Medical Marijuana

By John Feld

It says something interesting about our society and about marijuana - a substance which is not advertised, whose use is illegal, officially condemned, vilified and discouraged by the threat of imprisonment - that pot smoking is so popular.)

These days you can hardly open a newspaper, magazine or turn on the TV without seeing some reference to the supposed therapeutic benefits of marijuana.

I have multiple sclerosis. I’ve had it for 20 years. But my relationship with marijuana is even longer than my involvement with MS.

When I started to hear reports that usually conservative sectors of our society, like lawmakers and doctors, are reassessing the benefits of marijuana and considering its legalization for therapeutic purposes, I thought that this was a step in the right direction.

There are millions of people in Canada who smoke pot. Millions more might benefit from the legalization of marijuana: including those who deserve a chance to discover whether grass can ease their discomfort from disease.

Until then, all pot smokers are committing a crime, punishable by many years in prison, each time they light up. Progressive law enforcement officials would likely welcome the chance to stop harassing and terrorizing otherwise law-abiding and responsible citizens who smoke marijuana, and devote themselves instead to tracking down and punishing real criminals.

Federal Health Minister Allan Rock started the ball rolling in Canada when he announced on March 3, 1999, that his department is developing guidelines for clinical trials on the therapeutic benefits of marijuana. (I called the Multiple Sclerosis Society of Canada to request that my name be put right at the top of the list of volunteers to register for those clinical trials.)

Meanwhile, Canadians have been doing informal, non-clinical trials of their own. In April, 1998, a woman with multiple sclerosis named Lynn Harichy tried to start a medicinal marijuana buyer’s club in London, Ontario. She said at the time: "We don’t want to be criminals, but there is a necessity for it. We intend to supply the medical need. If the police want to act, they can come and bust me."

What are the claims and counter-claims? According to certain advocates for the decriminalization of marijuana for medical purposes, including some respected scientists, grass can be effective in alleviating nausea associated with cancer chemotherapy, and controlling
spasticity in multiple sclerosis. (I called my neurologist and asked her if she could substitute marijuana for my prescription for Baclofen, the drug most commonly prescribed to people with MS to control muscle spasms. She said she would talk to her people and would get back to me. I’m still waiting for her call.) Marijuana can also treat the wasting syndrome associated with AIDS, and prevent the progression of vision loss in glaucoma.

"The New England Journal of Medicine", "The Lancet", " New Scientist" and the Lindesmith Center are among those esteemed organizations and publications which have given recognition to marijuana’s medical uses and the futility of cannabis prohibition.

An American association, the Institute of Medicine (a branch of the National Academy of Sciences), released a report on March 15 strongly backing certain medical uses of marijuana, declaring that for some people with serious diseases, such as AIDS and cancer, it may be one of the most effective treatments available. The study was commissioned by the White House Office of National Drug Control Policy. It could mark a reassessment of the decades-long U.S. drive to ban almost all marijuana use.

Dr. John Benson, one of the principal investigators, declared: "We uncovered an explosion of new scientific knowledge about how the active components in marijuana affect the body and how they might be used in a medical contest." The study concluded that marijuana clearly controls some forms of pain is not particularly addictive and does not appear to be a "gateway" to harder
drugs. The study assessed what is currently known and what is not known about the medical use of marijuana, including:
- Natural and biological mechanisms that underlie the effects of marijuana and cannabinoids;
- Patterns of marijuana use, including the potential for addictions and progression to other drugs;
- Efficacy of marijuana and cannabinoids for a variety of health problems, including AIDS wasting, glaucoma, nausea induced by chemotherapy, muscle cramps associated with multiple sclerosis, and others;
- Efficacy of different delivery systems for marijuana, such as smoking, other forms of inhalation, oral ingestion and others; and
- Costs of various forms of marijuana compared with other medications.

A Multiple Sclerosis Society of Canada update bulletin, issued in response to Allan Rock’s announcement about medical marijuana, read in part: "The Multiple Sclerosis Society welcomes the announcement by Health Minister Allan Rock that the federal
government will initiate clinical trials on the medical use of marijuana. The MS Society hopes to work with Health Department officials to ensure that people with multiple sclerosis are included in clinical trials evaluating the question of whether there are therapeutic benefits
to marijuana."

