Jim Finnel
Fallen Cannabis Warrior & Ex News Moderator
As debate over Arizona's medical-marijuana proposition heats up, physicians across the state say the proposition is a double-edged sword.
Physicians agree that marijuana can provide relief for patients with serious illnesses, but they also find ethical dilemmas in recommending a drug that is not federally approved. Others warn against the potential for abuse similar to prescription pills.
If voters approve Proposition 203 on Nov. 2, licensed physicians would be able to recommend medical marijuana to patients with debilitating medical conditions, including cancer, glaucoma, HIV/AIDS, hepatitis C and Alzheimer's disease.
Patients would register for identification cards with the Arizona Department of Health Services. They could receive up to 2 1/2 ounces of marijuana every two weeks from dispensaries or cultivate up to 12 marijuana plants if they live 25 miles or farther from a dispensary.
There would be about 120 dispensaries.
In addition to the state health department, several drug-addiction and -prevention organizations have spoken out against the proposition, including Arizona Addiction Treatment Programs Inc., Arizona Students Against Destructive Decisions and the Yavapai County Methamphetamine Advisory Task Force.
No medical organization in Arizona has publicly endorsed Prop. 203.
The Republic interviewed doctors whose patients could qualify for medical marijuana about what impact the measure might have on their patients.
Even physicians who staunchly oppose the proposition said marijuana can provide medicinal relief for patients.
Dr. Lesley Meng, an oncologist who runs Desert Springs Cancer Care in Scottsdale, said 5 to 10 percent of her patients have told her they use marijuana for medicinal reasons. The clinic sees about 50 to 60 patients a day, she said.
Patients who lose their appetite or experience severe nausea after chemotherapy become too weak to keep up with their treatments, Meng said.
Dr. Sue Sisley, who has a private practice in Scottsdale and specializes in internal medicine and psychiatry, said she has seen patients' quality of life improve after using marijuana to cope with chemotherapy or AIDS side effects.
Heather Torgerson, 29, was diagnosed with stage 4 brain cancer in 2007. She lost 20 pounds in four weeks of chemo and radiation and became too weak to continue the treatments.
Torgerson's cousin suggested marijuana. Within five minutes of smoking it, she said, she regained her appetite. She returned to chemo after gaining back some weight.
Torgerson said she smokes once or twice during the week following her monthly chemo treatments.
"Without it, I wouldn't be here," she said.
Tom Maza, 46, a Tucson resident who was diagnosed with AIDS in 1985, said he wants to see this measure pass so that he can access the type of marijuana that relieves pains from his peripheral neuropathy, a common condition among AIDS patients that affects nerves in fingers, toes and limbs.
Lack of federal approval
Although physicians agree that marijuana can bring some relief, one of the main concerns they say they have about using marijuana as medicine is the lack of U.S. Food and Drug Administration approval. The FDA conducts clinical trials to determine which drugs are safe for public use and over-the-counter sale. The FDA bases its approval on two criteria: safety and efficacy.
Marijuana is classified as a schedule-1 drug by the U.S. Drug Enforcement Administration, meaning it has a "high potential for abuse," no accepted medical use and "lack of accepted safety."
The lack of FDA approval raises ethical concerns for physicians, said Dr. Kenneth Fisher, a family practitioner in Phoenix who has worked with AIDS patients for decades.
He prescribes Marinol to patients, but he said he is not comfortable recommending marijuana because it lacks the federal regulation, oversight and quality control that other medications go through.
Marinol, a synthetic THC pill approved by the FDA, is available by prescription. It is commonly used to treat weight and appetite loss and relieve nausea for cancer and AIDS patients. THC is the active ingredient in marijuana.
If the proposition passes, all parts of a marijuana plant and its seeds would be legal to use. This includes smoking marijuana, ingesting it by food or brewing it as tea.
According to the National Institute on Drug Abuse, studies have found that marijuana contains carcinogens, which irritate the lungs. Several physicians, including those who support the proposition, said they are worried their patients would smoke the marijuana.
