Journal Assails U.S. Stand on Medical Pot Use

Attacking the federal government’s threat to crack down on California doctors who recommend marijuana to sick patients, a leading medical journal said today that the policy was “foolish,” “hypocritical” and “inhumane.”

The 800-word editorial in the New England Journal of Medicine represents a dramatic endorsement by a respected mainstream medical authority of pot’s clinical merits. In contrast, the American Medical Assn. has urged doctors not to recommend that patients smoke marijuana because the practice goes against federal law.

In the editorial, Dr. Jerome Kassirer, the journal’s editor-in-chief, urged the U.S. government to change marijuana’s classification from so-called Schedule 1, meaning it is a drug of abuse with no clinical value, to Schedule 2, which includes drugs such as morphine that are medically useful despite being potentially addictive.

That change would allow doctors to prescribe marijuana without fear of being hunted by federal drug agents--a scenario envisioned by some in California and Arizona, despite November ballot measures making pot available to certifiably sick people. After the elections, federal officials threatened to discipline doctors in those states who recommended pot to patients.

The central conflict, Kassirer said, is “between the rights of those at death’s door and the absolute power of bureaucrats whose decisions are based more on reflexive ideology and political correctness than on compassion.”

Meanwhile, U.S. marijuana policy also came under fire Wednesday in San Francisco, where nine doctors released a review of published studies on marijuana’s use in the treatment of AIDS, cancer and other illnesses. The group said it found 75 studies since 1970 that discovered a medical benefit.

“They all come to the same conclusion: Marijuana is a safe and effective medicine,” said attorney Kevin Zeese, who authored the report for Common Sense for Drug Policy, a Virginia group.

Opponents of medicalizing marijuana decried the journal editorial. The Federal Office of National Drug Control Policy, headed by drug czar Barry McCaffrey, a retired Army general, said in a statement that officials “respectfully disagree with the proposition that marijuana should be available for medical purposes now.”

The officials “have no bias against any drug that meets established and proven scientific standards,” he said, adding that “smoke is not a medicine” and “other treatments have been deemed safer and more effective than a psychoactive burning carcinogen self-induced through one’s throat.”

California Atty. Gen. Dan Lungren, who opposed the state measure, Proposition 215, and has struggled against the new law, said the medical journal’s call for a switch of marijuana to Schedule 2 status seems premature.

“If there was scientific proof that it was medically efficacious, then it would be different,” said Lungren spokesman Steve Telliano. “The attorney general supports having the scientific study done to once and for all put to rest this question of whether or not marijuana is a medicine.”

Stu Mollrich, a political consultant who led the fight against Proposition 215, said the editorial doesn’t amount to much “when you stack it against all of the other medical opinion that says marijuana is harmful.” But he admitted that it could provide ammunition to advocates of medical marijuana. “Sure, it will help them,” he said.

Bill Zimmerman, political director of Americans for Medical Rights, the group that pushed through the California measure, said the editorial “is a complete repudiation of the federal government’s response to Proposition 215.” He said it was part and parcel of a “rebellion by the medical community.”

Indeed, journal editor Kassirer said that what most irked him about the federal government’s policy against medical uses of pot was that it implied that doctors couldn’t be fully trusted to handle the drug. “I think that’s outrageous,” he said in an interview. “They’re trusted with more dangerous drugs than marijuana.”

Kassirer, who conceded that he smoked marijuana perhaps a dozen times until the late 1960s, said the sort of controlled scientific trials that are normally done before a drug is approved for use have not been done for marijuana. The problem, he added, is they are not likely to be done because of federal government restrictions.

But while the evidence of marijuana’s effectiveness in treating a range of illnesses is not complete, he felt confident that it has passed an important test: safety. “There is no risk of death from smoking marijuana,” Kassirer wrote. In contrast, morphine can be deadly if a little too much is taken.

“What really counts for a therapy with this kind of safety margin is whether a seriously ill patient feels relief as a result of the intervention, not whether a controlled trial ‘proves’ its efficacy,” he wrote.

But the American Cancer Society, which is officially neutral on the medical use of marijuana, believes there are legitimate safety questions.

“There are data showing that marijuana is a risk factor for head and neck cancers,” said society official Dr. James Lowman. “I think it would be amazing to hear us recommend smoking something for any reason.”

Monmaney reported from Los Angeles and Bailey from Sacramento.

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Marijuana and Medicine

With a leading medical journal editorializing in favor of medical uses of marijuana, new controversy has erupted over pot’s supposed medical merits.

Advocates say:

* Marijuana restores appetite in patients with AIDS wasting syndrome.

* It controls chemotherapy-induced nausea and vomiting.

* It reduces eye pressure in glaucoma patients.

* It alleviates pain and spastic movements associated with multiple sclerosis.

* It relieves pain and other symptoms of migraine.

* It reduces chronic discomfort such as menstrual cramps and “phantom limb” pain suffered by amputees.

* It is less addictive than many prescription drugs, including muscle relaxants and painkillers.

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Opponents say:

* Many of the supposed benefits are unproven or open to interpretation.

* A synthetic marijuana, tetrahydrocannabinol (THC), is already allowed for medical use, primarily to control chemotherapy-induced nausea.

* Pot causes lung damage from smoking.

* It is a threat to a damaged immune system from fungal or bacterial contaminations.

Sources: Journal of the American Medical Assn., American Medical News