Source: Toronto Star Contact: 29 November 1997 Author: Sidney Katz, Special to the Star Section: E1E2 Website: http://www.thestar.com/ MARIJUANA AS MEDICINE? AARON HARNETT: Lawyer says marijuana is a ``medical necessity'' for Terry Parker. For 20 years, Terry Parker has been fighting to have marijuana legalized because it controls his epileptic seizures Should Terry Parker, a 42yearold Torontonian, be permitted to use marijuana legally to control his severe epilepsy? Judge Patrick Sheppard of the Ontario Court, provincial division, will provide Parker with the answer to this politically and legally sensitive question on Dec. 10. Two months earlier, Parker went on trial charged with the cultivation and possession of marijuana with the intention of trafficking. He pleaded not guilty. Parker's lawyer, Aaron Harnett, argued that for his client, marijuana was a ``medical necessity.'' As such, he pointed out, the Charter of Human Rights included ``a right to access to a medical treatment for a condition representing a danger to life without fear of criminal sanction.'' With good reason, Parker is restless and anxious as he awaits Sheppard's decision. ``For me, it's a matter of life and death,'' Parker explains. ``I have everything at stake. I'm an epileptic whose seizures cannot be controlled by conventional drugs. They can be controlled by marijuana. Without marijuana, I have no future. I might as well be dead.'' _________________________________________________________________ `It hasn't been a very pleasant ride but what other choice do I have?' _________________________________________________________________ Slightly built, Parker's face and eyes reflect the inner turmoil of a man who, during his entire lifetime, has endured the ravages of an intractable and severe form of epilepsy. ``My life has always been in grave danger because I've had so many seizures in public,'' Parker says. He has been robbed while lying unconscious in a subway station; he was hit on the street by a speeding ambulance and required a week's treatment in a hospital intensive treatment unit; he has been repeatedly arrested because his seizure symptoms were viewed as drunkenness. Says Parker: ``I can't drive a bicycle or car; I can't work with heavy machinery, I can't hold down a job because my seizures are not under control.'' Since smoking marijuana enables Parker to lead a relatively normal life, it's understandable why he has spent the last 20 years crusading for the right to have legal access to cannabis. At times, Parker has paraded through busy streets, carrying a sign, and explaining his plight to anyone who would listen. He has written countless letters to health and government officials. He has participated in an endless round of press interviews. On one occasion, he allowed himself to be used as a guinea pig for a test of the effectiveness of synthetic marijuana conducted by the Addiction Research Foundation in Toronto. His apartment has been repeatedly searched by police. He has been arrested, jailed, fined, harassed and reviled. ``It hasn't been a very pleasant ride,'' says Parker, ``but what other choice do I have?'' After one arrest in 1987 for possession of marijuana, Parker obtained a lawyer and offered ``medical necessity'' as a defence. He won his case and an appeal court upheld the decision. But it was an empty victory. ``It was a crazy situation,'' explains Parker. ``The courts said I could use marijuana because it was a bona fide medicine for my epilepsy but I had no way of legally obtaining a supply. So I continued to be busted by the police.'' Parker's most recent arrest was the result of a search of his highrise apartment in the west end of Toronto on the evening of July 16, 1996. Police found 14 marijuana plants, 1.2 metres tall, growing in his bedroom in a hydroponic setup; 57 additional plants on the balcony and a white plastic shopping bag half full of harvested marijuana. Parker was charged with cultivating and possession of marijuana with the intention of trafficking. Why did he so flagrantly risk arrest by filling his apartment with marijuana plants? Parker has a ready answer. Buying marijuana on the street, he explains, is even more risky. ``You are dealing with people who may cheat you or rob you.'' But more important, street marijuana is an unknown quantity. It may be tainted with pesticide, laced with heroin or contain some other noxious substance. ``Marijuana is my medicine and I don't want to poison myself,'' says Parker. He's a fastidious marijuana grower. For example, to get rid of insect pests, he uses ladybugs and soap instead of a toxic insecticide. ``My stuff is absolutely pure,'' says Parker. Economic considerations are also important. Because he's unable to work, Parker's only income is his disability pension. ``I can't afford to spend $500 a month for street marijuana so I grow my own at a fraction of that cost.'' Parker's view that marijuana should be a legitimate medicine is shared by many people. The demand for access to marijuana as a