March 26, 2004 - The Providence Journal (RI) Myths About Medical Marijuana By Dr. Joycelyn Elders, U.S. surgeon general, 1993-94, and Distinguished Professor of Public Health at the University of Arkansas School of Medicine

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THE RHODE ISLAND General Assembly is now considering legislation to permit the medical use of marijuana by seriously ill patients whose physicians have recommended it.

This sensible, humane bill deserves swift passage. The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS -- or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day.

But right now, Rhode Island law subjects seriously ill patients to the threat of arrest and jail for simply trying to relieve some of their misery. There is no good reason that sick people should face such treatment.

Still, foes of the medical-marijuana bill keep raising objections. So let's look at their arguments, one by one:

"There is no evidence that marijuana is a medicine."

The Truth: The medical literature on marijuana goes back 5,000 years. In a 1999 study commissioned by the White House, the Institute of Medicine reported, "nausea, appetite loss, pain and anxiety . . . all can be mitigated by marijuana." In its April 2003 issue, the British medical journal The Lancet reported that marijuana relieves pain in virtually every test that scientists use to measure pain relief.

"The medical community doesn't support this; just a bunch of drug legalizers do."

The Truth: Numerous medical and public-health organizations support legal access to medical marijuana. National groups include the American Academy of Family Physicians, the American Public Health Association and the American Nurses Association. Regional groups include the New York State Association of County Health Officials, the California Medical Association and the Rhode Island Medical Society.

I know of no medical group that believes that jailing sick and dying people is good for them.

"Marijuana is too dangerous to be medicine; it's bad for the immune system, endangering AIDS and cancer patients."

The Truth: Unlike many of the drugs we prescribe every day, marijuana has never been proven to cause a fatal overdose. Research on AIDS patients has debunked the claim of harm to the immune system: In a study at San Francisco General Hospital, AIDS patients using medical marijuana gained immune-system cells and kept their virus under control as well as patients who received a placebo. They also gained more needed weight.

"There are other drugs that work as well as marijuana, including Marinol, the pill containing THC (the main psychoactive chemical in marijuana)."

The Truth: These other drugs don't work for everyone. The Institute of Medicine noted: "It is well recognized that Marinol's oral route of administration hampers its effectiveness, because of slow absorption and patients' desire for more control over dosing." Inhalation gives a more rapid response and better results. For some very sick people, marijuana simply works better.

"Smoke is not medicine; no real medicine is smoked."

The Truth: Marijuana does not need to be smoked. Some patients prefer to eat it, while those who need the fast action and dose control provided by inhalation can avoid the hazards of smoke through simple devices called vaporizers. For many who need only a small amount -- such as cancer patients trying to get through a few months of chemotherapy -- the risks of smoking are minor.

"Medical-marijuana laws send the wrong message to kids, encouraging teen marijuana use."

The Truth: That fear, raised in 1996, when California passed the first effective medical-marijuana law, has not come true. According to the official California Student Survey, teen marijuana use in California rose steadily from 1990 to 1996, but began falling immediately after the medical-marijuana law was passed. Among ninth graders, marijuana use in the last six months fell by more than 40 percent from 1995-96 to 2001-02 (the most recent available figures).

It is simply wrong for the sick and suffering to be casualties in the war on drugs. Let's get rid of the myths and institute sound public-health policy. The Rhode Island General Assembly should pass the medical-marijuana bill immediately.

Dr. Joycelyn Elders was U.S. surgeon general in 1993-94 and is Distinguished Professor of Public Health at the University of Arkansas School of Medicine.