--------Newspaper Editorial-----------
Marijuana: What's the fuss?
An Iowa woman smokes it legally.
Why can't others, by prescription?
Des Moines (Ia) Register, December 5, pg 10A
Lost in the dust kicked up by the suddenly renewed storm over legalizing
marijuana is the fact that the drug has been legal for 10 years, in pill
form.  Distributors in Cedar Rapids and Omaha supply the prescription pills
to Iowa, and it's on the approved list for the poor.  In fiscal '96, Iowa
Medicaid paid $17,800 for the drug, trade name Marinol, at $4.63 per pill,
primarily for treatment of nausea caused by cancer chemotherapy.
In theory, the pill is the therapeutic equal of the cigarette.  The U.S.
Public Health Service has found no evidence that smoking marijuana provides
any greater therapeutic value than Marinol, whether used to treat glaucoma,
multiple sclerosis, AIDS, or any of the other conditions for which it's
prescribed.  The National Institutes of Health agree.  Others-including an
Iowan who has used both legally-disagree.
Meanwhile, months of stormy debate in California and Arizona over legalizing
marijuana for medical use came to a head last month when voters in both
states said yes, by comfortable margins.  But far from putting the matter to
rest, the vote has shifted the argument to the national stage.  In congres-
sional hearings this week, the two states' actions were blasted as part of
an insidious national drive to legalize drugs and push users toward harder
stuff.
With the pill form available, and two medical/scientific branches of the
federal government contending that the effects of the pill and the cigarette
are equivalent, why the fuss over making marijuana cigarettes available
through medical channels?
Because they're far from equal, according to an Iowa victim of multiple
sclerosis.  Marijuana cigarettes work for her.  Marinol doesn't.
Barbara Douglass of Storm Lake is one of only eight Americans provided with
legal marijuana cigarettes through a U.S. Food and Drug Administration
program for "compassionate" relief.  She became ill with multiple sclerosis
in 1988.  She was given a prescription for Marinol, and found it far too
powerful.
"You took Marinol, and the Marinol took you" she said.  "It's too heavy, too
strong."
The pills came in a gel form whose dosage was difficult to regulate, she
said.  It would "knock out everything you wanted to think, say and do."
She continued the treatment for three months in 1991 and told her doctor
it was not helping.  Then a lawsuit temporarily opened a tiny window of
opportunity that allowed distribution of marijuana cigarettes to a handful
of people, she among them.  The cigarettes come from North Carolina's
Research Triangle (sic).
The advantage of smoking marijuana, she said, is that you can adjust the
dosage as needed to ease your pain, simply by the number of draws on the
cigarette before setting it down.  She smokes 10 per day.
But while Marinol failed her, Douglass said, it worked for a friend.  It
eased the pain and nausea caused by the chemotherapy after surgery for
breast cancer.
Some who favor legalizing marijuana cigarettes argue that Marinol contains
just one of several substances in marijuana that provide pain relief.  The
contradiction between that contention and the findings of the PHS and NIH
may be worth further study.
But the fundamental issue of legalization remains:
Should doctors have the prerogative to prescribe dangerous and possibly
addictive drugs when they think their patients need them?  And the answer
is the same, whether the drug be marijuana, morphine, codeine, Demerol, or
any of a bunch of others on the "controlled substance" list:  Yes.  To deny
doctors all the tools that should be available to them is to let those who
misuse drugs dictate medical policy.
Far from weakening either our laws or our resolve in the war on drugs,
recognizing the value of some misused drugs helps to dispel the notion that
our policy is grounded in hysteria.
 * SLMR 2.1a *  Ah, but fortunately, I have the key...-John Prine
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