Pubdate: Thu, 21 Oct 1999 Source: Daily Telegraph (Australia) Copyright: News Limited 1999 Contact: http://www.dailytelegraph.com.au/ Author: Piers Akerman MEDICINAL SMOKE IS A DOPEY IDEA THE Carr Government’s decision to investigate the therapeutic effects of marijuana must be regarded with some scepticism. While no one would dispute the need to continually search for new treatments to help the suffering, numerous trials on the efficacy of cannabis as a pain reliever have been conducted in a number of countries with results that can, at best, be termed indifferent. Premier Bob Carr is clearly aware of the risk of sending the wrong signal about marijuana use to the community as he went out of his way to emphasise that "those who advocate the legalisation of cannabis should not consider my statement (agreeing to the trial) as a sign of support for their cause". Sound sentiments but the reality is that the pro-marijuana lobby is already celebrating the proposed marijuana trial as a major victory in its battle to have the drug legalised. In his short address to State Parliament on Tuesday, Mr Carr balanced his concerns about those left racked in pain after chemotherapy treatment, those dying or seriously ill with cancer or AIDS and the risks associated with marijuana use. He appeared to have few illusions about the problems of marijuana dependence, its proven association with mental illness, cancer and respiratory problems, and the risk of creating a legal supply of cannabis or its extracts. It would be hard to argue that there isn’t a need to explore any avenue for pain relief on compassionate grounds. Among those on the working party however, is the Australian Medical Association, which earlier this month called for the immediate legalisatlon of marijuana for medicinal purposes. At the time NSW AMA president Kerryn Phelps said many doctors already encouraged patients who used marijuana to relieve their symptoms to continue using the drug. "Commonsense dictates that we already have enough evidence for this," she said. "We think there should be exemptions for such people immediately. If marijuana doesn’t work for them, they won’t use it, and if it has some side effects they won’t continue using it. "As far as I can see, legallaing prescription marijuana is a win-win situation." The publicity-conscious Dr Phelps has a curious view of the law in line with the self-important view some medicos have of themselves. Given her obvious prejudice in this matter the ethical thing to do would be to withdraw her organisation’s participation from the review panel. Even as Mr Carr was yesterday agreeing to the investigation of possible medicinal uses of marijuana, the National Drug and Alcohol Research Centre (NDARC) was warning that more than 200,000 Australians were dependant on the drug. The directors of the study said cannabis dependence was too often trivialised with its effects, depression, problems with concentration, memory, isolation and lack of motivation, not fully appreciated. And there is a wealth of other research material available for those with genuinely open minds to explore before the report is due to go to the government next July. Published in such reputable organs as the New England Journal of Medicine, The International Journal of Addictions, Lancet and others, a multitude of authors have found that marijuana use can contribute to a host of serious health problems. According to a 1997 paper published by the British Medical Association "arguments in favour of sanctioning cannabis for medical use have been based mainly on anecdotal reports... do not constitute scientific evidence". It continued, "smoked cannabis is clearly not a therapeutic option"; "hypotension, palpitations and psychotropic effects ... occurred with such frequency as to militate against the routine use of cannabis in glaucoma"; "evidence of a therapeutic potential for cannabinoids for epilepsy is scanty ... trials have been small, uncontrolled and have given conflicting results"; "ineffective in anorexia nervosa"; "tremor and hypokinesia was exacerbated"; "no beneficial effects for Parkinson’s disease or Huntingdon’s disease". The Health Council of the Netherlands Standing Committee on Medicine reported in 1996 that "evidence is insufficient to justify the medical use of marijuana". As Andrew Fraser, MP, has pointed out, THC, the active ingredient in cannabis has long been available in tablet form by prescription in the US but is rarely utilised, as those who want to use marijuana do so because they like to smoke dope. He is also correct in suggesting the AMA’s motives in regard to marijuana must be questioned as it did not seek to fast-track studies of Naltrexone, which is used to detoxify heroin addicts. We all wish to reduce suffering and alleviate pain but those slyly attempting to legalise marijuana by holding out the hope that the drug may be a panacea can only inflict greater hardship through such empty promises. - --- MAP posted-by: Derek Rea