Should it be legal for people with cancer, AIDS and other conditions to use marijuana for medical purposes? Well, that controversial question was on the ballot this past week in Alaska, Arizona, Nevada, Oregon, Washington state and the District of the Columbia. And, despite strong opposition from the Clinton administration, the answer from voters was a resounding "yes." The election has thrust medical marijuana back into the headlines as a hot political issue. But the science behind it is still evolving. HealthWeek's Eugenia Halsey reports on what health experts have to say about marijuana as medicine.
EUGENIA HALSEY: This was the scene in Washington DC this week as voters cast their ballots on pot for patients.
POLITICAL ADVERTISEMENT: "There's a medicine that can help. It's marijuana."
EUGENIA HALSEY: And across the nation, ads like this helped stoke voter support. Those in favor of using marijuana as medicine say sometimes it's the only thing that works. This physician has seen it relieve pain, nausea, and weight loss in his AIDS patients.
DOUGLAS WARD, MD: "I think it's an effective drug in controlling symptoms and should be available to people without having to risk arrest or risk personal danger in buying it."
EUGENIA HALSEY: Last year a scientific panel brought together by the National Institutes of Health reviewed the medical research on marijuana and found it does show promise for the treatment of some conditions. It issued this report which recommended further research into whether marijuana can help control nausea and vomiting associated with cancer chemotherapy, stimulate appetite in patients with AIDS or cancer, ease chronic pain, relieve symptoms associated with neurological disorders, and treat glaucoma, a condition that can cause blindness. Charles Schuster, who has done research on marijuana, agrees it has potential for some patients.
CHARLES SCHUSTER, PhD, WAYNE STATE UNIV SCHOOL OF MEDICINE: "I think it is more of a boost for researchers saying this is a legitimate area to be researched and one that should be done. And I think we are going to see an increasing number of clinical trials in this area."
EUGENIA HALSEY: As that research goes forward, critics of medical marijuana, including the White House, say there's still not enough solid scientific evidence to prescribe it. And any use should be OK'd by the medical community, not voters.
TOM HEDRICK, PARTNERSHIP FOR A DRUG-FREE AMERICA: "The bottom line is approving medicine through public referenda as opposed to through the Food and Drug Administration process is not good medicine."
EUGENIA HALSEY: Hedrick also fears legalizing marijuana now would send the wrong message to children, who are the targets of a new White House anti-drug campaign. Some critics also say there is no need for marijuana, because there are already effective medications, including an FDA-approved pill form of marijuana called Marinol. But Dr. Ward says for some of his patients, smoking the drug works better.
DOUGLAS WARD, MD: "With marijuana, you can smoke it, get an immediate effect and use just as much as you need."
EUGENIA HALSEY: Still, telling patients to smoke their medicine is a radical step, one the government and many doctors aren't ready to bless.
NANCY OLSON: We're joined now by HealthWeek's Andrew Holtz from Portland, Oregon, one of the state's where this issue was on the ballot. Andrew, where do doctors in Oregon, and elsewhere in the country, stand on this issue?
ANDREW HOLTZ: Well, here and elsewhere, there is a split. There are some doctors who actively supported the measure here. Other doctors who actively opposed it. Although it is not their number one priority apparently. I talked with a representative of the Oregon Medical Association, which took a neutral stand on Oregon's initiative. He said since the election they have had no calls from physicians about how to respond to the passage of the bill legalizing the medical use of marijuana here. Around the country, major medical organizations tend to support further research into marijuana, but then they diverge. The American Medical Association discourages the use of marijuana. They say doctors and patients should be free to discuss the matter, but they aren't quite ready to put a pat on the back to prescription use for marijuana. The American Cancer Society supports further research, but the American Academy of Family Physicians says it does support the use of prescriptions for the certain medical uses of marijuana.
NANCY OLSON: You know, we constantly hear a call for more research, yet right now there is only one government-funded study on marijuana ongoing. Why is that?
ANDREW HOLTZ: Well, for one thing, marijuana is a little bit hard to do a traditional placebo controlled blinded study because you give a patient a joint of marijuana, and he or she tends to know whether or not she's getting the active ingredient, because they get high. Also there's the matter of, who pays for it? Is there going to be government support for these studies? And, if not, will private industry do it? Because marijuana is not something they can patent and make a profit off of.
NANCY OLSON: Andrew, thank you for helping to clarify the issue a little more.
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