Dr. Carol Peairs, an anesthesiologist in Phoenix who specializes in pain management, said she does not support Prop. 203 because "anecdote and emotion are not the way to prove a new medicine."
But to proponents of the measure, getting marijuana approved by the FDA is a catch-22. Because marijuana is classified as a schedule-1 drug, it is difficult to secure enough funding to conduct the extensive research necessary to get it approved by the FDA, said Andrew Myers, campaign manager of the Arizona Medical Marijuana Policy Project, which is largely funded by the Washington, D.C.-based lobbying group backing the Arizona effort.
Safer than painkillers?
A disputed point among doctors is whether legalizing medical marijuana would alleviate or augment problems with prescription medication, such as abuse.
Proponents of the measure said marijuana would provide a safer and more effective substitute for painkillers, such as Vicodin, Oxycontin and Demerol, commonly prescribed to patients with serious illnesses.
Long-term use of these opioids can lead to addiction and physical dependence, according to the National Institute on Drug Abuse. And people can die from overdosing on prescription pills, but they can't die from overdosing on marijuana, said Sisley, the private-practice doctor in Scottsdale.
But doctors who oppose Prop. 203 said marijuana can be just as sedating and addictive as prescription pills. Peairs said THC affects multiple sites in the brain rather than just focusing on pain receptors, she said. "Essentially, marijuana's activity in the brain is like a bomb. What we need for pain relief is a sniper, targeting the pain receptors only," she said.
Dr. Ed Gogek, a psychiatrist in Prescott who specializes in addictions, said the medical community "absolutely recognizes" that marijuana is an addictive drug. Marijuana is not as addictive as tobacco or cocaine but about as addictive as alcohol, Gogek said.
Meng, the oncologist, who supports the measure, acknowledged that regulation of medical marijuana would be challenging if it passes. But she said she still thinks the positives outweigh the potential downsides.
NewsHawk: User: 420 MAGAZINE
Source: azcentral.com
Author: Michelle Ye Hee Lee
Copyright: 2010 azcentral.com
Contact: Contacting The Arizona Republic
Website: Arizona doctors may face marijuana dilemma
Physicians agree that marijuana can provide relief for patients with serious illnesses, but they also find ethical dilemmas in recommending a drug that is not federally approved. Others warn against the potential for abuse similar to prescription pills.
If voters approve Proposition 203 on Nov. 2, licensed physicians would be able to recommend medical marijuana to patients with debilitating medical conditions, including cancer, glaucoma, HIV/AIDS, hepatitis C and Alzheimer's disease.
Patients would register for identification cards with the Arizona Department of Health Services. They could receive up to 2 1/2 ounces of marijuana every two weeks from dispensaries or cultivate up to 12 marijuana plants if they live 25 miles or farther from a dispensary.
There would be about 120 dispensaries.
In addition to the state health department, several drug-addiction and -prevention organizations have spoken out against the proposition, including Arizona Addiction Treatment Programs Inc., Arizona Students Against Destructive Decisions and the Yavapai County Methamphetamine Advisory Task Force.
No medical organization in Arizona has publicly endorsed Prop. 203.
The Republic interviewed doctors whose patients could qualify for medical marijuana about what impact the measure might have on their patients.
Even physicians who staunchly oppose the proposition said marijuana can provide medicinal relief for patients.
Dr. Lesley Meng, an oncologist who runs Desert Springs Cancer Care in Scottsdale, said 5 to 10 percent of her patients have told her they use marijuana for medicinal reasons. The clinic sees about 50 to 60 patients a day, she said.
Patients who lose their appetite or experience severe nausea after chemotherapy become too weak to keep up with their treatments, Meng said.
Dr. Sue Sisley, who has a private practice in Scottsdale and specializes in internal medicine and psychiatry, said she has seen patients' quality of life improve after using marijuana to cope with chemotherapy or AIDS side effects.
Heather Torgerson, 29, was diagnosed with stage 4 brain cancer in 2007. She lost 20 pounds in four weeks of chemo and radiation and became too weak to continue the treatments.
