Marijuana and the Treatment of Chronically Ill Patients


Is there any possibility to treat chronic illness with the aid of a menacing drug? Voters in two states say yes. Many health experts say no. Ten times a day, Irvin Rosenfeld, 44, steps outside to smoke a marijuana cigarette. He's not puffing to get high. He's battling a bone disorder he's had since birth. After eight operations, Rosenfeld says marijuana is the only drug that offers relief from the tumors that tear through his muscles and veins. "Nothing else," he says, "works as well to ease the pain." Thousands of other chronically ill Americans would like to give marijuana a try to see if it would alleviate their symptoms from diseases like cancer and AIDS. But Rosenfeld, a subject in a medical research program, is one of only eight people who can smoke the drug legally in the United States.

Voters in California and Arizona want to change that. Last November, they passed laws allowing all doctors to prescribe or recommend marijuana for their patients. But the change won't come easily. Though 26 other states currently have similar laws, possessing, growing, and selling marijuana are still federal crimes. And the new state laws have triggered a strong response--especially from those concerned about drug use among teens. Since 1991, the percentage of eighth graders who say they have smoked marijuana has nearly doubled, from 10.2 percent to 19.9 percent. Legalizing medical uses of marijuana could make the problem even worse, warns General Barry McCaffrey, head of drug policy for the Clinton administration. "Just when the nation is trying its hardest to educate teenagers not to use drugs, now they are being told that 'marijuana is medicine.' There could not be a worse message to young people," he says.

Is there any possibility to treat chronic illness with the aid of a menacing drug? Voters in two states say yes.

The Clinton administration says it plans to enforce the law--even if it means arresting doctors or patients. Still, the government recently agreed to spend $1 million to look into the possible medical benefits of the drug. What do you think? Should "medical marijuana" be legalized? Read opinions on both sides, then debate and decide.


"Smoking marijuana is more likely to cause new health problems than solve existing ones," says Donna Shalala, the U.S. Secretary of Health and Human Services. There's no question that pot is a psychoactive (mind-altering) drug. Made from a plant called Cannabis saliva, it contains about 460 chemical ingredients. The one that affects the brain most is known as THC (delta-9 tetrahydrocannabinol). THC molecules travel from the lungs through the bloodstream to the brain. There the drug binds with proteins called receptors on the surface of nerve cells. These cells then send sensations, including a feeling of intoxication, throughout the body. Within a few minutes of smoking pot, a person might feel thirsty and, hungry. Blood pressure rises and the heart speeds up to twice its normal rate. With high doses of THC, a pot smoker might experience fear or anxiety and suffer paranoid thoughts.

Marijuana also blocks short-term memory and makes problem-solving difficult. So people using pot might forget things or perform poorly on tests. And because the drug interferes with balance and slows a person's reaction time, it can make driving a car or riding a bike especially dangerous. Some drug researchers also argue that the long-term effects of pot will make sick people sicker. "Research shows that marijuana is harmful to the brain, heart, lungs, and immune system," Shalala says. Marijuana smoke contains more cancer-causing chemicals than cigarette smoke. And like cigarette smokers, people who regularly smoke pot suffer from chronic coughs and frequent colds. THC may even damage the immune cells that help fight diseases.


But many doctors say pot has positive effects, too. "More and more people are finding how useful marijuana is as a medicine," says Dr. Lester Grinspoon, a psychiatrist at Harvard Medical School. The main evidence comes from patient experience: In one study, 78 percent of cancer patients said that smoking marijuana --unlike other drugs--helped stop the nausea caused by chemotherapy (drug treatments used to kill cancer cells). A 1990 survey concluded that 44 percent of cancer doctors had already recommended marijuana to at least one of their patients; many people with AIDS say that marijuana stimulates their appetite. That prevents "wasting syndrome," severe weight loss that can be fatal; Patients with glaucoma, an eye disease, say marijuana has prevented them from going blind by reducing fluid pressure in their eyes; some people also say marijuana prevents epileptic seizures; reduces migraine headache pain; and alleviates the muscular tremors and paralysis of multiple sclerosis. In 1985, the federal government recognized that marijuana might have some therapeutic effects, and approved the use of Marinol, a synthetic (human-made) version of THC. With a professionally experienced doctor's prescriptions patients suffering from chronic illness can legally buy Marinol pills.

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