Bloomberg Article on Medical Marijuana

Medical Marijuana Relieves Patient's Pain, Obama Ends Worries

By Elizabeth Lopatto
Last Updated: October 20, 2009 00:00 EDT

Oct. 20 (Bloomberg) -- Madeline Martinez is in constant pain from a
disease that is destroying her joints and the discs in her back.
Marijuana relieves her discomfort, she said, and the Obama
administration has ended her worries that she may someday be jailed for
using the drug.

Martinez, 58, of Portland, Oregon, had previously been given Abbott
Laboratories' Vicodin and codeine for her pain. Use of those drugs
led to stomach problems, and now she takes marijuana prescribed for her
by a doctor. Medicinal marijuana is legal in Oregon, one of 14 states to
allow so-called compassionate- care use.

The U.S. Department of Justice yesterday advised federal prosecutors not
to seek criminal charges against those who use medical marijuana in
accordance with state laws, reversing a Bush administration approach.
Along with chronic pain, the American College of Physicians, the
second-largest U.S. doctors group, has said marijuana can be used to
treat glaucoma, multiple sclerosis and nausea.

"Having disabled people jailed for no reason, that's
terrifying," said Martinez, who mostly uses a tincture of the drug
rather than smoking it. "As a medical marijuana patient, it's
always good to have some stress and anxiety alleviated."

Of 23,873 people in Oregon who hold cards allowing them to use marijuana
legally, 21,087 are approved because of severe pain, according to the
state's public health division. Another 7,550 Oregonians take
marijuana to relieve muscle spasms from conditions such as multiple
sclerosis, and 3,997 use it for nausea. Patients may be approved for
more than one condition.

6,000 Applications

Over 6,000 applications for the program are under review, either for
initial treatment or renewal, according to the division's Web site.

Marijuana, produced from the cannabis plant, is classified by the U.S.
government as a Schedule I drug, which declares it has no accepted
medical use. Possessing and using marijuana are crimes in most states.

"Our old Drug Enforcement Agency people thought it was a Cheech and
Chong thing," said Donald Abrams, the chief of oncology at San
Francisco General Hospital, referring to the comedy team of Cheech Marin
and Tommy Chong that made drug use a central part of their act in the
late 1970s. "I see patients who have loss of appetite, nausea from
chemotherapy, pain, depression, anxiety, insomnia, and I know I have one
medicine I can recommend that takes care of all these symptoms.

"I hope this makes more patients ask their providers about
marijuana," said Abrams, who added that today he will be leading
grand rounds entitled "Marijuana: Is it Medicine Yet?"

Waive Penalties

The Philadelphia- based College of Physicians, with 124,000 members, said
in February 2008 that criminal penalties should be waived for doctors
who prescribe marijuana and their patients.

Marijuana has been used for centuries as a medicine, and was marketed by
companies such as Eli Lilly & Co. before the drug became illegal,
according to the physician group.

Marijuana wasn't sold as a prescription medicine. Rather, it was
sold as an herbal extract, said Judy K. Moore, a Lilly spokeswoman. The
Indianapolis, Indiana-based company deleted it from their price list in
1915, she said.

The drug is thought to work by attaching to areas in the brain called
cannabinoid receptors. The active ingredient, tetrahydrocannabino l or
THC, has been proven to be a pain reliever in animal studies. In humans,
it has been shown in studies to reduce pain from nerve damage in AIDS
patients.

A non-smoked form of THC called Marinol, marketed by Solvay
Pharmaceuticals, of Brussels, is used to curb nausea.

Research Source

The science is difficult to define in part because the only legal source
of marijuana for research in the U.S. is the Bethesda, Marilyn-based
National Institute on Drug Abuse, said Abrams, who is also a professor
of medicine at the University of California, San Francisco.

"It's been difficult to generate evidence because NIDA only
wants to provide it as a subject of research for abuse, not for
treatment," Abrams said. "There isn't evidence because we
don't have the resources to generate it."

Chronic use of marijuana may lead to lung damage, pneumonia, and poor
pregnancy outcomes, according to the 2008 College of Physicians report.
Smoking is generally unsafe, and the group doesn't support the
long-term use of smoked marijuana, the ACP said.

The National Drug Control Policy office in 1997 asked the Institute of
Medicine, an independent scientific research group, to review evidence
on the risks and benefits of marijuana. The drug has therapeutic
properties for many ailments, the study concluded.

`Not a Priority'

Yesterday's Obama administration guidelines don't legalize
marijuana, said Attorney General Eric Holder in a statement.

"It will not be a priority to use federal resources to prosecute
patients with serious illnesses or their caregivers who are complying
with state laws," he said. "But we will not tolerate drug
traffickers who hide behind claims of compliance with state law to mask
activities that are clearly illegal."

The Justice Department will continue to focus resources on "serious
drug traffickers, while taking into account state and local laws,"
Holder said.

The Bush administration didn't target patients and instead went
after larger operations that were selling marijuana for recreational
use, said Tom Riley, who was the spokesman for the Bush Office of
National Drug Control Policy, in a telephone interview yesterday. The
Obama Justice Department announcement will make it easier for criminal
operations that claim to be medical marijuana producers, he said.

`A Green Light'

"By announcing it this way, I'm almost positive it's going
to be sending a green light to people that medical pot is legal,"
Riley said. "A very significant portion of the medical pot business
is a fraud."

California is among the states that has established medicinal marijuana
dispensaries through a permitting process in a manner similar to other
businesses. The clinics provide easier access to the drug for those with
a prescription. Patients such as Martinez who live elsewhere must grow
the drug on their own or find other suppliers.

"The impact of the Department of Justice decision is really
interesting, " said Jeffrey Miron, an economist at Harvard University
in Cambridge, Massachusetts, who has studied drug law. "This
effectively legalizes marijuana not just for medicinal purposes but for
all purposes."

Many prescriptions for marijuana are for "vague" conditions such
as back pain and anxiety, he said in a telephone interview yesterday.

`Willy-Nilly' Prescriptions

"It just takes a few doctors to write prescriptions willy- nilly,
and marijuana's legal," Miron said.

Legalizing marijuana would result in savings of $12.9 billion per year,
according to a December 2008 report from Miron. Taxing marijuana at a
rate comparable to alcohol and tobacco would add $6.7 billion in annual
revenue.

The city of Oakland has begun taxing marijuana at a higher rate than
other local businesses, said Barbara Killey, an assistant to the city
administrator.

Businesses classified in the "cannabis" sector are taxed $18 for
each $1,000 of gross receipts. Previously, they had been taxed like
other businesses, at a rate of $1.20 per $1,000 of gross receipts.
Almost 80 percent of Oakland voters voted in favor of the proposition.

"This was a way for them to be more accepted by the community, and
the city has experienced dramatic tax shortfalls with the
recession," Killey said in a telephone interview. "They were
trying to help us resolve the shortfall."

Grows Her Own

Martinez, who struggles with chronic pain from degenerative disc and
joint disease, grows her own marijuana because Oregon doesn't have
official dispensaries, she said. She also participates in a collective
to give away cuttings and medicine.

"We struggle with access," Martinez said. "The black market
mostly controls the marijuana in the country, and we need to grab it
away from him and use it for our own economy, and to make it a priority
for patients."

contact the reporter on this story: Elizabeth Lopatto in New York at
elopatto@bloomberg. net.

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