Snake-oil Salesmen
Why does the Bush administration seem so intent on denying medical marijuana to adults in extreme discomfort? by Kristen Lombardi
LAST RESORT: Linda Macia tried every prescription drug to ease her arthritis pain, but nothing helped — except marijuana. 'I'm tired of people playing God when they don't have a clue what they're talking about,' she says.
THE WHITE HOUSE Office of National Drug Control Policy (ONDCP) ? whose anti-pot road show blew through Boston last week ? wants you to believe that everything about marijuana is bad, bad, bad. That the plant?s promising medicinal benefits are simply a "Trojan-horse issue," perpetrated by drug-reform advocates who are taking advantage of sick and dying people to advance a decriminalization agenda. That legalizing medical marijuana would confuse the "just say no" message for adolescents and cause them to glamorize debilitating diseases like cancer, AIDS, and multiple sclerosis.
It?s a lot to concede if you?re a responsible adult who has taken the occasional (or even frequent) toke. It?s especially difficult to concede if you?re a responsible adult who smokes to ease the physical symptoms of glaucoma, epilepsy, or asthma, among other diseases. But that pretty much sums up the tenor at the ONDCP-sponsored New England Anti-Drug Summit, which took place at Faneuil Hall on October 8. Headed by ONDCP director John Walters ? a/k/a the nation?s "drug czar" ? the event was part of a 25-city tour aimed at helping local leaders with three things: "stopping drug use before it starts; healing those who are using drugs; and disrupting the market for drug use," according to the ONDCP Web site. To date, Walters and his entourage have traveled to San Diego, Seattle, Detroit, and Denver. Here in Boston, the Just Say No brigade met with New England governors, as well as health-care and law-enforcement personnel. They talked about the region?s heroin problem (see "Baby Talk," page 27). They introduced President George W. Bush?s "Access to Recovery Treatment Initiative," a three-year, $600 million drug-treatment program pending before Congress. And then, they let loose on the subject of medical marijuana.
Unlike the day?s other debates, this three-person panel ? Andrea Barthwell, an ONDCP deputy director; Mark Kraus, president of the Connecticut Society of Addiction Medicine; and Billy Martin, pharmacology chief at Virginia Commonwealth University ? paraded reams of disinformation. Forget about meaningful discussion. Indeed, in keeping with the Bush administration?s general assault on patients who smoke pot to manage their illnesses (see "Domestic Stealth Bombs," News and Features, February 28), the federal government will go to extreme lengths to prevent the push for legalizing medical marijuana ? and last week?s panel was no exception. If anything, it amounted to a one-sided exercise suggestive of propaganda such as Reefer Madness (1938), whose characters are driven insane by taking a puff of a joint. As Scott Mortimer, a Brookline resident and medical-marijuana user who attended the October 8 summit, put it: "The event reminded me of a West Virginia liar?s contest, with panelists spinning elaborate tall tales. The [ONDCP] policy concerning medical marijuana is always rooted in ridicule and scorn."
IT'S NOT AS IF Mortimer, who suffers from paralyzing back pain, and other proponents of medical marijuana didn?t see the propaganda fest coming. By 9 a.m. last Wednesday, he and two dozen or so patients and drug-reform advocates had gathered outside Faneuil Hall to protest what they dubbed the ONDCP?s "whitewash." After all, no one in favor of legalizing marijuana for medicinal purposes had been included on the list of handpicked speakers. This, despite the fact that the Marijuana Policy Project (MPP), in Washington, DC, had hounded the ONDCP for a chance to be heard. Local MPP members had suggested panelists. They?d offered to submit testimony. They?d asked to sit in the audience. Yet their requests were denied. Says MPP communications director Bruce Mirken, "[ONDCP officials] clearly know there will be opposition wherever they go, and they?re trying to avoid it."
And the opposition at Faneuil Hall specifically set out to counter the slanted rhetoric flowing from summit speakers. They held signs that read IT IS EVIL TO DENY SICK PEOPLE MEDICAL MARIJUANA and STOP ARRESTING PATIENTS FOR MEDICAL MARIJUANA. They bellowed, "John Walters is coming to town to spread lies!" while handing out fliers to preoccupied professionals and tourists. They lectured wayward passers-by on the miracle of pot for people suffering from chronic pain, nausea, and physical tremors.
