cannabisnews.com: Are the Legal Alternatives To MMJ Effective?
Are the Legal Alternatives To MMJ Effective?
Posted by CN Staff on March 09, 2006 at 10:43:48 PT
Editorial
Source: Plainville Citizen
Connecticut -- Proponents claim that marijuana is often the only drug that helps for a variety of ailments, whether it's relieving pain or increasing appetites in those treated for cancer or AIDS. But yesterday's ruling adds further ammunition to those who have long contended that the drug is unsafe."Our national medical system relies on proven scientific research, not popular opinion," said John Walters, director of National Drug Control Policy, to reporters after the ruling was announced on Monday. "To date, science and research have not determined that smoking marijuana is safe or effective."
Illegal and Unknown The effort to make marijuana available for medical purposes gained momentum after an Institute of Medicine (IOM) report suggested that the illegal drug held therapeutic potential. In the 1999 study, which was sponsored by the government's anti-drug office, the IOM stated that marijuana's active ingredients might prove effective for a range of conditions. These included countering nausea and lack of appetite from cancer treatment, to helping with painful conditions such as multiple sclerosis. The researchers called for rigorous testing in clinical trials.Stanley Watson, the co-director of the Mental Health Research Institute at the University of Michigan and one of the authors of the IOM report, said there has been a lack of political interest in pursuing further studies. "There's not enough evidence to let us say that marijuana is a great treatment, nor is there enough evidence to let us say that marijuana is a bad treatment," he said. "The fact is we're stuck." The OptionsAt the moment, the only legal marijuana option is Marinol, a prescription pill that contains THC, the active ingredient found in its illegal counterpart. The Food and Drug Administration approved Marinol to help relieve the nausea and vomiting associated with cancer chemotherapy. This past April, Canadian health authorities allowed for the use of a marijuana spray called Sativex. The new spray, which dissolves in the mouth and treats neurological pain associated with multiple sclerosis, contains THC and another marijuana ingredient, cannabidiol.For those who have tried marijuana to help with their medical conditions, are either of these an effective alternative? Margaret Haney of Columbia University said that a marijuana pill has not exactly caught on, but she contends that such drugs can help."Marinol has gotten some bad press," said Haney, an associate professor of psychiatry at Columbia. After a rocky start, research is now showing that Marinol can help increase appetites, at least in those who are accustomed to smoking marijuana. "In these patients, Marinol is very well tolerated and effective," she said.In a recent study, Haney and colleagues compared Marinol to smoking marijuana in 30 HIV-positive patients who smoked marijuana and who had lost significant amounts of weight. At doses four to eight times higher than what is usually prescribed, the pill led to a similar increase in appetite in former marijuana users compared to those who continued to smoke the drug.Small studies also suggest some potential benefit with Marinol for those who have pain from multiple sclerosis. Dutch researchers evaluated 24 patients and found that the marijuana pill reduced pain intensity compared to those who took a placebo. The authors, who published their results in the British Medical Journal last June, concluded that Marinol should be offered to those whose pain is not severe enough to be treated with medications such as anticonvulsants, antidepressants or opioids. Is a Pill Good Enough?Donald Abrams, a prominent AIDS researcher at the University of California, San Francisco, said that the side effect of dizziness is a major detraction from Marinol. "Most don't like feeling that dopey," he said. The pill can keep people feeling groggy for 16 hours versus a couple of hours from smoking marijuana. Moreover, naturally grown marijuana contains upwards of 400 ingredients that can possibly help, whereas a pill version has only one.As part of the Center for Medicinal Cannabis Research, Abrams said that he and others are studying the safety of alternative forms of administrating marijuana. He admitted that the research has been hard going. "Marijuana has been demonized by the government," he said.Both Abrams and Watson expressed greater optimism for a marijuana spray, which appears safer than smoking and still provides immediate and quicker relief than a pill.Watson said that the U.S. government should do more to study the potential benefits and downsides to marijuana as therapy. "We think marijuana can work," he said. "But we don't know what for."Complete Title: Are the Legal Alternatives To Medical Marijuana Effective?Source: Plainville Citizen (CT)Published: Thursday, March 9, 2006 Copyright: 2006 The Plainville Citizen Contact: news theplainvillecitizen.comWebsite: http://www.theplainvillecitizen.com/CannabisNews Medical Marijuana Archiveshttp://cannabisnews.com/news/list/medical.shtml
