will be on the ballot in November. Californians being Californians — I’m one; I know — and pot being pot, there is no shortage of heated opinion. Here is one more.

Countless Americans suffer from chronic or short-term conditions which could be relieved by marijuana. To deny them such relief simply makes no sense at all. The sooner everyone wakes up to the logic of marijuana as comfort care, and it becomes universally legal and available, the better.

Legalizing the weed for recreational delight, though — essentially making it available to all comers — makes very little sense at all. It’s an addictive substance, folks. It messes with your mind. All we need is a whole new population of messed-up folks to add to the messes we already have.

This is just one addict’s opinion. But if one addict’s opinion is only anecdotal, some others, below, are worthy of serious consideration. They were offered by the California Society of Addiction Medicine in an op ed piece by the Society’s president, Dr. Timmen Cermak, in the San Francisco Chronicle, August 22. The Society is taking no position on Prop. 19, Cermak explains, “but we wish Californians would look at the research before they make up their minds on how to vote.” This space applauds that suggestion.

The Society of Addiction Medicine is made up of “the doctors who specialize in the treatment of drug abuse; we work every day with people addicted to drugs, including alcohol,” Cermak writes. “We are a diverse group of doctors committed to combining science and compassion to treat our patients, support their families and educate public policy makers.”

Since very few of the Society of Addiction Medicine’s 400 physician members believe prison deters substance abuse, legalizing marijuana would have that small, back-handed benefit. “Most (of us) believe addiction can be remedied more effectively by the universal availability of treatment,” Cermak writes. “When, according to the FBI, nearly half – 750,000 – of all drug arrests in 2008 in the United States were for marijuana possession, not sales or trafficking, we risk inflicting more harm on society than benefit. Prop. 19 does offer a way out of these ineffective drug policies.”

But other research should raise alarm bells. Cermak’s essay is excerpted below, with a few points worth pondering bold-faced:

“Two-thirds of our members believe legalizing marijuana would increase addiction and increase marijuana’s availability to adolescents and children. A recent Rand Corp. study estimates that Prop. 19 would produce a 58 percent increase in annual marijuana consumption in California, raising the number of individuals meeting clinical criteria for marijuana abuse or dependence by 305,000, to a total of 830,000.

“The question of legalizing marijuana creates a conflict between protecting civil liberties and promoting public health… between current de facto legalization in cannabis clubs and revenue-generating retail marijuana sales… The society wants to make sure voters understand three basic facts about how marijuana affects the brain:

“– The brain has a natural cannabinoid system that regulates human physiology. The flood of cannabinoids in marijuana smoke alters the brain’s delicate balance by mimicking its chemistry, producing a characteristic “high” along with a host of potential side effects.

“– Marijuana is addicting to 9 percent of people who begin smoking at 18 years or older. Withdrawal symptoms – irritability, anxiety, sleep disturbances – often contribute to relapse.

“– Because adolescent brains are still developing, marijuana use before 18 results in higher rates of addiction – up to 17 percent within two years – and disruption to an individual’s life. The younger the use, the greater the risk.

“Marijuana is a mood-altering drug that causes dependency when used frequently in high doses, especially in children and adolescents. It’s important that prevention measures focus on discouraging young people from using marijuana.

“Prop. 19 erroneously states that marijuana “is not physically addictive.” This myth has been scientifically proven to be untrue. Prop. 19 asks Californians to officially accept this myth. Public health policy already permits some addictive substances to be legal – for instance, alcohol, nicotine and caffeine. But good policy can never be made on a foundation of ignorance. Multiple lines of scientific evidence all prove that chronic marijuana use causes addiction in a significant minority of people. No one should deny this scientific evidence.”

So we could use the tax revenues from legalized pot. But it may surely be worth thinking twice about what the concurrent costs will be, in illness and crime and human lives.

