SHOULD POT BE LEGALIZED? NO

DUSAN PETRICIC/TORONTO STAR One side says prohibition is more harmful than
marijuana itself. The other side sees no reason to legalize and lots of
reasons not to.

Trends in California usually knock on Canada's door a few years later. In
1996, California voters approved the use of marijuana for seriously ill
patients upon written recommendation by a physician. Should marijuana be
approved in Canada for medical use? We say no.

The inhalation of marijuana smoke has been proposed for several illnesses,
but most often for nausea and vomiting during cancer chemotherapy, or in
AIDS. The nausea associated with these conditions is now treated with low
doses of Haldol, Stemetil or Gravol. Even more effective are the newer
(albeit expensive) medications, Kytril and Zofran.

NO What is the best treatment for the nausea which is so often an extra
cross to bear for patients receiving chemotherapy or dying of AIDS? It is
essential to stop the nausea and vomiting so that patients may gain
strength to withstand illness and take medications with meals.

Compared to these currently used medications, smokeable marijuana is highly
overrated; it is not consistently effective because the inhaled dose is
difficult to control, and, therefore, not medically useful. In fact, the
active ingredient in marijuana (THC or tetrahydrocannabinol) is already
available by prescription in Canada and the U.S. as Cesamet and Marinol.
Excess doses of oral or suppository forms of these drugs do make patients
drowsy and dizzy with blurred vision. Yet despite the occasional dramatic
example of how smokeable marijuana stops nausea, there is simply no
evidence among any analyzed cohort of patients that marijuana bestows an
advantage over the current medications.

Now that hospitals have finally been made smoke-free, the idea of inviting
marijuana smoke on to cancer or AIDS wards should make hospital workers
gasp. Marijuana cigarettes - which contain some 400 known chemicals and
possibly many more unknown chemicals whose effects are potentially
dangerous - have at least 50 per cent more tar than tobacco cigarettes.
Moreover, marijuana smoke usually irritates the bronchi, causing bronchitis
and pre-cancerous lung pathology, all not helpful to patients who are
getting along reasonably well.

From a medical viewpoint, there is no over-all benefit to be gained by
legalizing marijuana and having it readily available. To be approved by the
Health Protection Branch in Ottawa, marijuana must be safe and effective.
Smokeable marijuana is not pure, and the inhaled doses are impossible to
regulate, so that any results are unpredictable - both the sought-after
results (relief of nausea or pain) and unwanted
effects (mental confusion and lung irritation).

Marijuana is not particularly safe. Its public health hazards far outweigh
any potential salutary benefits. In addition to pre-cancerous bronchitis,
the long-term hazards of marijuana include confusion, brain damage, highway
deaths, work accidents, spousal abuse and neglect, increased risk of
genetic abnormalities, and a high potential for addiction.

Would legalization of medicinal marijuana result in increased usage?
Probably. One piece of evidence is a Council on Drug Abuse survey, which
asked Canadian teenagers if they would use more if marijuana were accorded
legal or quasi-legal status; 30 per cent of respondents said they would. If
this were the case, increased use of marijuana would lead to more
use-related accidents and medical complications.

There is no evidence that marijuana offers benefits over current
medications. Even if such evidence did exist, it should be evaluated not by
speculation, hearsay or by arguments purporting to champion civil
``liberties,'' but by the same rigourous scientific standards to which we
subject all new drugs and medications.

Neil Seeman is a lawyer currently studying health policy at the Harvard
School of Public Health. Philip Seeman is professor of pharmacology and
psychiatry and the Max and Anne Tanenbaum Chair of Neuroscience at the
University of Toronto. What do you think? We'll publish a selection of
views in a column on the Letters page next Monday. Please limit responses
to about 50 words. Write: Readers Face-Off, 1 Yonge St., Toronto, M5E 1E6
(fax: 416-869-4322 (e-mail: lettertoed@thestar.ca).