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Comment #42 posted by afterburner on March 11, 2006 at 05:10:58 PT
Joanna's Intuition Was Quoted by Tim Leary
"Since I was in my twenties I have nurtured the intuition that psychotropic substances could function as an antidote to the atomic, hydrogen and neutron bombs." Tim Boucher interviews Joanna Harcourt-Smith
http://www.metahistory.org/JHSBoucher.phpTim Boucher: {Why don't we start with a little background about yourself? I read somewhere that you're the daughter of a British aristocrat and the niece of a London publisher. Is that correct? Are you of any relation to the Harcourt in the publishing company Harcourt, Brace, Jovanovich?} Joanna: {My father, the British aristocrat was a secret agent for Britain during the 2nd world war, his brother was a writer who owned a small publishing company in England called Harcourt Press. My uncle Dr Stanislas Ulam, lived in Santa Fe and worked in Los Alamos on Robert Openheimer's team. Stan Ulam is generally regarded as the "mother" of H Bomb, because he provided the mathematics for it, working with Edward Teller. Because of my genetic inheritance, I have felt a responsibility to redeem the destructive impulse that led my uncle to invent such a monstrous WMD. Since I was in my twenties I have nurtured the intuition that psychotropic substances could function as an antidote to the atomic, hydrogen and neutron bombs. By the way the formula for LSD and the mathematical equation that opened the door to the bomb where discovered almost at the same time. Albert Hoffman stumbled on the chemical formula for L.S.D on the 17 th of April 1941. The H bomb was conceptualized from 1942 onwards.}
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Comment #41 posted by charmed quark on March 11, 2006 at 04:59:31 PT
Cold War + Vietnam
I think the combo of growing up under the Cold War, then the threat of getting drafted and shipped to fight, what to us seemed a nonsensical war in Vietnam, really shapped out attitude of living in the moment. I have a hard time explaining the mindset to younger colleges, who don't understand when I'm not totally supportive of their worrying every minute about grinding away in college so they can be more secure and/or make more money. I simply don't care about such things.
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Comment #40 posted by Hope on March 10, 2006 at 23:02:19 PT
In times past
how easy it was to die of nearly anything and all the infant and child mortality made them very aware of it, too, probably.The "A pocket full of posies" generation probably realized the value of each moment, too.Thinking about the possibility of all of civilization being entirely wiped out, though, may have been begun in our lifetimes.Maybe not.
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Comment #39 posted by Hope on March 10, 2006 at 22:56:10 PT
Our generation,
because of all those missles everywhere... was among the first to have learned the real value of "one day at a time" and "living in the now". We all were very aware that any minute could be the last. Of course, that's always been true in anyone's life, ever...but Hiroshima and Nagasaki and the missle silos everywhere and those dang nuclear drills at school and warnings regularly on the radio and television, made it abundantly clear to an abundant amount of us.Charmed Quark, you said, " I'm still fearful of an accident or a crazy person getting ahold of the missles."I am, too. It did make it easier to live in the "now"...because we were made very aware that that very well might be all there is...so...better live in it. I think the bomb and the cold war had more of an effect on the lives and attitudes of our generation more than anyone has ever truly realized...at least that I know of.
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Comment #38 posted by FoM on March 10, 2006 at 22:23:04 PT
Afterburner
I'm not sure. It was about people that knew that ultimately the radiation would make it to Australia and how they lived while waiting for the inevitable. They had pills to take when the time came. One scene there is a husband, wife and baby. The man's wife got sick first and they had agreed to take the pill so no one would be left to suffer alone. That meant the father had to give his wife, then baby the pill.http://www.imdb.com/title/tt0053137/http://www.imdb.com/title/tt0053137/plotsummary
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Comment #37 posted by afterburner on March 10, 2006 at 22:14:27 PT
FoM & Others
"When I was a young mother I saw a movie called On The Beach."Was that the one where criminals were robbing jewellery stores for radioactive jewellery after the blast? The images were frightening. If On The Beach is not the right movie, does anyone know the name of the movie/TV special that did contain the radioactive jewellery?