Medical marijuana: a painful issue all around

Courtesy of http://prospect.rsc.org/blogs/cw/?p=655She is 46, a breast cancer survivor for four long years, a regular user of medical marijuana. She told me — as we were introduced by a mutual friend and she was updating the friend — a horror story too ridiculous even for an ‘Only in California’ tale. Her name is not Emily, but I’ll call her Emily to protect the innocent.

Emily has a solid career in social services with a California nonprofit. For years their funding has come partly through federal grants. This has been fine with Emily’s regular use of medical marijuana, which is legal in California and which keeps her chronic pain — a result of cancer and several other issues — under control. She smokes one joint in the morning, and four at night. (An editorial caveat here: I’ve not tried marijuana, which is wise since I’m addicted to anything that comes down the pike, so I know from nothing about dosages, etc. I’m just repeating what she explained.)

Not long ago, a new project was offered Emily’s organization and she was named as its head. Only problem? Everyone would have to take the federally-mandated drug test. Only solution? get Emily off of the weed for six weeks in order for her to pass the test. She had done that, finishing it all and passing the test and starting the project, a few months earlier. It was not fun.

“In order to get through all this,” she said, “I was prescribed a total of six different pain-relief drugs which I took every day. They were expensive, but the only way I could have made it. So for six weeks I poured six different toxins into my system at an obscene cost, both financially and physically. But hey, you do what you have to do.”

Emily is now back to growing, and smoking, her own.

California voters, thanks to a ballot issue certified yesterday by our secretary of state, will decide next November whether to legalize marijuana for any adult use. The issue is being rather hotly debated elsewhere on True/Slant and I frankly have no idea where I’ll come down when the dust settles and I read the whole business. Friends tell me it’s fine, others tell me it’s addictive, the state needs the money, who knows where legalization and regulation could lead? Neither does much to curb alcohol abuse, but then, I quit drinking years ago so it’s easy to be holy about alcohol abuse; some of us can handle the booze, some of us can’t.

But all of us need pain relief. Marijuana is a proven pain-relief drug. Why in the world it should be denied those who need it boggles this increasingly boggled mind.

Medical marijuana benefits proven

Surprise. Medical marijuana really helps. What millions of us have known ever since friends with AIDS proved it more than a decade ago is now affirmed. San Francisco Chronicle writers Victoria Colliver and Wyatt Buchanan broke the news today:

The first U.S. clinical trials in more than 20 years on the medical efficacy of marijuana found that pot helps relieve pain and muscle spasms associated with multiple sclerosis and certain neurological conditions, according to a report released Wednesday by a UC research center.

Dr. Igor Grant, a UC San Diego psychiatrist who directs the center, called the report “good evidence” that marijuana would be an effective front-line treatment for neuropathy, a condition that can cause tingling, numbness and pain.

The results of five state-funded scientific clinical trials came 14 years after California voters passed a law approving marijuana for medical use and more than 10 years after the state Legislature passed a law that created the Center for Medicinal Cannabis Research at UC San Diego, which conducted the studies.

California’s Proposition 215, passed in 1996, allows patients with a valid doctor’s recommendation to grow and possess marijuana for personal medical use. It is one of 14 state laws legalizing medical marijuana. But the federal government still says pot is illegal and without medical benefit. Perhaps that may now change.

“This is the first step in approaching the (U.S. Food and Drug Administration), which has invested absolutely nothing in providing scientific data to resolve the debate,” said state Sen. Mark Leno, D-San Francisco, who noted that marijuana showed benefits throughout the AIDS epidemic in helping people afflicted with neuropathy and other ailments.

Dale Gieringer, a Berkeley resident who is executive director of the California branch of the National Organization for the Reform of Marijuana Laws, agreed.

“This is finally the evidence that shows that the (U.S. Drug Enforcement Administration) stance that marijuana does not have medical use is just wrong,” he said. “It’s time for the Obama administration to act.”

The bad news is that funding for research that could further confirm the potential medical benefits of marijuana may soon run out.

The Center for Medicinal Cannabis Research has approved 15 clinical studies, five of which were completed and reported Wednesday, and two are in progress. While researchers said more studies are needed, the future of the center is in doubt.

