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MEDICAL REEFER MADNESS

11:00 PM, Dec 8, 1996 • By JOHN P. WALTERS and WILLIAM J. BENNETT
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AS IF COPS DIDN'T HAVE ENOUGH PROBLEMS, the Drug Enforcement Administration is up against a new obstacle. A DEA press release paints this scene:


A patrol officer encounters a 16-year-old female accompanied by an 18-year- old male. Both state he is her "primary caregiver." Both are found to be in possession of marijuana and he readily admits providing it to her on the " recommendation" of a doctor at a local clinic for relief of "nausea."

Make all the players in this little drama Californians, and the patrol officer is powerless to intervene. Thanks to a ballot initiative legalizing the " medicinal" use of marijuana, California is now virtually unable to restrict marijuana use by people of any age. Proposition 215, which passed with little fanfare three weeks ago, also allows cultivation and possession by individuals who are not sick, provided they claim, as did the young man above, to be the "primary caregiver" of someone using marijuana to combat "any . . . illness for which marijuana provides relief."


The problem is that marijuana has never been scientifically demonstrated to provide "relief" from any medical condition -- at least no more relief than other licensed drugs that are much less prone to abuse. This critical point was obscured in a campaign whose small band of wealthy out-of-state backers outspent the opponents of Prop. 215 seventy-five to one.


In fact, the notion that marijuana has demonstrated medical utility has been rejected by the American Medical Association, the National Multiple Sclerosis Society, the American Glaucoma Society, the American Academy of Ophthalmology, and the American Cancer Society.


Pot activists rhapsodize about marijuana's usefulness in "treating" glaucoma. But medical researchers believe otherwise. Dr. George L. Spaeth, first president of the American Glaucoma Society and director of the Glaucoma Service at the Wills Eye Hospital in Philadelphia, has "not found any documentary evidence which indicates that a single patient has had his or her natural history of the disease altered by smoking marijuana." Dr. M. Bruce Shields, president of the American Glaucoma Society and chairman of the department of ophthalmology at Yale University, expresses "reservations" about the use of cannabinoids to fight glaucoma, particularly since there are "many drugs that are much better than the marijuana analogues and that have significantly fewer side effects." Dr. Richard P. Mills, vice chair of the University of Washington department of ophthalmology, explains that glaucoma sufferers already have access to six "families" of glaucoma medication, at least one of which controls the disease in almost every patient. Dr. Keith Green, director of ophthalmology research at the Medical College of Georgia, has studied the use of marijuana and its active ingredient, THC, to treat glaucoma and finds "no evidence that marijuana use prevents the progression of visual loss."


Proponents also cite marijuana's alleged utility in controlling nausea. Yet Dr. David S. Ettinger, associate director of the Johns Hopkins Oncology Center, writes, "There is no indication that marijuana is effective in treating nausea and vomiting resulting from radiation. . . . No legitimate studies have been conducted which make such conclusions." As for nausea resulting from chemotherapy, the American Cancer Society states that "other . . . drugs have been shown to be more useful than marijuana or synthetic THC as 'first-line therapy' for nausea and vomiting caused by anti-cancer drugs."


Marijuana boosters often cite a 1988 study (Vinciguerra, et al.) showing that smoking marijuana helped 44 of 56 cancer patients who suffered from nausea. But this study lacked a control group, and 87 percent of the subjects experienced toxic side effects. Moreover, although the authors admit that " oral THC is an effective treatment for chemotherapy-induced [vomiting]," only 29 percent of the subjects who benefited from smoking marijuana had already tried oral THC. In other words, patients were asked to use marijuana before the scientifically approved remedies had been exhausted. The entire debate may be irrelevant, however. Notes Dr. Richard J. Gralla, director of the Ochsner Cancer Institute in New Orleans, "There has been a revolution in the treatment and prevention of nausea since 1988."