"The scientific evidence has not been there; however, some MS patients believe they are helped by using marijuana," added Dr. William J. McIlroy, national medical advisor to the MS Society. "Minister Rock’s announcement is a useful step forward in helping
to resolve the question of whether the drug has a use in chronic diseases such as MS and for people with terminal illnesses
such as cancer and AIDS."

Linda L. lives in Ontario. Her multiple sclerosis causes painful muscle spasms which prescription drugs have not able to control to her satisfaction. The spasms are so agonizing that she finally sought relief from unconventional sources. Up to that point, Linda had never smoked marijuana in her life.

Linda’s first experience with pot did not involve any especially psychedelic preparations such as mellow music or dimmed lights. "I was seeking relief from my pain and discomfort, not a hippie turn-on experience," she says. "The only preparation I made was to choose the time of day. Before I smoked, I made certain that I had not taken my usual dose of Baclofen, at the time recommended by my neurologist."

"Before I smoked," reports Linda, "my body was tense, and I could feel the twinges of impending spasms. Almost as soon as I lit up, I could sense a relaxation. I wasn’t subjected to painful tremors for a few hours." She had enough marijuana for two sessions, and her second experience was just as beneficial as the first.

But not all health authorities or lawmakers are keen on legalizing marijuana for medical purposes. In the United States (one of the most rabid opponents of any move toward the legalization of marijuana), the Federal Drug Administration, the National Multiple Sclerosis
Society, the American Glaucoma Society, the American Academy of Ophthalmology and the American Cancer Society have all rejected the use of smoked marijuana as a medicine.

In 1995, Drug Watch International issued a position statement on medical marijuana entitled, "By any Modern Medical Standard, Marijuana is No Medicine." It begins with this assessment: "Leaf marijuana is not medicine. It is a harmful psychoactive
drug, composed of over 400 different chemicals, which should not be used by anyone, especially by people who are ill."

The statement goes on: "Smoked marijuana is neither an acceptable medical treatment nor an alternative medical treatment. Marijuana has serious health consequences. Concentration, motor coordination, memory. Lungs, reproductive and immune systems are
all adversely impacted by marijuana use; marijuana is addictive."

In Canada, the notion that marijuana should be legalized is not new. Of course, hippies and their descendants have been calling for its decriminalization for decades, but today’s bid by eminent citizens has its precedents also. In 1971, a federal commission of inquiry headed by Justice Gerald LeDain concluded that it was inconsistent to treat the use of marijuana more harshly than alcohol or tobacco. The commission recommended, among other things, that possession of cannabis and cultivation for personal use be permitted, but importing and trafficking remain a crime.

To say that the findings of the LeDain Commission were somewhat controversial would be the understatement of the century, if not the millennium. Virtually none of the commission’s recommendations made it into law. Politicans worried about public reaction and opted to do nothing - even though LeDain maintains to this day that the commission findings reflected what the public wanted.

There’s something absurd about the entire issue of medical marijuana. Nothing I’ve read sums it up better than a New York Times article in March discussing a handful of Americans who are able to smoke marijuana legally under a "compassionate use"
program sanctioned by the Food and Drug Administration and the National Institute on Drug Abuse.

"I get no euphoric effect," one of the lucky ones is quoted as saying. In this regard, medical marijuana reminds me of de-alcoholized beer. What’s the point of drinking it? Why smoke marijuana if it doesn’t make you high? It’s like the little old lady who says she drinks rye whiskey "for medicinal purposes" - trying to camouflage the secret pleasure she gets from the booze.

Would Linda L., the Ontario woman who experimented with grass to alleviate her spasms, try it again? "Yes!" she says emphatically. "Except I’m afraid of a knock on the door by the police."

Will marijuana ever become decriminalized? For therapeutic reasons? No one can predict it. But no established political party in the country seems to feel it can gain votes by championing the legalization of marijuana. All it can do is lose votes.

Does medical marijuana work? The jury is still out. The wheel is still in spin. But people with disabilities who believe in its therapeutic application can lobby the federal government directly, or through their disability support organization, to make their voices heard.

Decriminalization of marijuana might be just what the doctor ordered.

(John A. Feld is a freelance writer living in Toronto, Ontario.)