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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."


Unfortunately, not only is marijuana not medicine, its use is especially contraindicated for many of the people who will be encouraged to use it by California's new law. Cancer patients' immune systems are weakened by radiation and chemotherapy, leaving them susceptible to infection, and marijuana use further compromises their immune systems. That's in addition to the drug's well-known harmful effects on brain cells, lungs, and circulation.


Yet, despite the evidence, and after 24 years of trying and failing, the pro-pot side carried the day. The California initiative passed with 55 percent of the vote, capping a 24-year effort by NORML and other groups to gain public sanction for widespread marijuana use on the basis of the drug's supposed "medicinal" qualities.


Why this sudden success? The difference is that in 1996 the potheads had access to that mother's milk of politics -- money. Campaign finance laws place a $ 2,000 ceiling on individual contributions in national races, but the ballot initiative process has no such limitations. Foremost among the financiers and businessmen whose backing secured passage of Prop. 215 was George Soros.


Based in London and New York, Soros is a currency trader and investor with a fortune estimated by Forbes at $ 2.5 billion. He is also sugardaddy to the drug legalization movement, committing, by his own reckoning, more than $ 15 million to various groups since 1991, including $ 980,000 to the California initiative and the similar initiative that passed this month in Arizona. Groups funded by Soros contributed at least another $ 300,000, and Soros solicited at least one contribution of $ 200,000. In all, the organization that flacked Prop. 215, Californians for Medical Rights, raised $ 2 million for the campaign, including $ 750,000 in the first 19 days of October alone. In contrast, the opposition, Citizens for a Drug-Free California, spent a total of $ 26,000 and aired no paid TV commercials.


Soros and company are pursuing a stealth strategy designed to conceal their real agenda: legalizing all drugs. In a 1994 interview with Rolling Stone magazine, the president of Soros's Open Society Institute, Aryeh Neier, explained that Soros gave the pro-legalization Drug Policy Foundation a "set of suggestions to follow if they wanted his assistance: Come up with an approach that emphasizes 'treatment and humanitarian endeavors,' [and] . . . target a few winnable issues, like medical marijuana and the repeal of mandatory minimum [sentences]."


Soros was joined in the recent campaign by Arizona businessman John G. Sperling, who gave $ 630,000 to the California and Arizona initiatives. Sperling is adamant that doctors should be allowed to prescribe all drugs, including heroin and LSD: "I don't think that there should be any substance outside the pharmacopeia." Sperling is less clear on exactly why. When asked for studies that show the utility of these drugs, he cited anecdotal evidence: "You go from anecdote to anecdote to anecdote, and there are so many people who say their lives have been changed for the better." Of course, nobody denies that marijuana's euphoric qualities would cause individuals to feel good (as would a few shots of Wild Turkey). The question for science is whether marijuana treats disease, not whether it makes people feel giddy.


Sperling disagrees. "The drug problem," he says, is "a public health problem, primarily. It only becomes a crime when you put people in prison for it." People who deny this are "either intellectually dishonest, stupid, or both, and that goes for most members of Congress, the president, and the man who wanted to be president."


Sperling is not alone. Former U.S. senator Dennis DeConcini served as the Arizona campaign's unofficial poster child, appearing in commercials and on TV news opposite drug czar Barry R. McCaffrey. Like others we interviewed, DeConcini was unable to cite a single scientific study showing marijuana's medical effectiveness. Not that this bothers him: "To me it's irrelevant whether you have a study or not," he says, so long as the law has "compassion" and requires a doctor's prescription (as it does in Arizona, but not in California).


Passage of the two initiatives notwithstanding, use of marijuana for nonmedicinal purposes remains a crime in California and Arizona. Unfortunately, as the DEA anticipated, the change in state law has weakened local law enforcement, and federal agents cannot be expected to take up the slack. There are 7,000 state and local narcotics officers in California, more than ten times the number of DEA agents in the state. And the federal agents concentrate on large traffickers, not users.


Even so, the feds may have a role in containing the damage from Prop. 215 and its counterpart in Arizona. Under a "public interest" provision of the Controlled Substances Act, the DEA can revoke the "registration" license every physician needs in order to store, dispense, or prescribe controlled substances. Historically, the DEA has worked in tandem with state authorities, but nothing in the law prevents it from moving unilaterally against the small number of pro-pot physicians who are likely to recommend marijuana for their patients. If the Clinton administration is serious about halting the rise in drug use among the young, its DEA will prepare to use this power.


DEA chief Thomas A. Constantine, for one, is clear-eyed on the issue. He likens medicinal marijuana to "snake oil," the harmful, all-purpose curatives sold by hucksters at the turn of the century. The analogy is apt.


Little more than diluted morphine, the likes of "Coats Cure" and the " Richie Cure" were eventually regulated out of existence under the 1906 Pure Food and Drug Act. This law was passed at the urging of Progressive reformers after the wild success of the snake-oil scam had brought on America's first great drug epidemic. Progressives were occasionally criticized for worshipping at the altar of science, a claim unlikely to be levelled against the proponents of medical marijuana.




William J. Bennett is the former director of the Office of National Drug Control Policy. John P. Walters is the former deputy director of that office. They are co-authors (with John J. DiIulio, Jr.) of Body Count (Simon and Schuster).