If the federal government were right that medical marijuana has
no medicinal value, why have so many doctors risked their practices by
recommending its use for patients with cancer or AIDS?
Marcus Conant, the doctor who identified the first cases of
Kaposi's sarcoma among San Francisco AIDS patients, can answer that. Imagine
you're the doctor for a "40-year-old lady with breast cancer. They put her
on chemotherapy and every time she takes her therapy, she throws up." She
can't sleep; she's up sick all night. She has trouble caring for her
children. Medical marijuana can alleviate her nausea and give her an
Conant wouldn't write her a prescription for medical marijuana.
He can't. But he would write a note for her file recommending marijuana.
Since his patients have access to their files, they can present a copy of
said note to a marijuana club authorized by California's Proposition 215. If
they use the note, well, that's their business.
Conant sued the federal government to prevent federal law
enforcement from investigating or punishing doctors who exercise their First
Amendment right to recommend medical marijuana. Last month, a Ninth Circuit
U.S. Court of Appeals panel ruled in his favor. The feds had argued that
recommending marijuana was analogous to prescribing it, but the court agreed
that this advice entailed "dispensing of information." That distinction goes
to the heart of the matter -- - the ability of doctors to give their best
advice to people who desperately need it.
Why not prescribe marinol, the legal pill form of marijuana?
Conant said that some patients don't respond well to it: It takes 45 minutes
to work. If they take too little, it doesn't work at all. If they take too
much, they fall asleep and don't eat.
My friend Julia, who is battling cancer, occasionally has used
marijuana to help her sleep, but not often. Too much pot makes her think
about dying. Still, Julia knows other cancer patients for whom cannabis is
"the only thing that stands between them and a complete inability to get
Cancer patients can take as many as 12 medications a day. They
juggle which pills they can take with or without food, and with or without
other drugs. There's something to be said, Julia added, for a drug that you
can smoke at any time.
It's not clear if federal drug czar John P. Walters will appeal
My advice: Don't.
Walters also should reconsider his opposition to medical
marijuana. Walters complains that advocates use sick people's pain as a
platform to legalize pot for everyone. Legalize medical marijuana, however,
and you take away that high ground.
It won't happen, said Daniel Abrahamson of the Drug Policy
Alliance, because, "The drug czar's office can't abide the thought of losing
any ground or having any legitimacy given to the issue of medical
Walters' spokesman Tom Riley resents "this caricature; it's very
frustrating. 'Oh, they're drug warriors. They don't care that people are
suffering and in pain.'"
Riley doesn't deny that marijuana can make patients feel better.
A cigarette, he said, can make an emphysema patient feel great. His bottom
line: The federal government doesn't make medical policy based on anecdotes.
But when the anecdotes are so plentiful, there's something
missing in the research. When nurses wear Proposition 215 pins, they surely
know something that the feds don't.
Conant, 66, has no use for a system that won't let him alleviate
misery. He closes his eyes, leans back in his chair and mutters, "To deny
sick people relief because of abuses is not humane."