Torgerson's cousin suggested marijuana. Within five minutes of smoking it, she said, she regained her appetite. She returned to chemo after gaining back some weight.
Torgerson said she smokes once or twice during the week following her monthly chemo treatments.
"Without it, I wouldn't be here," she said.
Tom Maza, 46, a Tucson resident who was diagnosed with AIDS in 1985, said he wants to see this measure pass so that he can access the type of marijuana that relieves pains from his peripheral neuropathy, a common condition among AIDS patients that affects nerves in fingers, toes and limbs.
Lack of federal approval
Although physicians agree that marijuana can bring some relief, one of the main concerns they say they have about using marijuana as medicine is the lack of U.S. Food and Drug Administration approval. The FDA conducts clinical trials to determine which drugs are safe for public use and over-the-counter sale. The FDA bases its approval on two criteria: safety and efficacy.
Marijuana is classified as a schedule-1 drug by the U.S. Drug Enforcement Administration, meaning it has a "high potential for abuse," no accepted medical use and "lack of accepted safety."
The lack of FDA approval raises ethical concerns for physicians, said Dr. Kenneth Fisher, a family practitioner in Phoenix who has worked with AIDS patients for decades.
He prescribes Marinol to patients, but he said he is not comfortable recommending marijuana because it lacks the federal regulation, oversight and quality control that other medications go through.
Marinol, a synthetic THC pill approved by the FDA, is available by prescription. It is commonly used to treat weight and appetite loss and relieve nausea for cancer and AIDS patients. THC is the active ingredient in marijuana.
If the proposition passes, all parts of a marijuana plant and its seeds would be legal to use. This includes smoking marijuana, ingesting it by food or brewing it as tea.
According to the National Institute on Drug Abuse, studies have found that marijuana contains carcinogens, which irritate the lungs. Several physicians, including those who support the proposition, said they are worried their patients would smoke the marijuana.
Dr. Carol Peairs, an anesthesiologist in Phoenix who specializes in pain management, said she does not support Prop. 203 because "anecdote and emotion are not the way to prove a new medicine."
But to proponents of the measure, getting marijuana approved by the FDA is a catch-22. Because marijuana is classified as a schedule-1 drug, it is difficult to secure enough funding to conduct the extensive research necessary to get it approved by the FDA, said Andrew Myers, campaign manager of the Arizona Medical Marijuana Policy Project, which is largely funded by the Washington, D.C.-based lobbying group backing the Arizona effort.
Safer than painkillers?
A disputed point among doctors is whether legalizing medical marijuana would alleviate or augment problems with prescription medication, such as abuse.
Proponents of the measure said marijuana would provide a safer and more effective substitute for painkillers, such as Vicodin, Oxycontin and Demerol, commonly prescribed to patients with serious illnesses.
Long-term use of these opioids can lead to addiction and physical dependence, according to the National Institute on Drug Abuse. And people can die from overdosing on prescription pills, but they can't die from overdosing on marijuana, said Sisley, the private-practice doctor in Scottsdale.
But doctors who oppose Prop. 203 said marijuana can be just as sedating and addictive as prescription pills. Peairs said THC affects multiple sites in the brain rather than just focusing on pain receptors, she said. "Essentially, marijuana's activity in the brain is like a bomb. What we need for pain relief is a sniper, targeting the pain receptors only," she said.
Dr. Ed Gogek, a psychiatrist in Prescott who specializes in addictions, said the medical community "absolutely recognizes" that marijuana is an addictive drug. Marijuana is not as addictive as tobacco or cocaine but about as addictive as alcohol, Gogek said.
Meng, the oncologist, who supports the measure, acknowledged that regulation of medical marijuana would be challenging if it passes. But she said she still thinks the positives outweigh the potential downsides.
NewsHawk: User: 420 MAGAZINE
Source: azcentral.com
Author: Michelle Ye Hee Lee
Copyright: 2010 azcentral.com
Contact: Contacting The Arizona Republic
Website: Arizona doctors may face marijuana dilemma
