Pubdate: Thu, 14 May 2009
Source: Concord Monitor (NH)
Page: Front Page
Copyright: 2009 Monitor Publishing Company
Contact: http://drugsense.org/url/WbpFSdHB
Website: http://www.cmonitor.com/
Details: http://www.mapinc.org/media/767
Author: Lauren R. Dorgan, Monitor staff

MARIJUANA DEBATE SHARPENS

Attorney General, Supporters Face Off

State Attorney General Kelly Ayotte and county prosecutors have 
aggressively pushed back against a bill that would legalize marijuana 
for some seriously ill patients, sending lawmakers a letter calling 
marijuana an addictive drug and claiming that reclassifying marijuana 
as medicine could undermine efforts to keep youths from trying drugs. 
The bill's supporters decry the letter as "misleading" and have 
circulated a seven-page rebuttal of the two-page letter.

The bill easily passed the House in March and the Senate last month, 
but its future remains in doubt. Gov. John Lynch has stopped short of 
vowing to veto it, saying he has "serious concerns" and calling the 
Senate version of the bill "unacceptable." In the House, supporters 
put the brakes on the bill last week, voting not to accept the 
Senate's amendments to the bill and instead calling for a conference 
committee to hammer out a final bill - with an eye toward crafting 
something Lynch will accept.

State Rep. Cindy Rosenwald said she met with senior Lynch staffers 
and left certain that Lynch would veto the current incarnation of the 
bill if it was sent to his desk. She left the meeting with a list of 
eight issues flagged by the governor's staff, the most difficult one 
of which is distribution. The current bill would allow medicinal 
marijuana users - individuals who suffer from specific illnesses or 
symptoms, who've been prescribed the drug by a doctor and who have 
registered with the state - to grow their own marijuana. They're also 
allowed to obtain it from other patients, including those from 
patients in one of the 13 states where medicinal marijuana is legal. 
Lynch, Rosenwald said, is "not comfortable with marijuana grown in residences."

"I was absolutely clear when I left the meeting that he would not 
allow the Senate version to become law," said Rosenwald, a Nashua 
Democrat. That, she said, "is why I asked for a committee of conference."

Debate over Ayotte's letter is a microcosm of debate over the bill 
itself, an argument in which the urge to help human suffering 
competes against fears about human frailty, where practical 
considerations meet a backdrop of the decades-long national fight 
over marijuana policy, including questions over whether the drug is 
addictive and whether it is a "gateway" to other drugs.

Matt Simon, the executive director of the New Hampshire Coalition for 
Common Sense Marijuana Policy, distributed a seven-page response to 
Ayotte's letter peppered with footnotes. The response says the letter 
co-signed by Ayotte and nine of the state's 10 county attorneys 
"makes several points that are simply incorrect and several other 
misleading statements," in particular taking on claims about 
marijuana as an addictive, gateway drug.

"I wish they would cite their sources and say where they're getting 
their information," Simon said in an interview yesterday.

Ayotte said she stands by every point in the letter and said there's 
no incarnation of a medicinal marijuana law that she could support. 
In addition to concerns cited in the letter, she cited practical 
concerns and noted that marijuana hasn't been through a normal 
approval process by the Food and Drug Administration. Marijuana 
remains illegal under federal law, she said, despite the recent 
statements by U.S. Attorney General Eric Holder pledging not to raid 
marijuana dispensaries that are legal under state law.

"I have to say that, despite the attorney general's statement, the 
law, the federal law is still the same," Ayotte said. "It's against 
federal law. The law hasn't changed."

Medicinal Validity?

Ayotte's letter cut to the heart of the bill, questioning the 
medicinal value of marijuana use.

"In fact, marijuana is an addictive drug that poses significant 
health consequences to its users, including those who may be using it 
for medical purposes," the letter said. "The use of smoked marijuana 
is opposed by all credible medical groups nationwide."

Matt Simon, the executive director of the New Hampshire Coalition for 
Common Sense Marijuana Policy, called that claim "simply untrue" and 
"the most frustrating." His response includes a list of several dozen 
medical groups that have "favorable medical marijuana positions," 
including the American Academy of Physicians, the American Nurses 
Association and the American Public Health Association.

Not on the list: the New Hampshire Medical Society, which is not 
taking a position on this bill. Also missing is the American Medical 
Association, which for years has called for further study of 
medicinal marijuana, a position that is extremely common among medical groups.

In a 2001 report, the AMA noted evidence that marijuana has helped 
those suffering from certain ailments, such as HIV wasting syndrome 
or chemotherapy-induced nausea, but concluded that a dearth of 
serious study into the benefits and risks of the drugs prevented the 
group from endorsing the drug.