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Comment #36 posted by FoM on March 10, 2006 at 17:53:28 PT
charmed quark
I wanted to hear Waltzing Matilda since we were just talking about it and found this interesting but odd music web site.
Make Love Not War
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Comment #35 posted by FoM on March 10, 2006 at 17:29:29 PT
charmed quark
On The Beach was a good movie. That's really interesting that Waltzing Matilda effects you the same way. I really like the song but it forever is associated with On The Beach. It was very hard to handle when I was young but I'm glad I saw it. I am not really afraid but I do know that a nuclear war could happen.
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Comment #34 posted by charmed quark on March 10, 2006 at 17:18:19 PT
On the beach
Yeap - I have the same reaction to that song.I don't think we have much to fear from, say, Iran firing nuclear missles at Iraq or Israel. But the USA and the former Soviet republics still have thousands of active nuclear missles. I wish we could get those down to a few 10s or so. I'm still fearful of an accident or a crazy person getting ahold of the missles.
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Comment #33 posted by FoM on March 10, 2006 at 12:00:43 PT
charmed quark
I think I figured it out. I forgot to load a program. Well duh!
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Comment #32 posted by FoM on March 10, 2006 at 10:34:42 PT
charmed quark
I have a computer question. I hope you don't mind. I re-installed everything I thought but the Picture It program for digital pictures isn't in my programs. Neither is Word. Do I put the CD back in and try to find it? Thanks for any help.Plus I have 60 GB's of space. Is that enough for awhile or should I buy an external drive or something else?
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Comment #31 posted by FoM on March 10, 2006 at 08:11:25 PT
Whig
Welcome home! If I had a choice I would rather live in Berkeley then CT. Get some rest and then tell us all about it when you feel like it.
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Comment #30 posted by whig on March 10, 2006 at 08:02:34 PT
Need to sleep...
Just got back from California.I have a couple interesting observations on different things in New Haven and Berkeley, but I'm not sure how coherent I'll be right now since we took a red-eye last night and I haven't really slept since Wednesday night.Group W Bench in New Haven was a friendly place and nice to visit. The Berkeley Patients Group in Berkeley is a barbed-wire defended camp. The difference is striking but in retrospect very understandable. GWB (hard writing those initials without thinking of the jerk in the White House, but it's just a coincidence) has nothing really to protect. A few posters and hats, basically. Nothing like it in Berkeley at all, though. Lots of coffee shops and juice bars. But in the Bay Area is something not to be found in Connecticut.Not the BPG. No, that's not for me. Too serious. Too paranoid. I'm sure they're really wonderful people. But I don't want a walled fortress.But there is also, Sanctuary. And we're moving to Berkeley.Yeah, I better sleep before I write more.
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Comment #29 posted by Hope on March 10, 2006 at 07:58:54 PT
Previous comment
In case it's not clear, this is what I was referring to."BTW - out local CNN cable channel had an entire 60 minute debate with call-ins about legalizing marijuana. I turned it off after the state attorney general started talking about how marijuana led to harder drugs and other stupidity. I can only hear those discredited lies repeated so many times. I know he was next going to talk about how today's pot is soooooo much more potent than hippy pot."
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Comment #28 posted by Hope on March 10, 2006 at 07:57:17 PT
Charmed Quark Comment 26
"Lying lips hate those they deceive."
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Comment #27 posted by FoM on March 10, 2006 at 07:46:07 PT
charmed quark
I tried to watch the movie last night but after about 15 minutes I couldn't take it anymore. When I was a young mother I saw a movie called On The Beach. They played a song called Waltzing Matilda and to this day when I hear that song my mind goes back to that movie. It is insane how easily we all could be killed. A push of a button can end it all and I wish we had someone I trusted in control of that button. I'm glad I live away from heavily populated areas.PS: My computer is working great. Thanks for all the help.