medicine is increasingly becoming a political, legal, medical and ethical hot potato. A recent poll indicated that 83 per cent of Canadians agreed that marijuana should be made legally available for health purposes. In London, Ont., Lynn Harichy, a 36yearold mother of four who suffers with multiple sclerosis, awaits trial for smoking marijuana to relieve her pain and muscle spasms. In the small community of Sooke, B.C., the local court acquitted a man who was using marijuana oil to soothe his psoriasis. In finding him not guilty, the judge urged him ``to share your knowledge with the medical profession.'' Two states, California and Arizona, recently passed a law permitting citizens to cultivate and possess marijuana on the recommendation of their physician. And, in a recent twoweek period, three TV network shows in Canada and the United States featured cancer and AIDS patients relating how marijuana had alleviated their disease symptoms where conventional medications had failed. A wide array of witnesses testified at Parker's trial, either in person or by affidavit. The preponderance of evidence was promarijuana. Typical were the observations of Dr. Lester Greenspoon, associate professor of psychiatry, Harvard Medical School: ``There is now a growing body of evidence that marijuana is a medically valuable treatment. . . It appears that the medical dangers of marijuana have been vastly overstated while the medical value grossly understated and ignored.'' The sole dissenting witness at the trial was Dr. Harold Kalant, a distinguished researcher in pharmacology at the University of Toronto. He urged caution because marijuana had not been fully investigated. It had not yet been fully proven, he pointed out, that cannabis was harmless or nonaddictive. But the most impressive testimony was Parker's recital of how his wretched, miseryladen existence was transformed by the simple act of smoking marijuana. Parker began having epileptic seizures at the age of 4 as many as 10 to 14 a day. The usual anticonvulsive drugs were prescribed for him Dilantin, Mysoline, Tegretol and various tranquillizers but they did little to alleviate his symptoms. Instead, his health worsened because of the massive adverse effects of the drugs extreme drowsiness, slurred speech, blurred vision and a drop in his white cell blood count. Hospitalized 100 times, Parker was forced to drop out of school when he was in Grade 6. In desperation, when he was 14, Parker agreed to submit to two operations frontal lobotomies which involved the removal of brain tissue. Unfortunately the operations didn't stop the seizures. ``I had a beauty of a grand mal seizure coming out of the anaesthesia and they just kept coming after that,'' says Parker. At the age of 22, Parker began to smoke marijuana to get ``high'' and thus escape from his state of constant depression. After a few weeks, he had made a fabulous and joyous discovery: ``Marijuana practically put an end to my epileptic seizures. It happened just like that!'' When Parker gave the happy news to his family physician at the time, Dr. Michael Rachlis, he was somewhat skeptical and urged him to keep a daily health diary. Parker's diary for the fourmonth period between December, 1980, and March, 1981, indicated that on the days he did not smoke marijuana he had several grand mals and petit mals; on the days he did smoke relatively few seizures occurred. Later, Rachlis noted in a written statement that ``marijuana makes a significant difference in Mr. Parker's seizure control and the quality of his life.'' Six years later, in 1987, when Dr. D.M. Cider had become Parker's family doctor, Cider made a similar observation. And, at Parker's trial, his mother, 61yearold Helen Lake, testified: ``Marijuana has been effective in treating my son's epileptic seizures. I have observed this phenomenon hundreds of times.'' At Parker's trial, a wide variety of people presented their experiences with marijuana patients, family doctors, medical specialists and researchers, judges, pharmacologists and sociologists. Valerie Corall, 45, who runs a farm near Vera Cruz, Calif., described how she had been treated for 10 years with anticonvulsive drugs for her epilepsy. The drugs had the unusual effect of actually increasing the frequency of her seizures and the accompanying side effects were so severe she had to be sent to hospital on several occasions. ``My doctor ordered me to get off the drugs,'' said Corall. She replaced them by smoking marijuana. ``I have now been smoking marijuana every day for 10 years and during that time I have been entirely free of grand mal seizures,'' she testified. A research team from Hebrew University in Jerusalem and the University of Sao Paulo in Brazil conducted trials with ``the eight worst epileptic patients we could find.'' All of them had failed to respond to conventional forms of therapy. When their regular medication was supplemented by 200 milligrams of CBD a synthetic form of one of the cannabinoids found in marijuana it was noted