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Posted by FoM on August 28, 2001 at 08:55:20 PT
By Robert K. Kubena, Ph.D. 
Source: Pittsburgh Post-Gazette 

medical This is a story about cancer. What is unusual are the parties involved. The cancer patient was a nurse, her daughter a toxicologist and her son-in-law a pharmacologist.

Unfortunately, this combined body of medical experience could do nothing to alter the course of this fatal disease, which is the second-leading cause of death in this country. What it did do, however, was allow the three of us to understand better than most what the treatment, the side effects and inevitable conclusion would be.

This story began when my mother-in-law, a robust 76-year-old who was still working as a head nurse in a nursing home near Washington D.C., was diagnosed with lung cancer. She was treated at Georgetown University Hospital by one of the country's pre-eminent oncologists. During surgery, doctors determined the cancer had spread, and she was given radiation and chemotherapy.

The therapy took its usual toll. She lost her hair, her appetite and wasted away to 87 pounds. Because I had extensively researched THC (one of the active ingredients in marijuana), and related topics for my masters', doctoral and post-doctoral theses, I was acutely aware of the anecdotal reports that marijuana could stimulate appetite and reduce nausea. My six years of research convinced me that marijuana was the safest therapeutic agent known to man.

Convinced of marijuana's safety, my wife and I suggested that my mother-in-law smoke some. She had no moral objection because she had smoked marijuana at Harlem jazz clubs in the 1920s while in nursing school. She was, however, reluctant, fearing it might interact unfavorably with the other drugs she was taking.

Fortunately, her doctor was one of the 50 percent of oncologists who recommend marijuana to their patients. (Seventy percent say that they would recommend it if it was legal).

When she smoked the marijuana, her spirits lifted immediately and she developed a ravenous appetite. There is no question that the drug enhanced her last weeks at home. Our only regret is that she did not use it sooner.

The only drugs I have seen act as quickly and effectively are narcotic painkillers such as morphine and Demerol. But, at what cost? With prolonged use, a person might need higher and higher doses to get the same relief. Yet, too high a dose can cause a dangerous slowing of breathing or even coma.

So the usefulness of these drugs is limited. This dilemma is usually put to the family in the form of a euphemism: "Do you want the patient to be pain-free?" In an attempt to accomplish this, the dose of morphine or Demerol is continually escalated.

This practice is known in hospital circles as "snowing." The patient takes a higher and higher dose until she can no longer metabolize the drug. A less polite, but no less ethical term, is euthanasia. In my mother-in-law's case, the high doses of morphine were a far better end than drowning in her own fluids because of the lung cancer.

While some right-to-life advocates might have a problem with this practice (until it is a member of their family), I see it as a compassionate course of action although it is technically illegal. If such compassionate acts occur in hospitals every day, why has the Supreme Court (which has successfully avoided the subject of this type of euthanasia) decided to prevent the medical use of marijuana by needy patients?

The court's recent ruling was based on the Controlled Substance Act of 1970. The act classified marijuana as a Schedule I drug, which presumed that it had "no currently accepted medical use" and "a high potential of abuse." This is in spite of findings by the Institute of Medicine of "potential medical benefits in the active ingredients of marijuana." Nonetheless, the National Institute of Drug Abuse stopped all research on marijuana in 1980.

It is impossible to determine marijuana's benefits if scientists cannot study it. Addiction researchers have long placed its addiction potential far below that of alcohol and nicotine, which are responsible for 500,000 deaths each year. In fact, the addiction potential of marijuana is most similar to that of caffeine.

Implicit in the Supreme Court's decision was the assumption that federal laws concerning marijuana preclude its prescription by doctors. There are federal laws against the possession and/or manufacture of cocaine, methamphetamine and opium -- although all are available by prescription. It also fails to address the fact that after alcohol and cigarettes, cocaine and methamphetamine are two of the most dangerous and debilitating drugs abused in our society. Only those profiting from the war on drugs would categorize marijuana with them. Such a categorization is responsible for 600,000 arrests per year for marijuana violations.

If the judiciary, law enforcement and most legislators are opposed to the medical use of marijuana, and scientists are prohibited from studying it, who is in favor of it? Only the people. Voter initiatives in seven states and legislators in two states have passed laws allowing doctors to prescribe it. Nationwide, 75 percent of those polled favor the medical use of marijuana.

Some believe that medical use of marijuana is a moot point for debate now that THC is on the market in a synthetic marijuana called Marinol. They are mistaken. It was my dream to see this compound reach the marketplace. Now, however, I am ambivalent concerning this development.

THC was first evaluated for appetite-stimulating and anti-nausea effects because of anecdotal reports of such effects among pot smokers. Equating THC with marijuana, as well as changing how it is consumed, is less than good science. This may account for the arguably meager clinical activity of Marinol. In controlled studies, patients given Marinol had an appetite improvement that was only 50 percent better than those given a placebo. With weight gain and nausea reduction, there were no significant differences between Marinol and a placebo. Better studies would have compared smoked marijuana with oral and/or smoked Marinol.

A pharmaceutical company is unlikely to conduct such a study because there is no profit in marijuana because it is a natural product and can't be patented.

