The Des Moines Register
Thursday, December 5, 1996, Page 16A
letters@dmreg.com
THE REGISTER'S EDITORIALS
Marijuana: What's the fuss?
An Iowa woman smokes it legally.
Why can't others, by prescription?
Lost in the dust kicked up by
the suddenly renewed storm over legalizing marijuana is the fact that the drug has been
legal for 10 years, in pill form. Distributors in Cedar Rapids and Omaha supply the
prescription pills to Iowa, and it's on the approved list for the poor. In fiscal
`96, Iowa Medicaid paid $17,500 for the drug, trade name Marinol, at $4.63 per pill,
primarily for treatment of nausea caused by cancer chemotherapy.
In theory, the pill is the therapeutic equal of
the cigarette. The U.S. Public Health Service has found no evidence that smoking
marijuana provides any greater therapeutic value than Marinol, whether used to treat
glaucoma, multiple sclerosis, AIDS, or any of the other conditiom for which it's
prescribed. The National Institutes of Health agree. Others - including an
Iowan who has used both legally - disagree.
Meanwhile, months of stormy debate in
California and Arizona over legalizing marijuana for medical use came to a head last month
when voters in both states said yes, by comfortable margins. But far from putting
the matter to rest, the vote has shifted the argument to the national stage. In
congressional hearings this week, the two states' actions were blasted as part of an
insidious national drive to legalize drugs and push users toward harder stuff.
With the pill form available, and two
medical/scientific branches of the federal government contending that the effects of the
pill and the cigarette are equivalent, why the fuss over making marijuana cigarettes
available through medical channels?
Because they're far from equal, according to an
Iowa victim of multiple sclerosis. Marijuana cigarettes work for her. Marinol
doesn't.
Barbara Douglass of Storm Lake is one of only
eight Americans provided with legal marijuana cigarettes through a U.S. Food and Drug
Administration program for "compassionate" relief. She became ill with
multiple sclerosis in 1988. She was given a prescription for Marinol, and found it
far too powerful.
"You took Marinol, and the Marinol took
you," she said. "It's too heavy, too strong."
The pills came in a gel form whose dosage was
difficult to regulate, she said. It would "knock out everything you wanted to
think, say and do."
She continued the treatment for three months in
1991 and told her doctor it was not helping. Then a lawsuit temporarily opened a
tiny window of opportunity that allowed distribution of marijuana cigarettes to a handful
of people, she among them. The cigarettes come from North Carolina's Research
Triangle.
The advantage of smoking marijuana, she said,
is that you can adjust the dosage as needed to ease your pain, simply by the number of
draws on the cigarette before setting it down. She smokes 10 per day.
But while Marinol failed her, Douglass said, it
worked for a friend. It eased the pain and nausea caused by the chemotherapy after
surgery for breast cancer.
Some who favor legalizing
marijuana cigarettes argue that Marinol contains just one of several substances in
marijuana that provide pain relief. The contradiction between that contention and
the findings of the PHS and NIH may be worth further study. But the fundamental
issue of legalization remains:
Should doctors have the prerogative to presribe
dangerous and possibly addictive drugs when they think their patients need them? And
the answer is the same, whether the drug be marijuana, morphine, codeine, Demerol, or any
of a bunch of others on the "controlled substance" list: Yes. To deny
doctors all the tools that should be available to them is to let those who misuse drugs
dictate medical policy.
Far from weakening either our laws or our
resolve in the war on drugs, recognizing the value of some misused drugs helps to dispel
the notion that our policy is grounded in hysteria.