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Comment #26 posted by charmed quark on March 10, 2006 at 04:57:58 PT
The Day After
I caught it by accident last night. It brought back really bad memories. I grew up in an area with Minuteman missles checkboarding the countryside. We actually had one blow up when a mechanic dropped a wrench into the silo and in penetrated the skin of the missle. The warhead got blown up and out and it took them several days to find it. We weren't allowed into that region for over a week due to the dangers of the rocket fuel and security.My hometown was next to a major SAC base. We were very "proud" that we were in the top 10 Soviet targets.During my entire childhood we were expcecting the possibility of nuclear anihilation. We did the stupid drills where you hid under your desk during the blast ( even as a first grader I was suspicious of the effectiveness of that) as well as whole city evacuation drills. A scary time.People ask, now that I live in a large Eastern city, why I'm not more concerned about terrorist attacks. Horrible as 9/11 was, I know that no terrorist can seriously threaten our country the way MAD did. Only our response to terrorism can really threaten us.BTW - out local CNN cable channel had an entire 60 minute debate with call-ins about legalizing marijuana. I turned it off after the state attorney general started talking about how marijuana led to harder drugs and other stupidity. I can only hear those discredited lies repeated so many times. I know he was next going to talk about how today's pot is soooooo much more potent than hippy pot.
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Comment #25 posted by FoM on March 09, 2006 at 19:51:15 PT
Ekim
Thanks. I turned it on.
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Comment #24 posted by ekim on March 09, 2006 at 19:45:32 PT
feel the love --------lets live together
Subject: URGENT! March 9-Tonight: Big Nuke War Movie on Sci-Fi Channel "THE DAY AFTER"PLEASE GET THIS EMAIL OUT TO EVERYONE ON YOUR LISTS!!!!When THE DAY AFTER was televised on ABC in 1983 it was a national event, with hundreds of peace groups nationwide holding parties to watch the movie together.The movie shows a regional conflict spiraling out of control into nuclear war between the US and the Soviet Union , graphically portrays the incineration of Kansas City by several nuclear explosions, and terrifyingly explores how the injured, maimed and dying try to survive in the weeks and months following.Today we may be on the verge of nuclear war against Iran -- dropping nuclear weapons either pre-emptively or to retaliation against Iran fighting back against attack. These bombs would be dropped just a few hundred miles from Russia's border and the electro-magnetic pulse alone will probably sufficiently interfere with their communications that Russians may believe this is a nuclear attack upon them. The radiation certainly may spread over southern Russia. And what happens when Pakistan explodes in rage and its radicals take over their nuclear weapons and possibly attack India and Israel?THE DAY AFTER may be only a month a way. (Maybe the SCI-FI channel has figured that out??)The US has bullied the IAEA into referring Iran to the UN Security Council merely for minor breaches of their agreement with the IAEA, even as the US coddles Israel, Pakistan and India which all developed nuclear weapons without ever joining the IAEA.The US and Israel are hot to attack, probably right after the Israeli elections March 28 - which is also a week after Iran begins trading its oil in euros instead of dollars, a possible threat to US economic stability.Watch the movie tonight. And wake up tomorrow morning and start working furiously to stop this war.Again, we may have only a few weeks left of our civilization unless we act NOW!If you can't see the movie, or are trying to decide whether to see it, look at photos from it athttp://carolmoore.net/nuclearwar/films.htmlAlso see photos of the similarly themed British movie THREADS.For more info go to:http://stopthewarnow.nethttp://stopwaroniran.org
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Comment #23 posted by Hope on March 09, 2006 at 18:41:04 PT
Freshy
"...that would suck to have exaggerated happiness.":0)If you ask me...that's a pretty dang neat "side effect".
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Comment #22 posted by Dankhank on March 09, 2006 at 18:20:21 PT
Imagine ...
ImagineImagine there's no heaven,It's easy if you try,No hell below us,Above us only sky,Imagine all the peopleliving for today...Imagine there's no countries,It isnt hard to do,Nothing to kill or die for,No religion too,Imagine all the peopleliving life in peace...Imagine no possesions,I wonder if you can,No need for greed or hunger,A brotherhood of man,Imagine all the peopleSharing all the world...You may say Im a dreamer,but Im not the only one,I hope some day you'll join us,And the world will live as one.John Lennon
1940-10-09 :: 1980-12-08assassinated by a christian ...obedient/disobedient?
