Advocates for decriminalization think voters will OK medical use
Tuesday, July 6, 2004
The Ann Arbor News
When Chuck Ream first began suffering severe stomach pains in 1968, doctors gave him antacids.
As the pain grew worse - endoscopies would later reveal gastritis, ulcers and lack of a proper membrane in the duodenum - he was prescribed barbiturates, tranquilizers and more antacids.
They worked, sort of, at first. But when the pain worsened again, a friend suggested he try smoking marijuana.
"I tried it, and my stomach untightened, and I could breathe a little bit," he said. "It didn't solve all my problems, but it allowed me to function and return to school."
Ream, a Scio Township trustee, is among an increasingly vocal contingent of people nationwide who tout the medicinal benefits of marijuana.
Those who support legalizing it say it can ease and even prevent nausea and vomiting in chemotherapy patients, lessen the pain of cancer patients, reduce the spasms of diseases like multiple sclerosis, reduce pressure in the eyes of people suffering glaucoma and induce appetite in wasted AIDS patients.
Though federal law still bans it, nine states and a few municipalities have laws permitting the use of marijuana for medical purposes. Ann Arbor could become one of those places this November when voters decide whether to amend the city charter to instruct local law enforcement not to arrest or charge those with a health care provider's recommendation to use the drug. Currently possession of marijuana in Ann Arbor is a $25 fine.
Similar drives by the Washtenaw Coalition for Compassionate Care are planned in Saline and Yspilanti and possibly, the state of Michigan.Casting aside social concerns about legalizing medical use of the long-banned plant, however, many who are opposed say there are plenty of other safe, legitimate, FDA-approved drugs to treat nausea, pain and other things advocates want to use marijuana for.
When California became the first state to pass a medical marijuana law in 1996, then-director of the White House Office of National Drug Control Policy Gen. Barry McCaffrey commissioned a comprehensive government study of marijuana's medical viability.
A group of 12 independent experts from the prestigious Institute of Medicine compiled all literature to date and studied it. The group then held public hearings attended by everyone from 80-year-old grandmothers using marijuana to prevent the pain and nausea of breast cancer treatment to staunch opponents of marijuana to those who seemed to be advocating marijuana for everyday stress.
"In the end, we came away with two substantial conclusions," recalled study co-director Dr. Stanley Watson, a University of Michigan psychiatry professor and co-director of U-M's mental health research institute. "There was nothing overwhelmingly good about marijuana over other drugs" for various conditions and symptoms, he said.
The report did conclude that it had potential therapeutic value for pain relief, control of nausea and vomiting and appetite stimulation, and that its psychological effects may enhance therapeutic value. But so do many other safe, FDA-approved drugs, Watson said.
The second conclusion, Watson said, was that marijuana had not been well-studied, and should be further examined under more controlled studies.
Proponents say that though there are other drugs, not all drugs work for everyone.
"Even if (marijuana) just helped 10 or 20 or 40 percent of the people, why not let them use it?" Ream asks.
An Ann Arbor woman who did not want her name used because she lives in drug-free government subsidized housing and feared being evicted, said marijuana was the only thing that helped her when gastritis and stomach problems did not allow her to keep food down.
"More often than not, I had to choose between eating or upsetting my stomach," she said. Gallbladder surgery earlier this year fixed the problem, and she said she hasn't used marijuana since.
"I am grateful for this little herb because it kept me out of the emergency room," she said. "So I will be at the polls come Nov. 2."
The medical community has increasingly been receptive to the possibility of using the drug for medicine. In 1993, a pair of Harvard University professors, one of whom held a medical degree, published a book called "Marijuana: The Forbidden Medicine." It presented numerous case reports of symptomatic relief of a wide variety of physical and psychological illnesses. Several medical societies and caregiver groups have since endorsed medical marijuana or more research into it.
But the vast majority of physicians balk at endorsing smoking marijuana. Its potential benefits are undermined by smoking, a crude and unhealthy delivery system. The IOM study called for study of other delivery systems, such as an oral spray.