Inside the hall, the ONDCP set the tone straightaway. Barthwell, who?s become the ONDCP mouthpiece on medical marijuana by penning op-eds against the cause for newspapers such as the Los Angeles Times, the Kansas City Star, and Newsday, kicked off her remarks with a blunt statement of opposition. Medical marijuana, she said, is "the worst scam" drug legalizers have perpetrated on this country. She went on to dissect the scientific research. Interestingly, she and her fellow panelists fixated on the fact that patients who use marijuana for medicinal purposes typically have to smoke it ? a delivery method that, they claimed, isn?t "scientifically proven." Smoking weed, they reasoned, goes against modern medicine, which shuns cigarettes, and which has an arsenal of legal prescription drugs that alleviate pain and nausea at its disposal.
As Barthwell declared, "No legitimate 21st-century physician would recommend that patients smoke or chew opium." Yet "frauds in white coats," she said, are encouraging seriously ill patients to inhale dope rather than participate in the latest drug regimens. "Is that the best that 21st-century medicine has to offer?" she demanded. The idea that crude pot has medicinal value, she added, "is an insult" to modern medicine.
Kraus, of the Society of Addiction Medicine, echoed the sentiment. "For each disease that?s been treated by smoking marijuana," he insisted, "there?s an accepted and more effective alternative treatment." Even Marinol, a synthetic pill of the tetrahydrocannabinol (THC) compound found in marijuana, which the federal Food and Drug Administration (FDA) has approved for cancer patients undergoing chemotherapy, is better than weed. The raw plant, he said, "has not passed the rigors of scientific examination."
Only one panelist, Virginia pharmacology professor Martin, had the courage to buck the status quo by acknowledging that marijuana has, in fact, helped patients. But he quickly got back on message. He noted the lack of research proving pot?s medicinal benefits. "We have a choice," he explained, "and it?s a simple one." Do we want to devote money and effort to determine whether marijuana has a place in medicine or not? As he sees it, the issue isn?t "worth the resources."
On closer scrutiny, the panel itself is what doesn?t seem worth it. The primary argument that smoking marijuana has no medicinal benefit comes across as disingenuous, to say the least. For one thing, it ignores published research ? more than 8858 medical articles? worth ? on marijuana. Most of these studies have examined the medicinal effects of the plant?s cannabinoids, including THC, CBN, and CBD. Many of them detail research involving patients in countries like the Netherlands, Canada, and Great Britain. In the US, one of the more definitive surveys came in 1999, after former drug czar Barry McCaffrey commissioned the National Institute of Medicine to conduct a two-year examination of the matter. The study, "Marijuana and Medicine: Assessing the Science Base," concludes that cannabinoids have clear therapeutic benefits, "particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation." Thus, it boggles the mind that panelists would try to say smoking pot has no medicinal value, since it still delivers cannabinoids. Steve Fox, the MPP?s director of government relations, likens the contention to "saying smoked cigarettes don?t give people nicotine. It doesn?t make sense."
If there isn?t enough definitive US-based scientific evidence to satisfy the ONDCP, that?s at least partly because the federal government has blocked any substantive research on marijuana since the mid 1980s. The Drug Enforcement Administration (DEA) and the National Institute on Drug Abuse (NIDA) grow and maintain the only legal supply of pot, which means that researchers must navigate a cumbersome application process just to obtain the plant. At the same time, researchers have complained that the DEA?s and NIDA?s marijuana contains low "bioactive ingredients," or cannabinoids. When researchers test pot with inadequate levels of cannabinoids, they cannot determine if the plant has little therapeutic value ? or is just ineffective. "It?s a way to sabotage research," says Rick Doblin, who heads the Belmont-based Multidisciplinary Association for Psychedelic Studies (MAPS), a nonprofit pharmaceutical-research organization. "The federal government has a monopoly on shitty pot and, as a result, you can?t do a serious drug-development program."
