Pubdate: Tue, 05 Dec 2000
Source: Akron Beacon-Journal (OH)
Copyright: 2000 by the Beacon Journal Publishing Co.
Contact:  http://www.ohio.com/bj/
Forum: http://krwebx.infi.net/webxmulti/cgi-bin/WebX?abeacon
Author: Cheryl Powell, and Katherine Spitz, Beacon Journal Medical Writers
Cited: Oakland Cannabis Buyers' Cooperative http://www.rxcbc.org/
Northcoast NORML http://www.timesoft.com/ncnorml/
Bookmarks: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)
http://www.mapinc.org/mmjcn.htm (Cannabis - Medicinal - Canada)

CANNABIS DEBATE

Medicinal marijuana is illegal in Ohio, but some still use it to ease
nausea, pain.

For one 37-year-old Akron man who is HIV-positive, a daily regimen of 22
pills can be tough to swallow.

The pills sap his appetite and often make him feel like vomiting, he says.
But he has found an effective -- and illegal -- antidote that works wonders.

The man, who asked not to be identified, smokes a marijuana joint about once
a day -- roughly $50 worth per week -- to ease his nausea and keep his
appetite strong.

``If I am nauseated, I can smoke a little bit and I want to eat,'' he says.
``It does the trick.''

Cases such as this Akron man's are at the heart of an ongoing debate about
the appropriateness of using marijuana for medical purposes.

In Ohio and all but eight states, it's against the law to use or possess
marijuana, even if it's supposedly for medicinal use.

The issue came to the national forefront last week, when the U.S. Supreme
Court agreed to decide whether the drug can be used by patients with medical
necessity, even though federal law makes its distribution a crime.

The justices will hear the Clinton administration's effort to bar the
Oakland Cannabis Buyers' Cooperative in California from providing the drug
to seriously ill patients for pain and nausea relief.

Physicians in California and the seven other states that allow medical use
of marijuana can't prescribe the drug. Instead, doctors can write a letter
recommending their patients use the drug, and the patients go to a state
agency for approval to buy it.

Even in Ohio and other states where it's illegal, an underground medicinal
marijuana circuit exists -- often with the knowledge but not participation
of physicians.

``My doctors know about it,'' says the Akron HIV patient who smokes
marijuana daily. ``They have never discouraged me from doing it. I never had
any negative reactions from any doctors.''

Two local physicians who are involved in end-of-life medical care say
patients have talked about using street marijuana to relieve symptoms.
However, neither physician helps patients obtain the drug.

``The question comes up,'' says Dr. Skip Radwany, an Akron internist who
directs Hospice of SummaCare. ``There are patients who swear by it.`

And the patients don't fit the stereotype of pot smokers.

``I have 80-year-old women who are using this to control the nausea related
to their chemotherapy,'' says Dr. John Petrus, an Akron General Medical
Center oncologist-hematologist who is also medical director for the Visiting
Nurse Service hospice program in Akron.

Among AIDS patients, illegal use of marijuana to help with side effects from
medication is extremely common, says Marsha Michaels, a clinical counselor
and a supervisor with Violet's Cupboard, a nonprofit agency in Akron that
provides services for HIV and AIDS patients.

``They're not smoking to get high,'' she says. ``A significant number of my
clients don't even really consider it a drug. They said, `I really consider
this an herb that allows me to live healthy.' ''

Supporters say marijuana can also be used as a relaxant or to ease pain.

Additionally, investigators in England and the United States have found
evidence that derivatives of marijuana called cannabinoids help control
spasticity and tremor symptoms in mice with a disease similar to multiple
sclerosis.

But currently, the most common -- and most widely accepted -- medicinal use
of marijuana is to combat nausea and stimulate appetite.

Although nausea feels like one wretched sensation, it's actually a
complicated series of events involving the brain and gastrointestinal
system, Petrus says.

There's an anxiety component to nausea. In other words, just thinking about
being nauseated can make people feel more nauseated, he explains.

Some theories exist that marijuana eases nausea by working on the thought
processes that contribute to nausea. It might also affect the actual part of
the brain that controls vomiting.

Legal anti-nausea drugs have ``dramatically improved,'' in the past 10
years, but they don't work for everyone, Petrus says.

Also, the active ingredient of marijuana is already available in a legal
pill form with the trade name Marinol. But Petrus says even when he
prescribes Marinol for some of his patients who have told him they have used
marijuana medicinally, they say the legal drug is ``nowhere near as
effective.''

And some people, such as migraine and seizure sufferer Eleanor Ahrens,
complain they can't use the synthetic Marinol because of allergies.

After years of suffering from health problems, the 47-year-old woman says
she has used marijuana as medicine.

When she had the visual disturbances or strange feeling that usually came
before a migraine or seizure, she slipped some leaves into a cup of hot tea
and slowly sipped her tension away.

The American Academy of Neurology, which deals with the study of headache,
seizures and other neurological problems, says it has taken no stand on
marijuana use.

But Ahrens says the marijuana-spiked tea helped her relax and relieve pain
and anxiety during episodes.

``I thought, `It's organic, it's natural,' '' she says.

However, her supply dried up considerably when she was arrested and
eventually pleaded guilty to drug trafficking in 1996 after police found
marijuana growing in the backyard of her Shalersville Township home.

Ahrens now shares her story with others who come to visit her at the NORML
Shop, a fund-raising store in downtown Ravenna that she manages for the
Northcoast Chapter of the National Organization for the Reform of Marijuana
Laws.

The store doesn't sell drug supplies, but it does offer books about medical
uses of marijuana.

``When you meet people who use marijuana as a medicine, it's usually as a
last resort,'' she says.

Northcoast NORML is working with state legislators to try to get a law
passed allowing medical use of marijuana in Ohio, says chapter President
John Hartman.

For the most part, the mainstream medical community remains somewhat
skeptical.

Radwany, Hospice of SummaCare medical director, emphasized that more
scientific research needs to be done on the medical uses of marijuana before
it could be used with confidence by the medical profession.

He compares it to the use of legal herbal supplements -- they're widely used
and available, he says, even though there's not enough research backing
their safety.

Petrus predicts that if medicinal marijuana is approved, it will only have
use on a limited basis.

``There might be a niche for it, but it's not going to be like Zantac or
Tagamet,'' he says, referring to two popular drugs used for gastrointestinal
upset.

A recent report issued by the Institute of Medicine and funded by the
federal Office of National Drug Control concluded that more research should
be done on the medicinal effects of marijuana.

The report advocated compassionate use of marijuana be allowed under
certain, narrow circumstances. It also advised against the use of smoked
marijuana for medical problems and called for the development of a medical
inhaler for marijuana.

The Akron HIV patient who regularly uses marijuana agrees the drug deserves
more attention.

``Definitely, I think it's time the laws changed,'' he says. ``I think if
they really looked into it, they would see more benefits. I do think it
could be an alternative to a lot of the prescription drugs that are out
there.''
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