Medical Marijuana is Coming to New Jersey
By Kim Pearson on January 18, 2010
BlogHer Original Post
Barring any last-minute surprises, this week Gov. Jon Corzine will sign the Compassionate Use Medical Marijuana Act, making it legal for patients with certain debilitating diseases to use marijuana as part of their treatment. The bill passed Jan. 10 with bi-partisan support in both the Assembly and Senate. New Jersey will then become the 14th US state to legalize medical marijuana.
As someone who first became aware of the debate over medical marijuana 30 years ago, the most remarkable thing to me about the new measure is how little controversy it has stirred. In part, that reflects the strict conditions under which the drug will be available. The proposed new law only allows doctors to write marijuana prescriptions for patients with certain specific maladies. Patients will not be allowed to grown their own pot; instead, they have to go to state-sanctioned dispensaries. Those dispensaries will be required to use the same safeguard with marijuana that they use for narcotics such as morphine.
However, as Seton Hall University law professor Kate Greenwood notes, it also reflects the changing view of marijuana control as a matter of public health, not criminal law. Certainly, that's how activists on both sides of the issue framed the debate before the New Jersey legislature. Advocates begged for a drug that they believe is the most effective way to prolong their lives. Opponents warned that even this limited legalization move will make it easier for teens to get access to a drug that has potentially serious side effects. The video clip below from the Newark Star-Ledger captures the passion on both sides:
My first job out of college, back in the late 70s, was as an information specialist at a comprehensive cancer center. In that job, I routinely spoke with cancer patients and family members struggling with the debilitating nausea that often comes with chemotherapy. it wasn't unusual to hear patients say that smoking marijuana was the only thing that helped. Occasionally, I would even meet health professionals who pronounced themselves so moved by their patients' suffering that they admitted, sotto voce, to giving out recipes for honey slides or marijuana brownies.
Just a few years earlier, in 1976, a Florida glaucoma patient named Robert Randall successfully sued for the right to use marijuana to slow the progression of his disease. (You can watch Randall and another legal marijuana user, Irvin Rosenfeld, talking about their experience.) I interviewed Randall in 1981 for a story about a clinical trial of a pill containing a synthetic form of the active ingredient in pot, tetrahydrocannabinol, or THC. I dug out the notes from that story in preparation for writing this post.
In my interview, Randall was contemptuous of the effort to produce a synthetic marijuana pill while continuing to criminalize use of the real thing. "Government agencies have a desire to be ignorant about the medical value of marijuana," he said, because conceding those benefits "prove government policy historically and factually absurd."
However, the doctors and officials I interviewed told a very different story. Dr. Robert Petersen of the National Institute on Drug Abuse insisted that there was no scientific evidence that smoking marijuana cigarettes was better for patients that ingesting the same chemicals in a pill. Moreover, he and other medical experts argued that there were significant disadvantages to dispensing marijuana to patients in cigarette form: the difficulty of standardizing the dosage, for example. Petersen charged medical marijuana advocates with seeking a back door to legalization by spreading
"half-truths to give the impression that we really do have a treatment for nausea in marijuana, but the government is holding back because we're all insensitive boobs."
Those clinical trials from the early 1980s led to a drug, Marinol, for treating nausea in cancer patients and improving the appetites of patients with HIV. According to a fact sheet on the US Drug Enforcement Administration website, the medical justification for marijuana smoking is still lacking:
"The most comprehensive, scientifically rigorous review of studies of smoked marijuana was conducted by the Institute of Medicine, an organization chartered by the National Academy of Sciences. In a report released in 1999, the Institute did not recommend the use of smoked marijuana, but did conclude that active ingredients in marijuana could be isolated and developed into a variety of pharmaceuticals, such as Marinol."
A 2001 review by the American Medical Association found that for many conditions, including the nausea and poor appetite associated with cancer and HIV, both oral THC and smoked marijuana provided some benefits, but neither was more effective than other available treatments. The AMA called for more research on the possible benefits of marijuana to treat a variety of other medical conditions, including epilepsy, multiple sclerosis and chronic pain, but noted that the limited evidence from prior research did not produce evidence that marijuana was some kind of miracle drug. Moreover, the "cardiovascular, pulmonary and [central nervous system] side effects of marijuana constitute "a grave concern" -- especially for older patients.
As blogger Patrice Collins reported last October, guidelines issued by Attorney General Eric Holder directs prosecutors not to prosecute patients' or caregivers' in states with medical marijuana laws. Instead, the guidelines call for a focus on the criminal drug rings that grow and sell pot for recreational use, noting:
"One timely example underscores the importance of our efforts to prosecute significant marijuana traffickers: marijuana distribution in the United States remains the single largest source of revenue for the Mexican cartels."
The debate over medical marijuana should be driven by research, not political agendas or media hype on either side. Patients needing safe and effective medical care are ill-served by rhetoric that overstates the benefits of marijuana. At the same time, there are some patients for whom marijuana appears to be an effective way to relieve symptoms and improve quality of life. The New Jersey model might be a way of striking an appropriate balance between the legitimate needs of law enforcement and the imperatives of compassionate care.
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