that four of the eight patients showed ``remarkable'' improvement, three ``partial'' improvement and one patient remained unchanged. The researchers noted in their report in the Journal Of Clinical Pharmacology, which was tabled at the trial, ``the results are very exciting, representing a success rate of 80 per cent.'' But, according to witnesses at the Parker trial, epilepsy patients are not the only ones who might benefit from marijuana. The plant may also play a valuable role in the treatment of people with AIDS and cancer. Patients with AIDS and cancer are subject to prolonged nausea and vomiting, caused by the disease and the heavy doses of powerful, prescribed drugs. ``They can't drink, eat or keep down their medication,'' observed Dr. John Goodhew, a Toronto family doctor whose practice includes several AIDS patients. Deprived of food and medicine, such patients can waste away. ``Smoking marijuana appears to be an effective and practical way of dealing with this situation,'' said Goodhew. After smoking, their nausea quickly subsides and their appetite returns. Goodhew noted, ``I had one patient whose immune system efficiency rose from 5 per cent to 50 per cent after smoking marijuana.'' As an alternative to marijuana, a legal antiemetic drug called Marinol is available. It is the synthetic form of THC one of the several cannabinoids to be found in marijuana. But nearly all patients have a strong preference for smoking. ``The Marinol takes much longer to act and has unpleasant side effects,'' says Goodhew. In a 1990 survey of 2,000 members of the American Society of Clinical Oncologists, the majority stated that ``smoking is more effective as an antiemetic than Marinol and just as safe.'' The marijuana issue poses a legal, ethical and professional dilemma for conscientious and lawabiding physicians like Goodhew. He explained, ``I can't advise a patient to smoke a forbidden substance, but based on my clinical observations, I feel that the law against marijuana works against the welfare of some patients.'' At the Parker trial, marijuana therapy was strongly endorsed for the treatment of multiple sclerosis (MS), a degenerative disorder of the central nervous system. In his affidavit, Greenspoon stated that ``cannabis can alleviate the pain and muscle spasm'' associated with this disease. To make their point, Greenspoon and other witnesses submitted material which contained several graphic case histories. Greg Paufler, 37, was a case in point. He suffered severe weight loss, excruciating muscle pain, and could no longer walk due to his inability to control his limbs. When he failed to respond to conventional medical treatment, he was advised to ``go home and rest.'' Instead, Paufler began smoking marijuana, which led to his return to health. He regained his lost weight and he could walk again. He boasted, ``I can even go out and show the kids how to kick a soccer ball.'' _________________________________________________________________ `We should be conducting more research into the possibility of cannabis as having a variety of medical purposes' _________________________________________________________________ Glaucoma, an eye disease commonly found among older people, can also be controlled by marijuana therapy, according to evidence presented at Parker's trial. The disease is caused by a buildup of fluid in the eyeballs, leading to heavy pressure which results in blurred vision and blindness. Many glaucoma patients claim that they have preserved their eyesight because marijuana lowers the intraocular pressure. As the result of his lengthy campaign to make marijuana available as a medicine, Parker has become an authority on the subject. His apartment is piled high with scientific reports, research papers, books and legal documents on the topic. In the material he has amassed, many highly respected individuals and institutions demand that we embark on a program which thoroughly investigates the medicinal properties of cannabis. Dr. Berry (Perry) Kendall, head of the Addiction Research Foundation said in a published interview: ``We should be conducting more research into the possibility of cannabis as having a variety of medical purposes.'' The authoritative U.S. Academy of Sciences echoes the same sentiment: ``The investigation of cannabis should be given a high priority.'' The highly regarded New England Journal Of Medicine shares the same view. Parker asks, impatiently, ``Since so many qualified people support the idea, why are we dragging our feet on marijuana research?'' On Dec. 10, if Sheppard grants Parker the right to use marijuana, he will regard it as a major victory for himself and thousands of other patients struggling with epilepsy, glaucoma, multiple sclerosis, cancer and AIDS. He feels he's entitled to have access to a drug which controls his seizures without being arrested by the police for drug possession. ``I've been fighting for this right for 20 years,'' he says wearily. ``In the name of humanity, how much longer will I have to wait?''