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Comment #21 posted by Hope on March 09, 2006 at 17:24:47 PT
JR Bob Dobbs comment 5
"Final: 399 pro, 5 anti, 29 abstain"Disgusting. Except for the Magnificent 5, of course.
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Comment #20 posted by freshy on March 09, 2006 at 17:19:43 PT
side effects
MARINOL® has been proven to be safe and generally well tolerated. The most frequently reported side effects during clinical studies involved the nervous system and included dizziness, feelings of exaggerated happiness, paranoid reaction, drowsiness, and thinking abnormally.that would suck to have exaggerated happiness...
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Comment #19 posted by global_warming on March 09, 2006 at 16:03:19 PT
sweet Jose
Wish I had the moneyto 'buy 'potAlas, I am a very poor person,Who cannot afford that 'gatewayThough I may be able to seeHow 'we those peopleForce our locked steppedDecent into HellI can salute you Jose,
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Comment #18 posted by global_warming on March 09, 2006 at 15:46:15 PT
cheap vodka
imagineour placein this universeimagine green pasturesfilled with foodimagineour worldfilled with powerthat can nourishour 'last breathas testament and martyr/witness
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Comment #17 posted by jose melendez on March 09, 2006 at 15:40:34 PT
Someone please explain:
Maine Residents:Access to this informationis not available due toChapter 392.H.P.1141-L.D.1628enacted by the legislature of the State of MaineNon-Maine Maine Residents:Click here to proceedto Product Information.http://marinol.com/ - - -strange days, indeed.they looked the other way and we called it here, for years ongoinglooked the other way while we wrote letter after letter to the editor, they just turn the page and yawnlooked the other way when the science and the history confirmed what we told them, right became wrong then, and all they could do was keep the truth all covered up and;locked up and away,disposing of economy, incarceration industries made money for their donors and their bankers and the judges thatlooked the other way while drug war cheerleaders and profiteerssuppress the truth and promote fearsfor near about a hundred yearsleveraging racist xenophobiato push their cornucopiaof poisons even as they:laugh in our face andattempt to induce fear through the newspapers and faux news. We may fear some but not alland will expose - every one of y'allcause you are not the only one who goes undercover, wired and mic'd,with video streaming and wireless kites,remote control blimps and black satellitesyour drug war is crime,we have proof, say good night."The Other Way"copyright 2006Jose Melendez, Concerned Citizens Coalition to Criminalize Prohibitionhttp://ccccp.org
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Comment #16 posted by global_warming on March 09, 2006 at 15:23:15 PT
Are You Sure?
Have you found the correct 'way?Are you certain?
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Comment #15 posted by global_warming on March 09, 2006 at 15:02:36 PT
Sorry JM
Read back to JR comment, This very momentThose JackalsAre 'VotingI sure that when they see the LightWhat they 'vomitWill be an 'eternal blindnessThat 'prohibits these barbaric and ignorant souls,From entering the 'fields of 'Eternal BlissI do understandThat this voteMay save their secular 'bottom line,There are fewer and fewer souls,Who pray for those wretched souls,They must find another wayTo the Glory Trail,
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Comment #14 posted by global_warming on March 09, 2006 at 14:50:16 PT
I seem to be an idiot
I understand that last comment about 'more carnage to come, but 'JM's" comment about Ron Paul and Jesus, that one just passes over 'my head...?
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Comment #13 posted by OverwhelmSam on March 09, 2006 at 14:41:15 PT
More Money Down The Tubes
I guess the American are not sick enough of the drug war yet. I know a woman who put her son in a lock down boot camp style "school" when she caught him smoking pot. These days she stays drunk beyond comprehension. More carnage to come.
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Comment #12 posted by jose melendez on March 09, 2006 at 14:38:46 PT
Ron Paul
Well then maybe he should switch parties and run for Vice President. There gonna try and crucify Hillary anyway, maybe she could use support from the 80 percent that support medmj far greater than 50 percent of all high school seniors have for decades admitted they self-medicate, seek the Great Spirit and party like it's your last day 'alive.' You know, like Jesus.
Holy Sacramental!
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Comment #11 posted by Taylor121 on March 09, 2006 at 14:32:05 PT
JR Bob Dobbs
I'd put money on Ron Paul being the Republican to vote against it.