Take, for example, Doblin?s latest project at the University of Massachusetts at Amherst. In 2001, he offered to donate $5 million over a five-year period to Lyle Craker, a UMass Amherst professor of plant and soil sciences, for a medical-marijuana-research project. Craker would apply to the DEA for a license to grow high-potency marijuana, which, in turn, he would distribute to researchers to study the plant?s therapeutic effects. It?s taken Doblin and Craker two years to appeal to the DEA for a license ? and they?re still waiting. Their experience shows that if there is a dearth of research it can?t be put down to lack of interest. Explains Craker, "We need a fair and honest trial. We haven?t had that" thus far.
Of all the pseudoscientific arguments at the summit, perhaps the most foolhardy was the idea that pills never fail. Mortimer, the Brookline resident, can certainly attest to the contrary. The 35-year-old former managing consultant had to quit his job because chronic pain prevents him from sitting at a desk for eight hours straight. His back condition is the result of an unsuccessful 1986 spinal operation. After years of popping pain killers that rendered him "a zombie," he tried anti-inflammatory medications. They seemed to work ? until, in 1995, he collapsed in the shower. He was rushed to the hospital, where doctors determined that Mortimer?s wonder drug had eaten through his stomach lining. To this day, he cannot physically tolerate oral medications. But his chronic pain hasn?t subsided. So every night, he inhales several tokes of marijuana to manage his symptoms. Why, he wonders, shouldn?t he be allowed this relief? Does his adverse reaction to pills mean that he doesn?t get an alternative? As he says, "Does the drug czar get to pick which of my organs" ? his lungs or his stomach ? "will be harmfully affected by medicine?"
Linda Macia, a 50-year-old Manchester resident who uses marijuana to manage the chronic pain of degenerative arthritis, relays a similar experience while at the October 8 demonstration. Seated in a wheelchair, her strawberry-blond hair hiding her tired eyes, Macia explains she?s tried every prescription drug she could find to ease the searing pain that lasts all day, every day. OxyContin. Demerol. Morphine. Codeine. Methadone. The list goes on. Yet the drugs have left her nauseated, or knocked out, or battling hot-and-cold flashes and fevers. "I live with no answers to my pain," Macia says. She endured a radical procedure whereby a super cocktail of pain relievers was injected into her spine. But even that didn?t work.
So she started smoking marijuana ? and found it helps. It doesn?t magically cure her pain, but it allows her brain to focus on other things. It gives her a reprieve from the mind-numbing jolt that shoots up her legs and along her spine. She, like Mortimer, expresses bewilderment ? and resentment ? at the ONDCP panelists who insist that smoking a joint does not alleviate her pain. "I?m tired of people playing God when they don?t have a clue what they?re talking about," she says. "I?m an exception to the prescription-drug rule. So what am I supposed to do?"
THE UNTRUTHS about scientific research spewed by last week's medical-marijuana panelists seemed bad enough ? until the "debate" turned to the subject of kids. The ONDCP?s Barthwell raised the specter of "the children" by suggesting that even considering the idea of legalizing marijuana for medicinal purposes sends the wrong message to adolescents ? who could come to believe that marijuana is "good for them." The governors soon picked up on the theme. Connecticut governor John Rowland, for instance, invoked his own parenting experiences. "One of my five teenagers begins every paragraph of every conversation by saying, ?Dad, don?t tell me that you didn?t do it,?" he said. He urged parents in the audience to get behind the anti-drug campaign. "Mixed messages are a mistake," he said. "We need to say, ?Marijuana is for losers. We are against drugs.?"
Mr. Drug Czar seized the moment to mention his two kids. "I was shocked to find out my fellow parents and neighbors were relatively accepting of drugs and alcohol," Walters noted. Medical marijuana, he said, will only tell his children and others that "we?re too soft on drugs."
Rhode Island governor Donald Carcieri also chimed in with the rather puzzling observation that his grandchildren, like most teens, rebel "no matter what." For that reason, he said, it?s "a good idea" to keep marijuana illegal ? otherwise, kids might end up snorting coke instead.
