Tuesday November 16 12:11 PM EST
Should patients with approved conditions be allowed to possess and use marijuana for medical purposes? ABCNEWS.com asked two voices - Allen F. St. Pierre, Executive Director, NORML Foundation and Barry R. McCaffrey, Director, Office of National Drug Control Policy - in the debate over legalizing marijuana for medical use to explain either side of the issue in 500 words or less. The essays are the opinions of the writers alone and not of ABCNEWS.
Marijuana Ban Hurts Some Patients
Marijuana prohibition applies to everyone, including the sick and dying. Of all the negative consequences of prohibition, none is as tragic as the denial of medical marijuana to the tens of thousands of seriously ill patients who could benefit from its therapeutic use.
It is clear from available studies and rapidly accumulating anecdotal evidence that marijuana is therapeutic in treating numerous serious ailments and is less toxic and costly than many conventional medicines for which it may be substituted.
Most recently, a federally commissioned report by the National Academy of Sciences (NAS) determined that, "Marijuana's active components are potentially effective in treating pain, nausea, the anorexia of AIDS wasting, and other symptoms" including the involuntary spasticity associated with multiple sclerosis.
The best established medical use of smoked marijuana is as an anti-nauseant for cancer chemotherapy. During the 1980s, researchers in six different state-sponsored clinical studies involving nearly 1,000 patients determined smoked marijuana to be an effective anti-emetic.
For many of these patients, smoked marijuana proved more effective than both conventional prescription anti-nauseants and oral THC (marketed today as the synthetic pill, Marinol).
Marijuana alleviates the nausea, vomiting, and the loss of appetite experienced by many AIDS patients without accelerating the rate at which HIV positive individuals develop clinical AIDS or other illnesses.
An earlier 1982 report by the National Academy of Sciences suggested that marijuana reduces intraocular pressure (IOP) in patients suffering from glaucoma, the leading cause of blindness in the United States.
Clinical and anecdotal evidence also points to the effectiveness of marijuana as a therapeutic agent in the treatment of a variety of spastic conditions such as multiple sclerosis, paraplegia, epilepsy, and quadriplegia.
A number of patients and older Americans use marijuana therapeutically to control chronic pain. The Society of Neuroscience pronounced that, "Substances similar to or derived from marijuana, known as cannabinoids, could benefit the more than 97 million Americans who experience some form of pain each year."
Many drugs that can be abused in a non-medical setting, including cocaine, morphine, and amphetamines, are legally available as a medicine, and no one suggests we "are sending the wrong message to kids." A recent federal survey found that marijuana use among adolescents in California, where marijuana has been available as a medicine since 1996, was no higher than the national average.
Since 1996, six states have passed medical marijuana initiatives including Alaska, Arizona, California, Maine, Oregon and Washington exempting patients who use marijuana under a physician's supervision from state criminal penalties.
Clearly, the American public can distinguish between the medical use and recreational use of marijuana, and a majority support legalizing medical use for seriously ill patients.
A March 26, 1999, Gallup poll reported that 73 percent of Americans support making marijuana available to doctors so they may prescribe it. Basic compassion and common sense demand that we allow America's seriously ill citizens to use whatever medication is most safe and effective to alleviate their pain and suffering.
By Allen F. St. Pierre, Executive Director, NORML Foundation
There's No Need to Legalize Marijuana
Recent ballot initiatives dealing with smoked marijuana in a number states would contradict federal law, undermine the scientific process for establishing safe medicines, and promote use of a crude substance whose purified equivalent is already available for medical use.
Determining what medicines are safe and effective must be done scientifically by doctors and researchers, not through political processes. Hard evidence, not anecdote and belief, must determine which pharmaceutical products should be taken for specific ailments.
The synthetic form of the psychoactive component in marijuana, tetrahydrocannabinol (THC), has been available for nearly 15 years as Dronabinol (brand name Marinol) for physicians who wish to prescribe it.
Just as people who are ill don't grow their own penicillin from moldy bread, individuals can't guarantee the purity and dosage of THC by growing crude marijuana. Furthermore, the cannabis plant (from which marijuana comes) also includes most of the carcinogenic agents and pulmonary irritants found in tobacco.
Americans are just beginning to comprehend the enormous public health consequences of cigarettes. Why would we want to encourage smoking marijuana? Smoking is a poor delivery system that exposes the person to harmful substances. By contrast, Marinol - the real "medical marijuana" - is available in pill form with purity and dosage protected by the manufacturer.
Marinol has been made easier for physicians to prescribe.
In light of the controversy surrounding so-called "medical marijuana" initiatives, the Office of National Drug Control Policy asked the Institute of Medicine to review all published articles about marijuana and make recommendations.
After eighteen months of rigorous study, the Institute of Medicine released its findings this past March. The report condemned the dangers of smoking marijuana, an unrefined botanical product that does not meet the standards for safe and modern medicines, yet noted that cannabinoids like THC may have some medical value in the relief of symptoms.
Legalizing the medical use of marijuana is unnecessary and even dangerous given the prevalence of drug abuse, especially among young people.
The context for today's drug abuse is unsupervised adolescents, on the one hand, and a global, multibillion-dollar outlaw drug industry, on the other. Too many youngsters no longer have the proverbial kitchen table where parents can tell them not to use drugs.
When states pass initiatives permitting use of marijuana, federal law making use of this substance illegal is still in force. Instituting contradictions between state and federal law only weakens respect for the law and confuses citizens.
The setting for marijuana will remain in classrooms where it interfere with learning, automobiles where it interferes with driving, and the workplace where it interferes with productivity - not in hospitals contributing to healing. Now of all times, when youth drug use is thankfully beginning to drop, we must strengthen our resolve to protect teens from dangerous substances that can compromise their health, education, and safety. We must protect our children's future by rejecting by illegal drugs. Don't be fooled: the attempt to legalize marijuana smoking was never a medical matter.
By Barry R. McCaffrey, Director, Office of National Drug Control Policy