>>> Part 25 of 28...
whether a drug's benefits outweigh its potential risks and the risks of 
permitting the disease to progress.
         22.  In the context of glaucoma therapy, it must be kept in mind 
that glaucoma, untreated, progressively destroys the optic nerve and 
results in eventual blindness.  The danger, then, to patients with 
glaucoma is an irretrievable loss of their sight.
         23.  Glaucoma is not a mortal disease, but a highly specific, 
selectively incapacitating condition.  Glaucoma assaults and destroys the 
patient's most evolved and critical sensory ability, his or her vision.  
The vast majority of patients afflicted with glaucoma are adults over the 
age of thirty.  The onset of blindness in middle age or later throws 
patients into a wholly alien world.  They can no longer do the work they 
once did.  They are unable to read a newspaper, drive a car, shop, walk 
freely and do all the myriad things sighted people take for granted.  
Without lengthy periods of retraining, adaptation and great effort these 
individuals often lose their sense of identity and ability to function.  
Those who are young enough or strong-willed enough will regain a sense of 
place, hold meaningful jobs, but many aspects of the life they once took 
for granted cannot be recaptured.  Other patients may never fully adjust 
to their new, uncertain circumstances.
         24.  Blindness is a very grave consequence.  Protecting patients 
from blindness is considered so important that, for ophthalmologists 
generally, it justifies the use of toxic medicines and uncertain surgical 
procedures which in other contexts might be considered "unsafe."  In 
practice, physicians often provide glaucoma patients with drugs which 
have many serious adverse effects.
         25.  There are only a limited number of drugs available for the
                                 - 61 -
treatment of glaucoma.  All of these drugs produce adverse effects.  
While several government witnesses lightly touched on the side effects of 
these drugs, none provided a full or detailed description of their known 
adverse consequences.
         26.  The adverse physical consequences resulting from the 
chronic use of commonly employed glaucoma control drugs include a vast 
range of unintended complications from mild problems like drug induced 
fevers, skin rashes, headaches, anorexia, asthma, pulmonary difficulties, 
hypertension, hypotension and muscle cramps to truly serious, even life-
threatening complications including the formation of cataracts, stomach 
and intestinal ulcers, acute respiratory distress, increases and 
decreases in heart rate and pulse, disruption of heart function, chronic 
and acute renal disease, and bone marrow depletion.
         27.  Finally, each FDA-approved drug family used in glaucoma 
therapy is capable of producing a lethal response, even when properly 
prescribed and used.  Epinephrine can lead to elevated blood pressure 
which may result in stroke or heart attack.  Miotic drugs suppress 
respiration and can cause respiratory Paralysis.  Diuretic drugs so alter 
basic body chemistry they cause renal stones and may destroy the 
patient's kidneys or result in death due to heart failure.  Timolol and 
related beta-blocking agents, the most recently approved family of 
glaucoma control drugs, can trigger severe asthma attacks or cause death 
due to sudden cardiac arrhythmias often producing cardiac arrest.
         28.  Both of the FDA-approved drugs used in treating the 
symptoms of multiple sclerosis, Dantrium and Lioresal, while accepted as 
"safe" can, in fact, be very dangerous substances.  Dantrium or 
dantrolene sodium carries a boxed warning in the Physician's Desk 
Reference (PDR) because of its very high toxicity.  Patients using this 
drug run a very real risk of developing sympto-
                                 - 62 -
matic hepatitis (fatal and nonfatal).  The list of sublethal toxic 
reactions also underscores just how dangerous Dantrium can be.  The PDR, 
in part, notes Dantrium commonly causes weakness, general malaise and 
fatigue and goes on to note the drug can also cause constipation, GI 
bleeding, anorexia, gastric irritation, abdominal cramps, speech 
disturbances, seizure, visual disturbances, diplopia, tachycardia, 
erratic blood pressure, mental confusion, clinical depression, renal 
disturbances, myalgia, feelings of suffocation and death due to liver 
failure.
         29.  The adverse effects associated with Lioresal baclofen are 
somewhat less severe, but include possibly lethal consequences, even when 
the drug is properly prescribed and taken as directed.  The range on 
sublethal toxic reactions is similar to those found with Dantrium.
         30.  Norman E, Zinberg, M.D., one of Dr. Weil's colleagues in 
the 1968 study mentioned in finding 2, above, accepts marijuana as being 
safe for use under medical supervision.  If it were available by 
prescription he would use it for appropriate patients.
         31.  Lester Grinspoon, M.D., practicing psychiatrist researcher 
and Associate Professor of Medicine at Harvard Medical School, accepts 
marijuana as safe for use under medical supervision.  He believes its 
safety is its greatest advantage as a medicine in appropriate cases.
         32.  Tod H. Mikuriya, M.D., a psychiatrist practicing in 
Berkley, California who treats substance abusers as inpatients and 
 >>> Continued to next message...
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