The center has spent all but $400,000 of the $8.9 million in research funding it started with in 1999. Leno said the state doesn’t have the money to continue funding it.

“It may be close to the end of its life unless there’s foundation money to continue the work,” Leno said.

If we could just combine the savings that could accrue from getting the feds out of the pot-prosecution business and the taxes that would accrue from legalization of medicinal use, a lot of that work could continue. And a lot of suffering could be alleviated.

Is marijuana a medicine?

Of course it is, to answer this rhetorical question posed by a January 18 headline in the Wall Street Journal. New Jersey is the most recent to recognize that fact, becoming the 14th state to legalize use of marijuana for medicinal purposes. The New Jersey law, signed this week by outgoing Governor Jon Corzine, limits use to patients with specific illnesses such as cancer, HIV/AIDS, multiple sclerosis and ALS (Lou Gehrig’s disease) and specifically forbids grow-it-yourself projects.

What’s needed now are serious studies of how good a medicine it really is, and these aren’t happening very fast. As outlined in a New York Times article this week, getting permission to study the weed is no easy task.

Despite the Obama administration’s tacit support of more liberal state medical marijuana laws, the federal government still discourages research into the medicinal uses of smoked marijuana. That may be one reason that — even though some patients swear by it — there is no good scientific evidence that legalizing marijuana’s use provides any benefits over current therapies.

Lyle E. Craker, a professor of plant sciences at the University of Massachusetts, has been trying to get permission from federal authorities for nearly nine years to grow a supply of the plant that he could study and provide to researchers for clinical trials.

But the Drug Enforcement Administration — more concerned about abuse than potential benefits — has refused, even after the agency’s own administrative law judge ruled in 2007 that Dr. Craker’s application should be approved, and even after Attorney General Eric H. Holder Jr. in March ended the Bush administration’s policy of raiding dispensers of medical marijuana that comply with state laws.

“All I want to be able to do is grow it so that it can be tested,” Dr. Craker said in comments echoed by other researchers.

Marijuana is the only major drug for which the federal government controls the only legal research supply and for which the government requires a special scientific review.

“The more it becomes clear to people that the federal government is blocking these studies, the more people are willing to defect by using politics instead of science to legalize medicinal uses at the state level,” said Rick Doblin, executive director of a nonprofit group dedicated to researching psychedelics for medical uses.

In California, where a mish-mash of laws and enforcement policies can bewilder all but the expert — (and there are many experts) — the Supreme Court ruled yesterday that lawmakers acted improperly in amending the voter-approved legalization of medicinal marijuana to limit the amount critically ill patients might have:

The high court ruled lawmakers improperly “amended” the voter-approved law that decriminalized possession of marijuana for “seriously ill Californians” with a doctor’s prescription by limiting patients to eight ounces (227 grams) of dried marijuana and six mature or 12 immature plants.

The Compassionate Use Act, passed by California voters in 1996, set no limits on how much marijuana patients could possess or grow, stating only that it be for personal use.

In 1997, the state’s Supreme Court defined a lawful amount as enough to be “reasonably related to the patient’s current medical needs.”

The state’s quantity limits were passed in 2003 as part of a voluntary identification card program designed to protect against both drug trafficking and wrongful arrest by allowing police to quickly verify a patient’s prescription.

The court on Thursday let stand the voluntary card program but found that the limits it imposes should not “burden” a person’s ability to argue under the Compassionate Use Act that the marijuana possessed or grown was for personal use.

California Attorney General Jerry Brown said in a statement the decision “confirms our position that the state’s possession limits are legal” as applied to medical marijuana cardholders.

While conceding that marijuana may have some just-for-fun attraction too, I can’t vouch for the recreational weed. Thankfully, since I am addicted to anything that comes down the pike and question the view that marijuana is non-addictive,  it hadn’t made its way to small-town Virginia when I was experimenting with other mood-altering substances. But I do know its medicinal value. My beloved now-deceased sister could have had much suffering relieved with legal pot. Countless friends I loved and worked with during the height of the AIDS pandemic would have suffered less with legal, easily-accessible marijuana.