Finally, one can only hope that, when cancer strikes the homes of those opposed to medical marijuana, they avail themselves of the 50 percent of oncologists who do not recommend it. Otherwise, they will become the worst kind of hypocrite -- those who would impose suffering on others while seeking solace for themselves. Of course, watching a loved one vomit to the point of causing a hernia might cause them to re-evaluate their unfounded opposition to medical use of marijuana.

Note: Hypocrisy about addiction and pain control keeps medical marijuana from needy patients.

Robert K. Kubena, Ph.D., of Derry Township, is a retired psychopharmacologist who developed his masters, doctoral and post-doctoral theses on THC and marijuana constituents.

Source: Pittsburgh Post-Gazette (PA)
Author: Robert K. Kubena, Ph.D.
Published: Tuesday, August 28, 2001
Copyright: 2001 PG Publishing
Contact: letters@post-gazette.com
Website: http://www.post-gazette.com/

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Comment #7 posted by anon on August 29, 2001 at 18:18:59 PT
addresses for senators
http://www.senate.gov/senators/senator_by_state.cfm

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Comment #6 posted by auto on August 29, 2001 at 08:05:19 PT
Cancer breakthrough....Hidden by the federal gov.
In 1974...medical researchers indicated that THC the active ingredient in our medicine actually helped to reduce tumor growth in cancerous rats. It also proved to increase the life expectantcy of cancerous rats. What an amazing discovery.

Why would this medical breakthrough not get out to the public? Why did the federal government make efforts to kill this story before it hit the press? This has got to be the biggest mis-information campaign in the US history. What are they afraid of? Are special interests in the US out of control?

The Nixon and Reagan administrations purged and destroyed the reseach findings out of the Labs and Universities so that you and I would never know the actual results and positive benefits of this amazing plant. This tells me, they found something that proves opposite the propoganda BS they have been feeding us.
Does this scenario resemble Hitlers burning of the books in 1939? This is an dileberate attempt to conceal the truth about Cannabis.
A shame that these politicians never studied history. May there acts someday be reflected in history books so their true ignorance and caving to special interests can be finally uncovered.
When will we have a government that is for the people and their wishes rather than a government that is clearly for special interests? What ever happened to Democracy?




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Comment #5 posted by Ethan Russo, MD on August 28, 2001 at 11:12:13 PT:

Clinical Cannabis Education
I should mention that there will be an all day seminar on cannabis in pain management in the Washington, DC area (Arlington, VA) on Friday September 7 as part of the American Academy of Pain Management meeting:

http://www.aapainmanage.org/AAPM/Confrnce/conf2001.html

One day registration is pricey: $210. Speakers include Denis Petro, Janet Joy, Kitty Tucker, Kevin Zeese, Jon Gettman, and an evening keynote by Geoffrey Guy of GW Pharmaceuticals, and yes, I will be speaking, too.

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Comment #4 posted by Ethan Russo, MD on August 28, 2001 at 10:54:20 PT:

Dear Hope
Please feel free. I usually have little success sending things directly, although Governor Johnson may recall the 10 minutes we had together at his press conference in Washington in April (see picture on NORML WWW site). I am happy to speak to any interested politicians, and would be happy to supply them articles.

[ Post Comment ]
 
Comment #3 posted by Hope on August 28, 2001 at 10:37:11 PT
Dr. Russo
I do hope you will drop an e-mail or snail mail to Gov. Johnson conveying this information to him. You could help see that he is well prepared for the debate. I would not hesitate to forward information to him through his government web site.

[ Post Comment ]
 
Comment #2 posted by Ethan Russo, MD on August 28, 2001 at 09:17:36 PT:

Another Hard-Hitting Commentary
This is another important testimonial, given a stupid title by the newspaper.

Granny smoked reefers in the clubs 75 years ago, and yet, was not struck down by her youthful indiscretion. Thank God she had this experience, and did not have to suffer the pangs of conscience many of her peers experience due to the propaganda of the dominant paradigm.

There are many important points raised in this article. The politicians say there are no studies. That is false. The government knows this, but chooses to prevaricate. The studies have been suppressed. Don't believe it? Try Journal of Cannabis Therapeutics 1(1) wherein Rik Musty and Rita Rossi report on numerous state studies done in the late '70's in which smoked cannabis proved to be far superior as an anti-emetic compared to existing pharmaceuticals or oral THC. This archival material was uncovered only by filing Freedom of Information documents. Its publication was rejected by mainstream medical journals as not being up to "modern scientific standards." You read and be the judge. In some series, smoked cannabis stopped vomiting after chemotherapy 100% of the time.

Ask any of your friends or family members who have smoked cannabis during their chemo which they liked better, the drugs or the dope. It is no contest, in my experience.

We live in a country that claims to be compassionate, but is truly reprehensible in its pious application of so-called morality. Me must help to stop the madness.

[ Post Comment ]

 
Comment #1 posted by Patrick on August 28, 2001 at 09:11:06 PT
Oh Asa...
...you said you would keep the governments eyes open to any studies on marijuana. I am not gonna go dig up your exact qoute here and now. But what you are doing sir is turning to a blind eye to all the evidence showing the relative "unharm" that is marijuana use. Johnson should be able to easily fillet you in this upcoming debate if you hold on to that hard line anti view! Just a tip Congressman, er I mean Narco Nazi.

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