The whole discussion amounted to a false argument. "It?s just baloney" is how the MPP?s Mirken describes it. In California, the first state to legalize marijuana for medicinal purposes, teen pot use had grown steadily from 1991 to 1995 ? from 19 percent to 34 percent. But since the medical-marijuana referendum was passed in 1996, California has witnessed a drop in the percentage of teens who smoke weed. Among ninth graders, for example, the numbers fell from 34 percent in 1996 to 19 percent in 2002 ? a drop of approximately one-third. The statistics show that the state?s law hasn?t left California teens any more eager to smoke pot because their ailing elders are allowed to.
If the ONDCP officials were honest with themselves, of course, they?d see that the just-say-no approach to drugs has failed kids far more than those who want to legalize medical marijuana have done. Consider the results of the national Parents Resource Institute for Drug Education (PRIDE) survey of American teens, one of two surveys designated by Congress to provide official measures of the drug czar?s success. Kids took the test after Walters saturated the airwaves with commercials telling teens that if they light up a joint, they?re likely to commit date rape and shoot their friends. What happened? The proportion of eighth graders using marijuana in the past month jumped from 7.2 percent to 10.2 percent ? a 43 percent increase. Obviously, as Mirken says, "what the ONDCP is doing now isn?t working."
Still, that didn?t faze the folks at the anti-drug summit, where the only worthwhile question was one raised by Massachusetts governor Mitt Romney. Why, Romney wondered, isn?t marijuana treated the same way as any other pharmaceutical drug? "Would it not be appropriate to subject marijuana to this same [drug-testing] process?" he asked, setting off a wave of applause among proponents. Yet it is precisely this sort of question that routinely goes ignored by Washington?s anti-drug pooh-bahs. (It took all he had for Doblin, of MAPS, to refrain from calling out from the audience, "We?d like to do more research, but the drug czar is holding us back.")
Meanwhile, John Baldacci, the governor of Maine ? the only New England state to approve a medical-marijuana law in 1999 ? sounded wishy-washy and apologetic. Though he recognized that the legislation "doesn?t appear to be a widespread problem" for either the state police or the children of Maine, he failed to defend the initiative. He failed to hold it up as a successful model for the rest of New England. He failed to challenge the ONDCP?s empty rhetoric.
IN THE END, the anti-drug summit was a disservice to New Englanders. Medical marijuana, after all, is no longer a fringe issue. Just this week, the US Supreme Court turned down the Bush administration?s request that it consider whether the federal government can punish doctors for even talking about the medicinal benefits of pot ? thereby paving the way for state laws that legalize marijuana for medicinal purposes. To date, nine states have enacted such legislation. Maine may be the only state in the region to do so, but the rest of the area isn?t far behind. Last year, a medical-marijuana bill made it to the desk of former Vermont governor Howard Dean, who vetoed it. Already, the bill has been refiled. Connecticut drug reformers are pushing to expand a 1981 state law allowing doctors to prescribe patients marijuana ? a law that Rowland, then a state representative, supported. Though the effort failed last summer, advocates plan to re-introduce amendments to protect medical-marijuana patients next February. In Massachusetts, a similar bill that would create legal protections for medical-marijuana patients is now pending before the legislature. And New Hampshire advocates are ambushing Democratic presidential candidates to get them on record about the issue. (The most favorable? Dennis Kucinich, who?s promised to sign an executive order legalizing pot for medicinal purposes if he?s elected president.)
Given the issue?s momentum in New England, the ONDCP panel could have engaged in much-needed debate. Yet panelists refused to consider the real questions. And the governors failed to take the issue seriously. Instead, the summit toed the Bush-administration line. It was easy for New England governors to do that in a gilded hall huddled together with the drug czar, as Robert Rooke, who heads the Connecticut drug-reform group A Better Way Foundation, points out. "But to do that in a room full of patients who need marijuana and have to go underground to get it is a whole other story."
Additional research by Camille Dodero. Kristen Lombardi can be reached at klombardi@phx.com
Issue Date: October 17 – 23, 2003
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