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Guest Column

July 31, 2010

Science supports medical marijuana

This is in response to Julia Dostal's column of July 17 about medical marijuana. She is largely misinformed.

The New York medical marijuana bill was introduced by Assembly Health Committee Chair Richard Gottfried in 1997 has been getting voted out of one committee after another since 2002.

There is certainly ample anecdotal evidence that marijuana is medicine, but there is more than that. In 1999, the National Academy of Sciences Institute of Medicine reported, "nausea, appetite loss, pain anxiety ... all can be mitigated by marijuana."

Three studies since 2007 from the University of California prove the efficacy of cannabis in relieving hard to treat peripheral neuropathy, pain sometimes common with diabetes, multiple sclerosis HIV. Historically, cannabis was part of the U.S. Pharmacopeia for nearly eight decades, until the late 1930s.

Is it reasonable to conclude that marijuana is not medicine after being in the U.S. Pharmacopeia for nearly eight decades? While admitting cannabis is medicine, Dr. Dostal says, "There are other safer medicines for theses conditions." Some of the conditions cannabis is reputedly useful for are some types of pain, nausea, muscle spasm. It is largely effective for these conditions because marijuana relaxes smooth skeletal muscle. What are these safer drugs to treat these conditions? Is morphine safer? Baclofen? Valium? In 1988, Frances Young, chief administrative law judge for the Drug Enforcement Administration, ruled after a two-year examination of the literature that "Marijuana, in its natural state, is one of the safest therapeutically active substances known."

Dr. Dostal expressed concern about unintended consequences should this bill become law. A study by Mitch Earlywine of the State University at Albany reviewed all public data about teen use of marijuana before after the enactment of the medical marijuana laws in 10 states. In every state, there was a decrease in teen use. An earlier study by the Government Accounting Office found the law in the various states was working as intended with no increase in youthful use or police services. Dr. Dostal irresponsibly claims, "Smoking marijuana causes cancer other health problems."

Smoking marijuana does not cause cancer any health problems arising from its use are neither life-threatening nor life-shortening. From the Institute of Medicine, "Assessing the Science Base," 1999: "There is no conclusive evidence that marijuana causes cancer in humans, including cancers usually related to tobacco use. ... Epidemiological data indicate that in the general population marijuana use is not associated with increased mortality."

The U.S. Food Drug Administration issued its 2006 "this is not safe medicine" statement without conducting any research or even reviewing the literature. It ignored the Institute of Medicine's report, Judge Young's ruling historical data.

The FDA statement was roundly criticized at the time as being political unscientific. Dr. Dostal expresses fear misgivings should a medical marijuana law come to pass in New York. Is it better that medical users now face arrest possible incarceration? Medical marijuana is not new. It is established law in 14 states, as well as in Washington, D.C., several countries. The proposed law is not to be feared.

It builds on the experiences mistakes of 12 other states is based on New York's Controlled Substances Act, the law that regulates the sale use of dangerous drugs. Dispensers of the drug would be licensed by the Board of Health as any pharmacy would be. For patients to access this medicine they would need a doctor's approval have a diagnosis of "severe debilitating or life threatening condition."

The Department of Health would have the name of the person, the condition being treated, dosage, etc. The system proposed would mirror that for prescribing dangerous drugs. Dr. Dostal erroneously claims that the American Academy of Family Physicians, National Multiple Sclerosis Society are opposed to medical marijuana. The AAFP accepts the use of medical marijuana under medical supervision control for specific medical indications, according to statements in 1989 2001.

The National Multiple Sclerosis Society's "Recommendations Regarding the Use of Cannabis in Multiple Sclerosis" expert opinion paper from July 2008 states that "There are sufficient data available to suggest that cannabinoids may have neuroprotective effects that studies in this area should be aggressively pursued. ... Because inhaled smoked cannabis has more favorable pharmacokinetics than administration via oral or other routes, research should focus on the development of an inhaled mode of administration that gives results as close to smoked cannabis as possible."

The American College of Physicians' 2008 position paper, "Supporting Research into the Therapeutic Role of Marijuana," "strongly urges protection from criminal or civil penalties for patients who use medical marijuana as permitted under state law." With 124,000 members, the ACP is second largest medical society in the United States.

The Medical Student section of the American Medical Association, the American Nurses Association, have also voiced their support for medical marijuana in 2008 2003, respectively. Beyond alleviating suffering, medical marijunana may have other health benefits, according to Dr. Gregory Carter, clinical professor of Rehabilitation Medicine at the University of Washington School of Medicine, co-director of the Muscular Dystrophy Association/Amyotrophic Lateral Sclerosis Center. "I have spent my entire career in search of more effective treatments for this awful disease (amyotrophic lateral sclerosis, or Lou Gehrig's disease)," Cartrer wrote in 2007.

"We have now found that the cannabinoids, the active ingredients in medical marijuana, work remarkably well in controlling the clinical symptoms of ALS. Even more exciting is that we are now discovering that the cannabinoids actually protect nerve cells may prolong the life of people with ALS."

The New York State Association of County Health Officials passed a resolution supporting medical marijuana in 2003, which read, in part, "Marijuana has proven to be effective in the treatment of people with HIV/AIDS, multiple sclerosis, cancer, those suffering from severe pain or nausea ... The legalization of medical marijuana would be a step forward for the health of all New Yorkers."

The legal system has also shown support for medical marijunana.

"It would be unreasonable, arbitrary, capricious for the DEA to continue to stand between those sufferers the benefits of this substance," chief administrative law judge Frances Young of the DEA wrote in 1988. Or ... we could lock them up. Bruce Dunn is a resident of Morris.

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