We are past time to establish, through definitive studies, the medicinal benefits of this natural bounty, and make it legally available to those in desperate need.

The aches & pains of medical marijuana

An article in Sunday’s New York Times details the struggle in Los Angeles to regulate the cannabis dispensaries which have proliferated around the  city over the past six or eight years, raising the old medical marijuana questions about how to control, whether to tax and how useful it is in the first place. Reporter Solomon Moore cites Oakland, California’s Harborside Health Center as the place to which many are looking for a model.

‘Our No. 1 task is to show that we are worthy of the public’s trust in asking to distribute medical cannabis in a safe and secure manner,’ said Steve DeAngelo, the pig-tailed proprietor of Harborside, which has been in business for three years.

Harborside is one of four licensed dispensaries in Oakland run as nonprofit organizations. It is the largest, with 74 employees and revenues of about $20 million. Last summer, the Oakland City Council passed an ordinance to collect taxes from the sale of marijuana, a measure that Mr. DeAngelo supported.

Mr. DeAngelo designed Harborside to exude legitimacy, security and comfort. Visitors to the low-slung building are greeted by security guards who check the required physicians’ recommendations. Inside, the dispensary looks like a bank, except that the floor is covered with hemp carpeting and the eight tellers stand behind identical displays of marijuana and hashish.

There is a laboratory where technicians determine the potency of the marijuana and label it accordingly. (Harborside says it rejects 80 percent of the marijuana that arrives at its door for insufficient quality.) There is even a bank vault where the day’s cash is stored along with reserves of premium cannabis. An armored truck picks up deposits every evening.

City officials routinely audit the dispensary’s books. Surplus cash is rolled back into the center to pay for free counseling sessions and yoga for patients. “Oakland issued licenses and regulations, and Los Angeles did nothing and they are still unregulated,” Mr. DeAngelo said. “Cannabis is being distributed by inappropriate people.”

I don’t know where Los Angeles will go with all this, or how well Harborside will continue to operate for how long. What I do know is that marijuana serves a real medical purpose. Probably serves a real recreational purpose too, and there’s the rub; but since I missed the pot party — thank heavens, as I am addicted to anything that comes down the pike, and please don’t try to tell me one cannot get addicted to marijuana — I can’t address that issue. Everything I know is anecdotal, but convincing.

Decades ago my beloved sister was suffering acute gastro intestinal distress, much later identified as a symptom of celiac disease but this was before anybody really knew anything about celiac sprue. One day she said, “You know, everybody at X High School either smokes pot or knows where to get it. Could you get me some so I could at least try it?” Well, even though the statute of limitations would probably protect the surviving players I think I won’t go into details of this adventure. But what I learned was: buying and selling illegal pot is a little scary for the novice, but the deal was easy and nobody went to jail. It did indeed give relief to my suffering sister. Though both of us wished she could have that relief on an ongoing basis, we reached a mutual conclusion that the risk was not worth the reward, and that was the end of that.

Fast forward to the 1990s, when everyone I knew with AIDS knew how marijuana could relieve some symptoms of the disease, and most had a supply. I was in San Francisco by then, and celiac disease pales in comparison to AIDS. I don’t even recall how legal it was for this relief; too many other issues were more important. But again, I saw its usefulness.

The Times article quotes Christine Gasparac, a spokeswoman for California Attorney General Jerry Brown, as saying his office is getting calls from law officials and advocates around the state asking for clarity on medical marijuana laws. I know that’s tough, and that the answer will in many cases be left to the courts. I also know that legalizing marijuana, whether here in woo-hoo California or elsewhere, raises a multiplicity of sticky issues.

But still. It’s a useful drug. If Big Pharma were producing and marketing it, it would probably come in a little pill that costs a fortune and would be covered by expensive insurance policies. Every governmental body in the U.S. needs money. Taxes raise money. Are there not some dots that could be connected here?