The study also noted that it is not as effective in reducing eye pressure in glaucoma patients as legal medicines are. It also noted that there is little evidence to support the notion that it helps treat movement disorders like Parkinson's and Huntington's disease.
The federal government has not changed its position on marijuana use for medical purposes either.
It remains illegal to possess, and the office of drug control policy notes that the FDA was created to ensure all medicine falls under the "safe and effective" standard before it's sold to consumers.
That does not include smoking raw plant materials with some 400 unknown compounds in addition to active ingredients, including toxic carbon monoxide and tar, according to the office.
And many in the drug abuse education community fret about the messages that legitimizing medical marijuana sends.
Justin Bishop, founder of Clean Teens and program director of the Washtenaw County Community Partnership, said marijuana is already too easy for kids to get.
Bishop said the dynamics of the debate have made it hard for people like himself to raise questions without seeming to lack compassion.
"If my grandmother was dying from cancer and was suffering, I wouldn't want her to suffer," he said. "But is marijuana the only answer? I doubt it. How do you take science against compassion?"
Bishop said the partnership plans to hold forums and hoped to air some educational videos on local television stations in an effort to make sure voters got a complete picture.
The IOM report, the most comprehensive analysis ever done on the question, resulted in a firestorm of attention and controversy.
It acknowledged in its opening paragraphs that many have criticized the medical marijuana movement as a hoax that exploits compassion for the sick and dying. The mission of the Marijuana Policy Project, which Ream said recently sent $2,000 to help with campaigning, is to "remove criminal penalties" for marijuana use. Though the project emphasizes its medical uses, their goal is legalization.
But the report also acknowledges what advocates have been saying for years: that it is a uniquely soothing medicine the sick have been unfairly denied.
One of marijuana's compounds, THC, is sold in synthetic pill form as an FDA-approved drug called Marinol. The drug is designed to stimulate appetite and help prevent illness- and treatment-related weight loss in AIDS and cancer patients.
Tonight, Ann Arbor City Council will vote on the proposed ballot language for the November election.
The proposed ballot language won't be finalized until council votes and the city attorney approves it.
Essentially, if the question passes, it would prevent medical users from being arrested or prosecuted by local police if they have a health care provider's blessing.
Ann Arbor Police Chief Dan Oates said the law might cause trouble for officers who wanted to charge someone, if that person tried to come up with a medical marijuana defense.
"The bottom line is this is up to the voters; whatever the law is, we will deal with it," he said. "As a person who has been in law enforcement for 24 years, I have never seen anything good come from the use of marijuana. But I have to admit I'm not fully up to date on marijuana's medical value."
It would not, however, prevent any federal or state law enforcement officers from arresting, charging and prosecuting the same person, because marijuana remains illegal under state and federal law, regardless of whether it is used, possessed or sold within the city limits.
So whether the move, if it passes, would be merely symbolic is arguable.
Few places have effectively implemented medical marijuana programs or laws, said Lloyd Johnston, a U-M research professor who directs the annual Monitoring the Future survey, which follows substance use trends among teens. And many physicians may be concerned about the consequences of recommending marijuana to patients.
Bruce Mirken, communications director for the Marijuana Policy Project, said it's more than symbolic. Local police do the vast majority of arrests in most marijuana cases, he notes, and federal agency arrests make up only 1 percent of all marijuana arrests.
Today nine states - Alaska, Hawaii, Oregon, Washington, California, Nevada, Colorado, Maine and most recently, Vermont - have laws for medical marijuana use. A few cities, including San Francisco and Burlington, Vt., also have them, but most initiatives have been at the state level, Mirken said.
In August, Detroit voters will take up the question through a similar, petition-driven poll.
Ream said he is confident Ann Arbor voters will pass the initiative.
"I think the city of Ann Arbor will respond with reason and compassion,"
Copyright © 2004, The Ann Arbor News