DRCNet Activist Guide 8/97

The Scientists and the General

Drug Czar Barry McCaffrey, a retired Army General who headed the U.S. Southern Command (Southcom), has waxed eloquent on the need for science, not politics, to decide the medical marijuana issue. But when contrasting McCaffrey's behavior with the reasoned discussion made by the scientists and doctors at the National Institutes of Health conference last winter, a different picture emerges.

The Scientists

Quotes from the National Institutes of Health (NIH) Workshop on the Medical Utility of Marijuana
Roundtable Discussion, February 20, 1997, Natcher Conference Center - NIH Campus, Bethesda, Maryland

(Compiled from NIH transcripts* by the Marijuana Policy Project (MPP)
P.O. Box 77492, Capitol Hill, Washington, DC 20013, (202) 462-5747, [email protected], http://www.mpp.org.)

The National Institutes of Health convened a panel of eight experts on February 19, 1997, to review the existing science regarding medicinal marijuana and listen to a full day of testimony from scientists, health care professionals, patients, and the general public. On February 20, the panel participated in a round table discussion of the topic. People with pre-existing support for medicinal marijuana were excluded from the panel. Apparently, the evidence is compelling, as the following quotes were taken directly from the transcripts.

Effectiveness of Smoked Marijuana - General:

"[W]e know that for some people, it makes a difference." (pages 74-75, Julie E. Buring, Sc.D.)

"[I]f someone is seriously ill and is not feeling well, and marijuana makes them feel better, who is to say that that's a bad thing?" (page 83, Avram Goldstein, M.D.)

"[T]he truth is it probably does work, assuming that it contains the active ingredient [THC] that we've already proven does work, so it's going to work." (page 86, Mark G. Kris, M.D.)

Relieving Nausea and Increasing Appetite (for AIDS Wasting Syndrome and Cancer Chemotherapy) with Smoked Marijuana:

"I think there's clear evidence that, at least in the short run, that smoking marijuana does alter caloric intake." (page 57, John P. Phair, M.D.)

"When you look at this literature, I think what we're saying is that it does clearly show that marijuana increases the appetite, increases caloric intake. ..." (page 67, Buring.)

Treating Glaucoma with Smoked Marijuana:

"In the case of smoked marijuana or Marinol, it's quite clear that it does lower intraocular pressure, often substantially. ... So I don't think there's any doubt about its effectiveness, at least in some people with glaucoma." (pages 96-97, Paul Palmberg, M.D., Ph.D.)

Treating Muscle Spasticity Disorders with Smoked Marijuana:

"In looking at the literature and listening to the discussion yesterday, I came to the conclusion that smoked marijuana does have an effect on spasticity." (page 111, Kenneth Johnson, M.D.)

Treating Epilepsy:

"[A]t least in experimental epilepsy systems, the cannabinoids seem to be quite effective for some kinds of epileptic conditions." (page 115, Johnson)

Treating Pain:

"And so I think there's probably little doubt that inherently there is an analgesic effect that can be mediated through the cannabinoid receptor." (page 119, probably William T. Beaver, M.D., but transcript is not clear)

Safety of Smoked Marijuana:

"[W]e know that there are no extreme immediate toxicity issues. It's a very safe drug, and therefore it would be perfectly safe medically to let the patient determine their own dose by the smoking route." (page 82, Goldstein)

"There's some epidemiologic information that says that smoked marijuana in gay men does not impact deleteriously progression of HIV infection. ..." (page 59, Phair)

"People do seem to be able to function, to speak articulately, not to appear inebriated even though they're on these kinds of doses for a long time." (page 98, Palmberg)

Smoked Marijuana versus Synthetic THC:

"[T]he last thing that they want is a pill when they are already nauseated or are in the act of throwing up." (page 89, Kris)

