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Weed science
To smoke or not to smoke:

weighing the benefits of medicinal cannabis
DAILY BRUIN | 4.20.2004

By Jeyling Chou and Joie Guner- DAILY BRUIN SENIOR STAFF
jchou@media.ucla.edu
jguner@media.ucla.edu

Dr. Jay Cavanaugh's first dose of marijuana was given to him by his mother – who had obtained it through a member of her bridge club.

Clearly not your usual drug trade.

In 1995, Cavanaugh lost the use of both arms because of a nerve disorder. He was literally wasting away, going from 180 pounds to 120 due to pancreatitis.

He needed something that would calm the nausea and allow him to eat again.

He said, "My mom brought it home and said, 'You go upstairs and smoke, and I'll start cooking.'"

Cavanaugh – the national director of the American Alliance for Medical Cannabis, an organization formed to educate the public about marijuana's medicinal properties – has been smoking his medicine for seven years.

"Medical cannabis got me off all the drugs they were giving me for years," he said.

"It's been almost four years since I've used any narcotic pain medication, sedative or anti-depressant."

Before falling ill, Cavanaugh was on the California Board of Pharmacy, running drug and alcohol abuse treatment centers for 20 years.

Now, as an active supporter of the use of medical cannabis, he has shifted his scientific and personal missions.

"I'm one of those 'normal' people. I hadn't smoked pot since I was in college back in the '60s," Cavanaugh said.

"I became a convert from my own personal experience. I turned my background in the biological sciences around to investigating this," he added.

With the passage of Proposition 215 in 1996, physicians in California could legally prescribe cannabis and oversee their patients' use.

"I'm not a doctor, but I believe Prop. 215 is a step in the right direction," said Allen Weinberg, a Los Angeles attorney who has represented individuals prosecuted for their use of medical cannabis.

"If there's anything that can provide a sick person with some relief, the doctor should be able to give it to them," he added.

The fight is far from over for Cavanaugh and the estimated 100,000 other Californians that use medicinal marijuana.

Proposition 215 does not specify how the marijuana is to be obtained or what is considered a legal amount for a patient to possess.

These ambiguities have brought clashes with law enforcement.

"I have friends in exile in Canada; I have friends right now in federal prison; I have friends ... who live under fear of arrest for this simple act of treating themselves with a substance that's not approved by some," Cavanaugh said.

"That's not a good way to live. It's bad enough to be sick."

Marijuana contains the toxin delta-9-tetrahydrocannabinol, better known as THC, which causes the "high" when smoking the drug.

Other components of marijuana have also been shown to decrease nausea, suppress inflammatory immune responses and increase appetite.

But medicinal cannabis also comes with its share of potentially dangerous side effects.

Marijuana smoke contains higher concentrations of many of the same carcinogens found in tobacco smoke.

"When you smoke marijuana, you get exposure to those carcinogens that increase the risk of cancer," said Zuo-Feng Zhang, a professor in the UCLA Department of Health and Epidemiology.

A study conducted by Donald Tashkin, a professor at the David Geffen School of Medicine division of pulmonary and critical care medicine, found marijuana smokers to be prone to chronic bronchitis.

"People who use ... marijuana for therapeutic purposes should take into consideration that there could be some harmful consequences to the smoking of marijuana," Tashkin said.

Unlike tobacco, marijuana has not been shown to cause chronic obstructive pulmonary disease or emphysema, but both drugs cause similar lung abnormalities when examined at the microscopic level.

Research has found that the habitual smoking of marijuana impairs the immune response to common microbes, increasing a risk for opportunistic infection.

This can pose a threat for cannabis users with AIDS and cancer, whose immune systems are already compromised.

Tashkin also found that injecting mice with THC accelerated the development of lung tumor cells.

"Someone with cancer might inadvertently be hurting himself by increasing the risk for the growth of his tumor, for which he took the chemotherapy in the first place," Tashkin said.

The medical and legislative communities have remained hazy on their positions on medicinal marijuana, slowing down the ability of patients who need it to obtain it.

"A lot of doctors are not willing to recommend (marijuana) for fear of repercussion from the medical community," Weinberg said.

Patients who use the drug for their medical conditions and are hoping to influence legislation are also up against the cultural stigmas associated with the drug.

"We give people toxic and addicting medications every day in large amounts and don't even balk at all, but when it comes to treating illness with medical cannabis, all these red flags go up," Cavanaugh said.

For some patients, marijuana's healing qualities are the only thing allowing them to lead a normal life.

"I need to smoke when I go to a restaurant immediately after I eat, just to make sure I'm able to eat that food and not be in severe pain or throw it up," said Ryan Landers, the California representative for AAMC.

Landers has been an active lobbyist for medicinal cannabis since 1995, working with patients, speaking at city halls and evaluating legislation.

He also has AIDS.

"Without marijuana, I would be very sick or dead right now," Landers said.

"It's a powerful medicine that people are very much prejudiced toward out of ignorance."

Landers uses marijuana to combat the side effects of the cocktail of drugs he takes every day.

"You take a handful of pills when you get up in the morning, you throw them up, and you have to settle your stomach just to take them again," he said. "Marijuana is the only thing that will really do it."

Users of medicinal marijuana, however, need the drug for its fast-acting potency as a therapy for muscle spasms and nausea – often the unpleasant side effects of their other treatments.

"There's no pill they can give me that will stop that so instantaneously – two hits and you stop the process of vomiting," Landers said.

"Once you start taking marijuana, you don't get high. You build up a tolerance to it. It becomes like any other medication," he added.

There is a version of the active ingredients in marijuana that has been approved by the U.S. Food and Drug Administration – the drug Marinol.

Cannabis can also be vaporized, greatly decreasing the amounts of harmful carcinogens.

These alternatives are widely used, but Landers maintains the right for patients to obtain their medication.

"You watch (patients) go through this suffering, and you know you'll never let up that commitment to saving everyone like them from suffering," he said.

"It will keep them eating a little longer; it will keep them suffering a lot less."

But the opponents of decriminalizing marijuana extend beyond legislation and hospitals.

"When it comes to people using cannabis, it's big entertainment, it's funny. Whenever we finally get some exposure, it's so often done tongue-in-cheek," Cavanaugh said.

"That's our biggest opposition – not being taken seriously."

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Torture Good, Healthcare Bad, Marijuana Evil.

There's no money for your issue so long as we're squandering $50 billion a year on the DrugWar. Ben Masel