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Comment #10 posted by global_warming on March 09, 2006 at 14:29:23 PT
Thats right,
"Our national medical system relies on proven scientific research, not popular opinion," said John Walters, director of National Drug Control Policy, to reporters.."That same proven 'system that allowed Thalidomide, Vioxx, and many other "scientifically" beneficial medicinal high priced patented preparations to reach society.It is my "popular opinion" old John, someday, when you retire from the OndcPP, maybe you can get a good paying job at Pfizer or Mercke, then you will have the time to ponder, what you have wrought, upon the flesh of your brothers and sisters.May God have Mercy upon your wretched soul...
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Comment #9 posted by FoM on March 09, 2006 at 14:28:54 PT
Just In Case Someone Doesn't Know
This link shows the last 100 comments from any article. It's very handy and I thought I should mention it.http://cannabisnews.com/newcomments.shtml
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Comment #8 posted by museman on March 09, 2006 at 14:21:58 PT
Yeah right
"Our national medical system relies on proven scientific research, not popular opinion,"... "To date, science and research have not determined that smoking marijuana is safe or effective."Is that the same 'system' which told us that fats were bad, then some of them were good, then they were bad again? These are the same guys that 'scientificly studied' all those chemical derivatives (drugs) with all the nasty side effects like, 'nausea and death.' These are the 'scientists' on the payrolls of the current political power structure, and they will lie for a buck as soon as tell the truth.Money might buy you credentials but it can't make you real.Funny how they alluded to the 'opinion' that marijuanna has unique and numerous medical uses, was 'popular.' I liked that.
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Comment #7 posted by Jose Melendez on March 09, 2006 at 13:36:00 PT
I knew it.
I knew I was right about Section 1713. Whatever. ONDCP are demonstrably lying about science anyway. In the age of the internet, that's like erasing 18 minutes of tape and burglarizing the offices of your political opponents.Bullspit may get you to the top Mahmoud, Walters and Barthwell, but it won't keep you there. -jmCCCCP.org - - -If Cannabis Didn’t Cause Lung Cancer, They Would Tell Us Right? And If It Might Prevent It??? Or Cure It?? The Sound of Silence.Imagine the publicity that would have ensued from a report by the leading government sponsored researcher in the field, if he had reported that the data demonstrated that cannabis caused lung cancer. That has been a major part of the prohibitionist party line for years, so the Drug Czar would have called a press conference and media outlets around the world would have led with the story.Instead the researcher reported just the opposite, and indicated that the data also indicated that smoking cannabis may even reduce the risk of lung cancer.And the media reaction??Nada. Zilch. Zero. It wasn’t because they were not told. In NORML’s July 7th Weekly Press Release, NORML informed thousands of media outlets. As usual, the inestimable Fred Gardner scooped the world with his report from this year's meeting of the International Cannabinoid Research Society, http://cannabinoidsociety.org and Gardner’s article was also posted on Counterpunch.org, a popular left of center website, but I have been unable to find a single instance of it being reported by a major news organization.Inasmuch as stories about any possible cause or cure for cancer are usually very popular, this omission is… well, typical of news coverage on cannabis, but not cancer.http://www.marijuananews.com/news.php3?sid=847
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Comment #6 posted by FoM on March 09, 2006 at 13:35:58 PT
JR Bob Dobbs
Thanks. I must have missed it. Nothing like that is on now.
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Comment #5 posted by JR Bob Dobbs on March 09, 2006 at 13:21:39 PT
On C-Span right now
They're voting on something called "Final Passage of Reauthorization of Nat'l Drug Control Policy Office", with about six minutes left as I type this. Of course it's passing - overwhelmingly. But there are five nay votes, one Republican and four Democrats. (There were 5 Dems a couple minutes ago - did somebody vote but then change their mind??) Who are these five brave congresspersons? I'd like to know. There needs to be a drug-war scorecard for congress, so we can see who voted for or against what. It would clarify who needs to go and which incumbents I could actually stomach voting for.Final: 399 pro, 5 anti, 29 abstain. And the one independant, which I presume must be Bernie Sanders of Vermont... voted YES??? For SHAME, Bernie!!
