Lit_Match

Experts: Medical Marijuana Best as Pill
12.29.06|Lansing State Journal|By Christine Rook

There's a lot of talk lately about giving Michiganders the right to take a toke.

A state House bill legalizing medical marijuana is going nowhere this month, but already there is a petition drive out of Eaton Rapids and talk of a second to allow Michigan voters to legally light up. It's fascinating politics, but is it good medicine?

Yes and No.

There is strong evidence that marijuana's main psychoactive ingredient has a place in the modern arsenal of medicines. Smoking it, though, hardly appears to be the best way to administer that drug, experts say.

In fact, smoking delta-9-tetrahydrocannabinol, commonly called THC, might be appropriate only for a few chronically ill patients who meet specific criteria.

Local oncologist Dr. Anas Al-Janadi called smoking marijuana "a very bad way to administer good medicine."

Al-Janadi, who treats cancer patients through the Michigan State University Breslin Cancer Center, said he would never advocate smoking weed for medicinal reasons.

"Even if the patient is terminal," he said.

Smoking, after all, is not the only way to medicate with THC. It is available by prescription in pill form.

THC Helps Some:

THC has been proven to reduce pain in some patients and to ease vomiting in about 25 percent of those in chemotherapy, according to a 1999 report by the Washington, D.C.-based Institute of Medicine of the National Academies. THC also shows promise in treating wasting syndrome in AIDS patients.

But some other health claims are just that - claims.

Marijuana, for example, has been shown to reduce pressure in the eyes of glaucoma patients, but the effect is short-lived and not worth the drug's side effects, according to the institute report. THC, for example, alters mood and can actually add to patient distress.

The debate shows no sign of waning.

Tim Beck is an insurance sales executive from Detroit who smokes marijuana to relieve pain. It's legal in Detroit, Ferndale, Ann Arbor and Traverse City, as long as the marijuana is smoked for medicinal purposes and the user has proof his physician approves. In Detroit, for example, police said they won't charge such a user even though state law prohibits marijuana possession.

Beck wouldn't divulge the details of his illness, but he noted that pharmaceutical-grade THC doesn't work for everyone.

"Everybody's metabolism is different," he said.

Available in Capsules:

Synthetic THC is marketed in capsule form under the trade name Marinol and comes in only three dosages, according to the U.S. Food and Drug Administration.

It's approved for the treatment of severe weight loss in AIDS patients, and nausea and vomiting associated with chemotherapy.

Its limited approval is cited as a civil liberties issue.

"Who should make decisions about medical health - the patients and their doctors or government officials?" asked state Rep. Leon Drolet, R-Macomb County.

His answer: patients and doctors.

As a doctor, though, Al-Janadi sees little point in advocating the smoking of a substance that can lead to dependence and has been proven to contain cancer-causing compounds.

"I had one patient who just swore that the only thing that helped him was smoking marijuana," Al-Janadi said. "The guy was doing great with Marinol."