Subject: Medical Marijuana
From: [email-masked] (Grant Hughes)
Date: Thu, 28 Oct 1993 06:15:43 GMT
Newsgroups: alt.hemp

The following is a widely distributed OP/ED piece addressing some of the
gross misinformation about the medical use of marijuana.

	MARIJUANA SMOKING AS MEDICINE:  A CRUEL HOAX

The anecdotal claims concerning the unique therapeutic properties of
marijuana smoking in alleviating the nausea and vomiting induced by the
chemotherapy of cancer or of AIDS do not withstand scientific scrutiny.

In the first place, modern therapeutics distinguish between a crude drug
and its pharmacological active pure ingredient, in this instance between
marijuana and THC.  While crude marijuana preparations made of plant
material and containing THC display similar pharmacological properties as
THC, their overall effect is quite different.  Indeed, marijuana contains
in addition to THC 60 other cannabinoids which modify absorption,
availability and transformation of THC in the body, and which are also
biologically active.  Besides cannabinoids, 360 other compounds have been
identified in the plant material such as terpenes, flavinoids, furan
derivatives and alkaloids.  The smoke if a marijuana cigarette contains in
its gas phase the noxious vapors of carbon monoxide, acetaldehyde,
acrolein, toluene, nitrosamine and vinylchloride, and in its particulate
phase phenol, creosol, methyl and napthalene.  Marijuana smoke also
contains twice as many cancer producing substances (benzanthracene and
benzopyrene) as a tobacco cigarette of the same weight.  The respective
amount of all of these different chemicals will vary with each marijuana
cigarette and its resulting smoke, therefore prescriptions of marijuana
cannot comply with the Pure Food and Drug Act, which requires that all
medicines be labeled with the exact amount of chemicals they contain.  In
addition, crude drug marijuana preparation can also be contaminated with
salmonella bacteria which gives diarrhea and with a fungus, aspergillus,
which may cause severe bronchopneumonia (It has been suggested that the
marijuana cigarettes prescribed to patients be sterilized.).

Damaging effects in man caused by prolonged exposure to marijuana smoking
have been reported in two recent International Symposia; they include
emphysema-like symptoms, cancer of the lung, mouth and tongue, prolonged
impairment of memory and of psychomotor performance resulting in train or
car accidents, a six-fold increase in the incidence of schizophrenia,
leukemia in children born from marijuana smoking mothers and damage to the
growing fetus.

However, if smoked marijuana had unique therapeutic properties, these
forgoing undesired effects could be overlooked.  Prominent cancer
specialists such as Dr. R. J. Gralla of Sloane-Kettering Memorial Cancer
Center, Dr. D. S. Ettinger of Johns Hopkins Medical School, Dr. George
Hyman of Columbia University College of Physicians and Surgeons, and Dr.
John Laszlo, Vice President for Research of the American Cancer Society
have concluded that the crude drug marijuana taken by inhalation has only
limited effectiveness in the treatment of vomiting caused by cancer
chemotherapy and documented negative effects on pulmonary, cardiovascular
and immunity systems.  The American Cancer Society stated in 1989 that the
results of clinical investigations were insufficient to warrant the
decontrol of marijuana smoking for medical use.  the American Medical
Association and the Food and Drug Administration (FDA) expressed a similar
opinion.

The therapeutic applications of smoked marijuana have been traced down to
the psychoactive ingredient it contains:  THC.  This compound taken by
mouth will relieve the vomiting resulting from cancer chemotherapy in a
limited number of patients.  But THC also produces acute undesirable
psychic and cardiovascular symptoms, and its depressant effect on immunity
is not a good indication for patients with cancer or AIDS who already have
impaired immunity.  To treat nausea associated with chemotherapy, modern
drugs with much greater bioavailability, specificity, and effectiveness,
and less side effects than THC, such as metoclopramide and ondansetron,
have already been used on millions of patients.  And these drugs have
become the preferred choice of the majority of physicians who wish to
treat their patients in the safest and most effective fashion.  However,
THC, because of its therapeutic properties, has been reclassified from
Schedule I to Schedule II, which permits its prescription by physicians. 
Marinol is one of the presently available preparations.  But most other
countries, signatories of the Single Convention of the United Nations on
Controlled Substances, did not concur with the U.S. Reclassification and
kept THC in Schedule I, among drugs which have no unique therapeutic
usefulness and high abuse potential.

While the reclassification of THC to Schedule II might be understandable,
this would not be the case for smoking the crude drug marijuana, which
would as a result become more available and more readily diverted for
non-medical use.

There is no medical justification for the use of marijuana smoking in the
treatment of nausea and vomiting associated with cancer or AIDS
chemotherapy.  Other claims formulated in the prescientific area of
medicine concerning the therapeutic properties of marijuana smoking for
epilepsy, multiple sclerosis, paraplegia, chronic pain, pruritis,
menstrual cramps, and labor pain are purely hearsay and may even be
harmful to the patient.  Such claims have been nonetheless recently
revived by the same Harvard professor who has also stated that 'used no
more than two or three times a week, cocaine creates no serious problem.' 
His latest book, "Marijuana, the Forbidden Medicine," is a loose
compendium of unverifiable anecdotes.

The unilateral reclassification by the United States of marijuana from
Schedule I to II would perpetuate a cruel hoax by sending the wrong
message to uninformed patients and health professionals who rely on safe
and effective medicine.  There is no medical justification for the use of
marijuana smoking in the treatment of nausea and vomiting associated with
cancer or AIDS chemotherapy."

Gabriel G. Nahas, M.D.
Nicholas A. Pace, M.D.
New York University Medical Center