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Comment #4 posted by FoM on March 09, 2006 at 11:31:15 PT
Treeanna
I don't know. I wonder if this little paper got it mixed up. I haven't heard of any ruling recently.
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Comment #3 posted by Treeanna on March 09, 2006 at 11:27:55 PT
??????
What is this "ruling" that Walters is prattling on about?That story is very poorly written.
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Comment #2 posted by FoM on March 09, 2006 at 11:02:23 PT
News Article from The NEJM
Congress, Controlled Substances, and Physician-Assisted Suicide — Elephants in MouseholesGeorge J. Annas, J.D., M.P.H. Volume 354:1079-1084 March 9, 2006 Number 10 The U.S. Supreme Court's decision in Gonzales v. Oregon to reject the U.S. attorney general's authority to prohibit physicians in Oregon from prescribing Schedule II drugs for their terminally ill patients to commit suicide can seem paradoxical and confusing.1 How is it that California cannot permit the patients of physicians who recommend marijuana, a Schedule I drug, to possess legally and use marijuana that they may need to survive, but Oregon can legally permit physicians to prescribe Schedule II drugs and patients to possess and use such drugs to end their lives? The key to the answer lies in distinguishing between the two classes of questions by which the U.S. Supreme Court primarily decides cases: is a statute consistent with the U.S. Constitution — that is, is it "constitutional"? — and what does a federal statute actually mean? The California case was decided on the basis of the first question, and the Oregon case on the second. More specifically, in the California case, Congress had outlawed any use of marijuana by classifying it under Schedule I, which includes drugs that have "no currently acceptable medical use." The legal question was whether Congress had the constitutional authority to make this classification under its Commerce Clause powers.2 The Court determined that it did, concluding that the Commerce Clause gave Congress the same power to regulate marijuana grown at home for personal, medically related uses as it had to regulate the amount of wheat a farmer grew on his farm for personal consumption.3 The fact that a physician would recommend or prescribe the marijuana for medical purposes was found to be irrelevant.2,3 In the Oregon case, the power of Congress to regulate the use of drugs in the practice of medicine is not at issue; Congress can set national drug-prescribing rules. The question is: how did Congress affect the authority of states to set medical practice standards by enacting the Controlled Substances Act in 1970, which places substances in one of five schedules on the basis of their potential for abuse or dependence? The Controlled Substances ActJustice Anthony Kennedy wrote the opinion of the Court in Gonzales v. Oregon, which was decided by a six-to-three vote. The opinion begins: "The question before us is whether the Controlled Substances Act (CSA) allows the United States Attorney General to prohibit doctors from prescribing regulated drugs for use in physician-assisted suicide, notwithstanding a state law permitting the procedure."1 In 1997 the Court had observed that "Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide."4 The current case is not about the Oregon law itself but about whether Congress had given the U.S. attorney general the authority to nullify its effect. The Oregon statute — the first and still the only state law to authorize physicians to write prescriptions for a lethal dose of drugs for patients who were terminally ill but mentally competent and who asked for such a prescription at least twice — was adopted by ballot measure, first in 1994 and again in 1997.5 In 1997, Attorney General Janet Reno was asked by a group of senators to determine that prescribing drugs for suicide was not a "legitimate medical practice," as required by the Controlled Substances Act, and that writing such a prescription could therefore result in the revocation of one's registration certificate with the Drug Enforcement Administration (DEA) and federal criminal prosecution. Reno refused, concluding that the Controlled Substances Act did not authorize her to "displace the states as the primary regulators of the medical profession, or to override a state's determination as to what constitutes legitimate medical practice."1 John Ashcroft, who as a senator had supported federal efforts to curtail physician-assisted suicide, was appointed attorney general in 2001. In November 2001 he issued an Interpretive Rule that stated: [A]ssisting suicide is not a "legitimate medical purpose" within the meaning of [existing regulations], and prescribing, dispensing, or administering federally controlled substances to assist suicide violates the Controlled Substances Act. Such conduct by a physician registered to dispense controlled substances may "render his registration . . . inconsistent with the public interest" and [is] therefore subject to possible suspension or revocation . . . regardless of whether