Reuters News Svc., Wednesday, August 6

LEGAL EXPERT SUPPORTS MEDICINAL MARIJUANA

By E.J. Mundell

NEW YORK Patients undergoing treatment for lifethreatening
illnesses should have legal access to marijuana, says a legal expert
writing in this week's issue of the New England Journal of Medicine (NEJM).

"Doctors are not the enemy in the 'war' on drugs; ignorance and
hypocrisy are, " writes Dr. George Annas, an occasional contributor
to NEJM and chair of the Health Law Department at the Boston
University School of Public Health. "...Seriously ill patients (and
their physicians) should have access to whatever they need to fight
for their lives."

Annas' comments add to the continuing debate over the restricted
legalization of marijuana as palliative medicine. California and Arizona
legislators stirred up nationwide controversy last year after state
referendums into the issue ended in the passing of laws allowing medicinal
use of the drug.

California's Compassionate Use Act of 1996 states that "...no physician in
this state shall be punished, or denied any right or privilege, for having
recommended marijuana to a patient for medical purposes." The Act lists
those purposes as treatment against "...cancer, anorexia, AIDS, chronic
pain, spasticity, glaucoma, arthritis, migraine, or any other illness for
which marijuana provides relief."

But federal government reaction to the state initiatives was highly
critical. "Nothing has changed," said Barry McCaffrey, director of
the Office of National Drug Control Policy, in December of last year.
He said the California wording ("any other illness") "...includes
recalling forgotten memories, cough suppressants, Parkinson's
disease, writer's cramp. This is not medicine. This is a Cheech and
Chong show."

Attorney General Janet Reno backed up McCaffrey's opposition to the state
legislation by vowing that physicians protected by the new state laws are
still liable to federal prosecution. She said potprescribing doctors risk
both the loss of their professional registration with the Drug Enforcement
Agency (DEA), as well as exclusion from participation in Medicaid and
Medicare.

Annas calls the federal government reaction "political posturing." He
agrees with NEJM EditorinChief Dr. Jerome Kassirer, who recently
wrote an editorial in which he called the legal restriction of
physicianprescribed marijuana "misguided, heavyhanded, and inhumane."

Both Kassirer and Annas advocate the reclassification of marijuana from
Schedule I drug listing (drugs with a high potential for abuse and no
currently acceptable medical use) to lessrestricted Schedule II (medical
use) status. Annas believes that movement of the drug to Schedule II does
not necessarily signal its social acceptance. He points out that medicinal
cocaine has been a Schedule II drug for years.

A group of California physicians have already filed suit against the
federal government, claiming that the Clinton administration position
violates free speech rights regarding physicianpatient
communications. Annas believes "the California physicians are on
strong legal ground with their lawsuit, and they should prevail."
Indeed, a preliminary ruling by a district court judge has already
put a temporary halt to DEA actions against California doctors who
may have advised patients to use marijuana to ease disease symptoms
or the sideeffects of disease treatment.

Annas believes he has much of the medical establishment on his side.
Contrary to DEA claims that only a "fringe group" of oncologists believe
marijuana can help ease chemotherapy sideeffects, Annas says a 1990
American Society of Clinical Oncologists survey found that "44% of
(oncologists polled) reported that they had recommended marijuana to at
least one patient."

Annas says that the federal government could easily verify (or disprove)
claims that marijuana has valid medicinal uses, if it would only agree to
fund appropriate research. However, he says the (federal) "National
Institutes of Health has consistently refused to fund (such) research. In
the wake of the California proposition, this position is no longer
tenable."

Annas also rejects arguments that medical use of marijuana sends the
wrong message to children, especially the belief that young people
might use this 'gateway' drug and get hooked on more harmful
substances. He cites a 1994 survey, which found that 17% of current
marijuana users had tried cocaine. "...One way to interpret (this
data) is that 83% of pot smokers, or five out of six, never try
cocaine," writes Annas. "Honesty is likely to make a greater and more
lasting impression on our children than political posturing and
hysteria." In any case, Annas believes opposition to the legalization
of marijuana among the general public is "not a good reason to keep
it from patients who are suffering."