"[T]he evidence is perfectly clear that smoking is an outstanding route of administration ... for several reasons. One is that the bioavailability is generally very good by the smoked route, and generally very predictable, whereas bioavailability by the oral route [i.e., pills] is both not good and not predictable in general. ... And secondly and very important and useful is the fact that by the smoking route, the person can self-regulate or titrate the dosage so that dosage issues become less important." (pages 81-82, Goldstein)

"And I think the argument that despite its objections, a plant product that could be made available more cheaply, I think that should be put into the equation." (page 95,Goldstein)

Other Issues:

"And we've already approved a bunch of drugs that don't make people gain weight but they do make people feel better. ... Demanding that we show that inhaled marijuana makes people gain weight is a test we haven't demanded of the other drugs in that area." (page 62, Kris)

"[W]e should pay attention to anecdotal evidence in terms of the responses of individual people." (page 81, Goldstein)

"There are four drugs which are approved ... for spasticity control. And all of them have substantial side effects of their own. We don't have an ideal drug to help patients to deal with spasticity." (page 112, Johnson)

NIH Panelists

William T. Beaver, M.D. (panel chair)
Professor, Pharmacology and Anesthesia, Department of Pharmacology, Georgetown University School of Medicine

Julie E. Buring, Sc.D.
Associate Professor, Harvard Medical School

Avram Goldstein, M.D.
Professor Emeritus of Pharmacology, Stanford University

Kenneth Johnson, M.D.
Professor and Chairman, Department of Neurology University of Maryland Hospital

Mark G. Kris, M.D.
Attending Physician, Memorial Sloan Kettering Cancer Center

Kathi Mooney, Ph.D.
Professor, University of Utah College of Nursing

Paul Palmberg, M.D., Ph.D.
Professor of Ophthalmology, Bascom-Palmer Eye Institute, University of Miami School of Medicine

John P. Phair, M.D. Professor of Medicine, Northwestern University Medical School

*All quotes taken directly from the official transcripts, Book Two, Tab C, "Transcript of Open Discussions Held on February 20, 1997." To verify or order transcripts, call ACE-Federal Reporters, Inc., at 202-347-3700.

The General

Since the initiatives passed last fall, government drug officialdom has behaved erratically and in a non-straightforward manner. On Nov. 14, nine days after the election, Drug Czar Barry McCaffrey met with California law enforcement officials from the 'No on 215' campaign, including Orange County Sheriff Brad Gates, to formulate strategy for the federal government and law enforcement officials to oppose Proposition 215. The next day, McCaffrey held a news conference on the federal government's response to the California and Arizona initiative victories. Chuck Thomas, of the Marijuana Policy Project, was present in the audience, having obtained a valid press pass after presenting a copy of their newsletter, Marijuana Policy Report. But before McCaffrey arrived to speak, Thomas was grabbed by a security guard and an ONDCP staffer and ejected with his arm twisted behind his back. Another staffer berated the front desk woman for letting Thomas in, calling the MPP an "arm of Soros". Another staffer ripped the press pass off of his jacket.

The Drug Czar himself has chosen the low-ground, as demonstrated by these quotes from McCaffrey and one of his key staff members, collected by Americans for Medical Rights:

In a press conference on Dec. 30, McCaffrey used a display of supposed medical uses of marijuana, falsely attributed to medical marijuana authority Dr. Tod Mikuriya, to ridicule Prop. 215 proponents. The display, captioned "Dr. Tod Mikuriya's (215 Medical Advisor) Medical Uses of Marijuana" listed such applications as "recalling forgotten memories," and "writer's cramp," which McCaffrey singled out for ridicule in charging Prop. 215 proponents with "Cheech and Chong medicine." Mikuriya, who was not a formal advisor to the Prop. 215 campaign, denies advocating marijuana for treating such conditions. When questioned about this claim, McCaffrey's office said that the information was obtained from the web site of the San Francisco Cannabis Buyers' Club, http://www.marijuana.org. But the actual document by Dr. Mikuriya on that site is a summary of the 19th century medical literature on marijuana. There is nothing in the document to indicate that Mikuriya himself recommends marijuana for those conditions.

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DRCNet Activist Guide 8/97

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