state law authorizes or permits such conduct by practitioners or others and regardless of the condition of the person whose suicide is assisted.6Every prescription filled under the Oregon law has included Schedule II drugs, and such drugs cannot be legally prescribed without registration with the Drug Enforcement Administration. Thus, in practice, the Oregon law would be rendered ineffective by the Ashcroft rule. Accordingly, a lawsuit was filed in the U.S. District Court of Oregon, and the court enjoined the enforcement of the rule.7 The Court of Appeals for the Ninth Circuit affirmed the decision, holding that the Ashcroft rule was invalid because, by making a medical procedure authorized under Oregon law a federal offense, the rule changed "the usual constitutional balance between the States and the Federal Government" without a clear congressional statement authorizing this change.8 Copyright: 2006 Massachusetts Medical SocietyComplete Article: http://content.nejm.org/cgi/content/full/354/10/1079
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Comment #1 posted by FoM on March 09, 2006 at 10:47:54 PT
Related Article from The Plainville Citizen
Pot-Pourri: Cannabis Preparations for Pain***Thursday, March 9, 2006
Recent surveys conducted in people with multiple sclerosis (MS) and epilepsy suggest that many people with these diseases are using marijuana to treat pain, stress and other symptoms associated with their conditions. While little research is being done on the medical uses of marijuana, a new study suggests that a drug modeled on a cannabinoid chemical in marijuana may help ease the pain associated with multiple sclerosis (MS) and perhaps provide a safer alternative to smoked marijuana for people with chronic pain conditions.Treating Pain in Multiple SclerosisThe MS study, published in the June 16th online edition of the British Medical Journal (BMJ), evaluated 24 people with MS between the ages of 23 and 55 who had central pain. Up to 80 percent of people with multiple sclerosis experience pain, including pain generated in the central nervous system known as central pain.The researchers, of the University Hospital of Aarhus in Denmark, divided the participants into two groups, giving one a placebo and the other group dronabinol (Marinol). Dronabinol contains a synthetic form of THC, which is believed to be the primary active ingredient in marijuana, or cannabis. Dronabinol, a prescription medication that is given as a capsule, is the only cannabinoid approved by the U.S. Food and Drug Administration (FDA). It is currently indicated for loss of appetite in people with AIDS and for the treatment of nausea and vomiting associated with chemotherapy for cancer.The Danish researchers found that dronabinol reduced pain intensity and improved pain relief in participants, and concluded it should be offered to people with MS whose pain is not severe enough to be treated with medications such as anticonvulsants, antidepressants or opioids. Some side effects, such as dizziness, were associated with dronabinol.
Marinol and Marijuana: What's the Difference?Dronabinol contains just one of the more than 60 cannabinoids in the marijuana plant, many of which may contribute to its beneficial effects. But unlike marijuana, which is illegal under U.S. federal law, dronabinol provides a standardized THC concentration and is free of impurities such as leaves, bacteria and mold spores. In addition to the quality control concerns, there is still a need for randomized trials of medical marijuana to establish its therapeutic value.Surveys, however, suggest that people with MS, for example, are smoking marijuana for medical purposes regardless. Of the 220 people with MS interviewed for a Canadian survey that was published in June in the journal Neurology, 29 said they used marijuana regularly for symptom relief. About half of these patients said marijuana eased pain and spasticity."I think the survey findings point to the reality that a proportion of patients with MS are using cannabis," says Mark Ware, MBBS, MSc, an assistant professor of anesthesia and family medicine at McGill University in Montreal who conducted the survey. "If physicians don't ask their patients about cannabis, the use may go undetected by the physicians, and cannabis may not be totally beneficial; it may cause harm and interact with other medications."While Dr. Ware does not advocate the use of medical marijuana at this time, he thinks that its use among patients points to a need for pain to be taken seriously. He and other physicians who treat people with painful conditions say that more research on dronabinol and marijuana is needed for this reason. "I think that clinical trials such as the one recently published in the BMJ add significantly to the body of evidence suggesting that cannabis, and products based on cannabis, have a role to play in the management of painful chronic diseases like MS," Dr Ware says.
Copyright: 2006 The Plainville Citizen http://www.theplainvillecitizen.com/articles/2006/03/09/health/multiple_sclerosis/ms_cannabis.txt
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