"The lack of this evidence base continues to hamper development of 
rational public policy," the association report said.

The American Academy of Physicians went a step further last year, 
calling for a review of marijuana's current classification federally 
as a schedule 1 drug, the most serious classification, for drugs that 
lack medicinal use and carry a high potential for abuse, along with 
LSD and heroin. Cocaine is a schedule 2 drug.

"A clear discord exists between the scientific community and federal 
legal and regulatory agencies over the medicinal value of marijuana, 
which impedes the expansion of research," the report said. It 
concluded: "Evidence not only supports the use of medical marijuana 
in certain conditions but also suggests numerous indications for 
cannabinoids. Additional research is needed to further clarify the 
therapeutic value of cannabinoids and determine optimal routes of 
administration. The science on medical marijuana should not be 
obscured or hindered by the debate surrounding the legalization of 
marijuana for general use."

Ayotte said those reports don't counter her claim that medical groups 
oppose smoking the drug.

"I think the letter expressly says that smoked marijuana is opposed 
by medical groups," she said.

It's unquestionably true that many medical groups have often urged 
scientific research into ways of getting the medicinal benefits of 
cannabinoids that don't involve smoking. A 1999 report by the 
Institute of Medicine, for example, likened smoking marijuana to 
smoking cigarettes: "Smoking marijuana is clearly harmful, especially 
in people with chronic conditions, and is not an ideal drug delivery system."

As for addiction, the Institute of Medicine report found that a 
"vulnerable subpopulation" of marijuana users may be at risk of 
becoming dependent but considered addiction "relatively rare" 
compared with other drugs.

Simon said marijuana's potential for dependence should be considered 
in the context of other drugs, such as cigarettes, alcohol and painkillers.

"The addiction possibility of pharmaceutical painkillers are off the 
charts compared to marijuana," Simon said.

Other Concerns

Ayotte's letter also delves into longstanding debates about marijuana 
policy, including whether it is a "gateway drug."

"One of the most harmful consequences of marijuana use is the role it 
plays in leading to the use of other illegal drugs. Studies have 
shown that very few young people turn to illegal drugs such as 
cocaine or heroin without first experimenting with marijuana," 
Ayotte's letter said. "The New Hampshire law enforcement community 
works diligently to discourage young people from venturing down that 
path. Those efforts will be significantly undermined by the passage 
of legislation legalizing the use of marijuana to any degree."

Simon said that claim had no merit. "The gateway theory has never 
been substantiated by any science, despite repeated attempts to prove 
its validity," he said.

He pointed to the 1999 Institute of Medicine Report, which found 
there was no conclusive evidence that marijuana's drug effects cause 
users to move on to other drugs.

"In the sense that marijuana use typically precedes rather than 
follows initiation of other illicit drug use, it is indeed a 
'gateway' drug," the report found. "But because underage smoking and 
alcohol use typically precede marijuana use, marijuana is not the 
most common, and is rarely the first, 'gateway' to illicit drug use. 
There is no conclusive evidence that the drug effects of marijuana 
are causally linked to the subsequent abuse of other illicit drugs."

Ayotte said her experience as a prosecutor has shown otherwise. She 
said if she were to ask officers of the undercover drug task force, 
which is run through her office, "many of them would tell me that, 
unfortunately, marijuana is a gateway drug."

Ayotte's deputy, Assistant Attorney Karin Eckel, pointed to another 
part of the Institute of Medicine report that dealt with the gateway 
drug question. The report discussed marijuana as an entree into the 
social environment of drug use, a theory that is "supported, although 
not proven, by the available data."

Sen. Kathy Sgambati, a Tilton Democrat who supported the bill, said 
she didn't find the gateway drug debate relevant to the medicinal 
marijuana bill. She was moved, she said, by testimony from cancer 
patients and others who said they'd been able to find relief by 
smoking marijuana. Many of those who testified had legal access to 
extremely potent medicines, she said.

"Ninety percent at least of the people who testified have medicine 
chests full of opiates," Sgambati said. "So this is not somebody 
seeking a stronger drug."

Only one of the 10 county attorneys didn't sign the letter: Coos 
County's Bob Mekeel. He cited two reasons.

"The first is, really just as a general principle. It's my job to 
enforce the laws. It's not my job to make them," he said. "I just 
don't think it's appropriate to tell the Legislature what the law ought to be."

His second: As a personal-injury lawyer for 25 years, he represented 
people who were in "terrible plights" and had lost limbs.

"In those instances, really if anyone in that situation can get 
relief from anything, I just don't think I should stand in the way of 
that," Mekeel said.

So far, he said, he hasn't heard much negative feedback on his stance, he said.

"I just think reasonable minds can disagree," he said. 
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MAP posted-by: Richard Lake