Archive for August, 2005

Like any other therapeutic drug

August 29, 2005

The estimable Prof. Althouse is hosting a discussion of the medical marijuana issue, the context being this story about suspected rigged research on the subject being done for the Feds. The Usual Suspects are all over the map on why/how, with a lot of discussion of the recent SCOTUS overturning of the California law, Gonzales v. Raich at the request of the US government.

Why is it that when libertarians talk about this issue it so often sounds like they are not really interested in cancer sufferers, they are just eager to get their hands on a good stash for recreational use? The public can be forgiven for concluding that they are, as in the California case (Gonzales-Raich), eagerly jumping on whatever train will get them there.

There is no drug in existence that does not have unintended consequences (just ask any COX-II inhibitor manufacturer, or chemotherapy patient, about side effects). And MJ, like another very effective drug, thalidomide, has a nasty reputation. But, just because a drug is capable of being misused does not mean that its therapeutic effects should be denied to sick people for whom its use is indicated.

However, the problem here is not the FDA, the DEA, or any other bureaucracy- bureaucrats do nothing more than what all bureaucrats do, that is, go with the flow and offer the policy proposals favored by those who provide the money. The issue is with Congress, where there are few serious policy people willing to play this issue when there are more camera-friendly dragons to assault.

The reason that Congress won’t change? There are two. First, there are those who are anti-recreational-drug and pretty much enthralled with the memories of Reefer Madness, just as there are those who want to kill vaccines and thalidomide. Second, the California gang that gave us the very dumb Raich law is the perfect illustration of how to kill any progress, by letting the overage ’60’s hippies get near the issue.

Raich, as written, was not a medical marijuana bill, it was an ill-disguised Trojan Horse for unfettered home cultivation by the most intemperate of recreational users. If you are trying to get some relaxation against a Schedule I drug on scientific grounds, you don’t pass a law changing the drug all the way out to Schedule III instead of II, and then eliminate the requirement that it be prescribed (what sane person would only require a doctor to “recommend” use of MJ). That philosophy of treating marijuana as being less problematic than Allegra and Viagra may reflect what the hemp enthusiasts truly believe, but it is no way to change either minds or laws.

The smart way for California to have handled this, before poisoning the well as they now have, would have been for a UCLA team to set up a carefully controlled double-blinded study using high quality extracted THC in suppository form, with a patient population that was clearly compassionate use- late stage cancer patients, hospice AIDS patients, etc. That gets away from the emotion and treats the alternate route administration drug as a drug.

Then, if the results are as expected- patients get relief from nausea, you publicize the outcomes broadly, expose the inevitable blue-haired Priscilla Goodbody opponents for the anti-science bluenoses they are, and move to the next stage, inhalation.

In the end, if you are right about the drug, you have the true clinical data to support a compassionate use application for Schedule II prescription in two different alternate administration forms. But MJ should be usable like any other drug, and controlled- by DEA prescription reporting, if appropriate, like any other abusable drug to prevent the wrong people from getting it or overdoing it. And I say that as a conservative evangelical who doesn’t even like wine, myself (I wish I did- red wine has very real health benefits).

Of course, if the real agenda is to make it easy for spaced out refugees from Haight-Ashbury 1968 to grow their own stuff, that strategy wouldn’t be terribly helpful in the short run.