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Reform Women Approve Medical Cannabis

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Jan.28, 00
Copyright: Forward
Author: Ivan Oransky
Cited: Dr. Grinspoon: http://www.rxmarihuana.com/
Marijuana Policy Project: Marijuana Policy Project | We Change Laws
Concerned that doctors should have more options for treating chronic pain and other syndromes, Women of Reform Judaism is urging legislators to make marijuana available to critically ill patients. Delegates to the annual December meeting of the WRJ, which represents 100,000 women nationwide, voted unanimously for a resolution that called for further research on "marijuana and its constituent compounds with the goal of developing reliable and safe cannabinoid drugs for management of debilitating conditions" and reclassification of the drug as a prescribed controlled substance. "Everyone has heard anecdotal evidence about marijuana's usefulness," the president of the WRJ, Judith Silverman, told the Forward in a recent telephone interview. "But how much research has there been on it?"
The debate on the medical use of marijuana has intensified in the past few years, most recently with the National Institute of Medicine recommending last March that clinical trials of marijuana be carried out for treatment of conditions including chemotherapy-induced nausea and vomiting and the wasting syndrome caused by AIDS. Advocates have been arguing for years that the drug is helpful to patients with such conditions.
Others, however, fear that permitting its use for medicinal purposes will set a dangerous precedent and foster recreational use. More than 30 states have passed legislation supporting the medical use of marijuana. Ms. Silverman said the WRJ was prompted to act after Western sisterhoods heard from members who had been told by their doctors that medical marijuana might be helpful. The group found, however, that federal and state regulations were in conflict, making it a federal crime for doctors to prescribe or dispense the drug. "We feel it should be like any of the other really strong medicines," Ms. Silverman said.
"Even though California's legislature agreed, the patients couldn't get it." Since the passage of the Federal Controlled Substances Act of 1970, marijuana has been considered a Schedule I drug, having no medical use and a high potential for abuse. The resolution calls for this designation to be changed to Schedule II, under which doctors can, for limited periods of time, prescribe drugs on triplicate prescription pads.
Harvard psychiatrist Dr. Lester Grinspoon, the author of "Marijuana Reconsidered" and "Marijuana, the Forbidden Medicine," said the WRJ resolution was symptomatic of what's happening in the movement for medical marijuana. "This is a substance which is remarkably safe as a medicine," Dr. Grinspoon told the Forward. "Government propaganda notwithstanding, there has never been a death attributed to its use in the literature. Second, when we get rid of the prohibition tariff, it will be a very inexpensive medicine relative to those it will replace. Third, it is a remarkably versatile medicine, useful not just for those conditions in the Institute of Medicine report. Altogether, there are about 30 different syndromes in which it's useful." Earlier this month, the American Cancer Society of New York and New Jersey announced that it will fund a three-year, $361,000 grant to the Albany College of Pharmacy for research into the feasibility of a patch to deliver a component of marijuana. Dr. Grinspoon said that while isolated compounds of marijuana such as dronabinol, packaged as the pill Marinol, are helpful to patients, they are not as effective as smoked marijuana. Doctors do not know exactly how marijuana works, but it is thought that its effects on nausea, vomiting, wasting and pain result from its actions on parts of the central nervous system. Dronabinol also has side effects, including changing blood pressure and speeding up the heart rate. Speaking of many patients in his practice, Dr. Grinspoon said, "There is not a one of them who find dronabinol as useful or efficacious or as easy to deal with as whole smoked marijuana. Part of the reason is obvious. Those who have trouble keeping food down will have trouble with a pill. Second, dronabinol takes 1 1/2 hours to take effect." Dr. Grinspoon said that while many very effective anti-nausea drugs are on the market, they don't work for all patients, and some have serious side effects. They can also be very expensive. For example, ondansetron, marketed as Zofran, is a highly effective antinausea drug, but it can cost as much as $600 for the dose required during a single chemotherapy treatment, compared with 30 to 40 cents for the one-third of a marijuana cigarette Dr. Grinspoon estimated would be effective. It is unclear if Jewish law would allow the use of smoked marijuana, although use of a pill form might be acceptable. In November, a group of rabbis condemned cigarette smoking. "There's every reason to believe that marijuana smoke is just as noxious as cigarette smoke," Dr. Grinspoon said. "But you don't smoke a pack a day's worth of marijuana. When you smoke, you can titrate your dose by puff." New technology using a vaporizer to deliver whole plant marijuana's active ingredients without smoke is another potential step forward," he said. Part of the problem, Dr. Grinspoon said, is that while the federal government has called for further study, the National Institute of Drugs and Addictions has made obtaining marijuana for research nearly impossible. He cited the experience of a San Francisco scientist who had to wait four years for a research protocol to be approved. Even then, his study was downgraded from an efficacy study to a safety study. "Anybody who tries to do studies immediately gets discouraged," Dr. Grinspoon said. The director of communications for the Washington-based Marijuana Policy Project, Chuck Thomas, applauded the WRJ resolution. "I think it's excellent," Mr. Thomas said. "Any major religion should be preaching compassion. If a person is taking a drug as prescribed by a doctor, he shouldn't be put in prison." The Department of Health and Human Services should change its guidelines to make it as easy to study medical marijuana as it is to study other pharmaceuticals," Mr. Thomas said. Ms. Silverman said that because news of the resolution was just released, the WRJ had not yet had any feedback. "We will promote it," she said. "Only by publicizing our stand do we feel that we might work toward the start of a change."