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Medical Marijuana

October 14, 2003 at 12:00 AM EST
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GWEN IFILL: The court decided today it would not involve itself in a debate over whether doctors can talk to patients about medical marijuana. So far, eight states– Alaska, California, Oregon, Washington, Nevada, Colorado, Hawaii, and Maine– have approved laws that legalize marijuana if a doctor recommends it. But federal law still bans the use of marijuana for any purpose. Here to look a little more closely at that debate are Rob Kampia, the executive director of the Marijuana Policy Project; and dr. Andrea Barthwell of the White House office of national drug control policy.

Dr. Barthwell, what is the practical effect, or noneffect, of today’s rejection of the Supreme Court, or the Supreme Court’s decision not to take this case.

DR. ANDREA BARTHWELL: Well, in the Supreme Court’s decision not to take this case today, it really upheld the 9th circuit court’s decision that marijuana is in fact not a medicine.

GWEN IFILL: But what is the practical effect of that?

DR. ANDREA BARTHWELL: The practical effect of that is that the federal law still trumps the state law in this area, but the decision today is a really narrowly focused issue. The larger issue is that there is a very well funded campaign, which is trying to drive a wedge in the drug policy in this country to appeal to people using illness and sick people to make marijuana more available to families and communities across the country.

Today I’m here in San Francisco meeting with the health and public health leaders who are in fact outraged by the campaign that has been waged in this state to make marijuana more available to people that they work with every day in trying to bring them out of the grips of addiction and into recovery.

GWEN IFILL: Mr. Kampia, what do you think is the meaning of today’s Supreme Court inaction, I guess?

ROB KAMPIA: Well, it’s good news for medical marijuana patients, and it’s good news for 80 percent of the American people who believe that marijuana should be medically available. The Supreme Court by not taking the case has essentially said that the 9th Circuit ruling will stand, and that said that states have the right to determine their own medical marijuana policies without federal interference. And doctors have the right to recommend marijuana to patients in order to keep the patients out of prison.

GWEN IFILL: That’s not what dr. Barr well just said about the meaning of this ruling.

ROB KAMPIA: She and I disagree often.

GWEN IFILL: Okay. Tell me what the value is in your point of view of having medical marijuana available, at least for recommendation by doctors.

ROB KAMPIA: Well, the institute of medicine four years ago, and this report was funded by Andrea’s office, the White House drug czar’s office, this report found that marijuana has medical value for certain patients, namely those suffering from cancer chemotherapy, AIDS wasting syndrome, chronic pain. And what this court decision today or inaction today really allows is doctors in these eight states to recommend that patients use marijuana to treat various medical conditions. And if a patient has their doctor’s recommendation, then they would be exempts from arrest and prosecution and jail.

GWEN IFILL: Dr. Barthwell, why shouldn’t doctors be able to recommend or at least even discuss the option of using marijuana as a palliative in cases of cancer or HIV, AIDS, or nausea?

DR. ANDREA BARTHWELL: Well, the facts here are that the Institute of Medicine did determine that there are constituent parts of marijuana that may in fact have some utility as medicine.

But they very clearly stated that there is no circumstance where nay would advocate for a smoked plant material to function as medicine. 21st century medicine requires that we function in that way, and we have a very time honored process of bringing medications to the marketplace after they have been tested for safety, after they have had their dosing profiles established and drug-drug interactions established. And the fact is that the constituent part of marijuana, which is useful in the treating of HIV wasting, nausea associated with chemotherapy, and potentially pain, is available to physicians to prescribe in the form of Marinol. And it shows tremendous promise in working in these areas, and the scientific study is on the verge of tremendous number of breakthroughs of manipulating the system where this medication works to solve a number of medical problems.

What we’re saying is that 21st century medicine dictates that we pursue the avenues that would allow us to develop the medications that would be useful in these disorders rather than turning our medical care system back to the 19th century where plant products were in fact distributed by snake oil salesmen for the treating of a number of symptoms and diseases.

GWEN IFILL: Will you suggesting, excuse me RRX you suggesting that doctors who would discuss this with their patients are snake oil salesmen?

DR. ANDREA BARTHWELL: No. What I’m suggesting is that physicians who are compassionate and practicing scientifically based, evidence based 21st century medicine would much prefer to use Marinol, which is available to them, than suggest that their patients smoke a plant. They would not want to engage in asking a patient to smoke opium to treat pain or to chew deadly Nightshade to stabilize their heart beat. And they have a medication that’s able.

GWEN IFILL: I’m sorry for interrupting. Let me ask Mr. Kampia about that. If there is a medication that exists on the market which has the elements of marijuana in it, why would you need to legalize an illegal drug in order to achieve the same end?

ROB KAMPIA: Well, I think that’s, the fact that this pill does exist shows that marijuana is a medicine. It would be like saying that vitamin c is good for you but an orange is not. Clearly, marijuana has chemical compounds in it that are medically beneficial.

The reason that some patients need to use marijuana and not the pill is because when you’re vomiting from cancer chemotherapy, you can’t keep a pill down oftentimes. And so some patients with their doctor’s recommendations actually need to smoke marijuana which allows them to get immediate relief if they’re vomiting.

GWEN IFILL: If marijuana remains, the law of the land, the federal law is that marijuana is illegal, how do, how does law enforcement distinguish between a stash of marijuana which was being grown for medical use and a stash that’s being grown for illegal use?

ROB KAMPIA: In some of these eight states where medical marijuana is legal there are ID card programs sets up by the state government where if a patient has cancer or AIDS or MS, they can get a card from the state, just like a drivers license, which tells the police that they should not arrest this person if they have marijuana.

GWEN IFILL: Dr. Barthwell, as you go and speak in local jurisdictions, as you’re doing in San Francisco which is of course the hotbed of this debate, what kind of reaction do you get from local officials who say to you, I think there’s a Proposition 215 which is on the books in California, in which there was a popular support for medical marijuana -

DR. ANDREA BARTHWELL: Well, local officials feel as if this is a tremendous hoax that is being perpetrated on the American people by frauds presenting themselves in white coats as if they’re physicians. There are no credible medical organizations that are clamoring to have a smoked weed on its medical formulary in the 21st century.

We have individuals who are celebrating what they’re claiming to be a victory because they know it is creating a greater tangle in the legal system, which is not solving a policy or a medical problem that is current, but creating policy and public health problems.

GWEN IFILL: Mr. Kampia –

DR. ANDREA BARTHWELL: And public officials are frustrated by this.

GWEN IFILL: Mr. Kampia, is this a legal debate, a cultural debate, a health debate, which is it?

ROB KAMPIA: I think the people in Andrea’s office think of it as a cultural debate, they think that somehow by allowing a cancer patient to use medical marijuana that that somehow is going to make marijuana legal for everyone. I would just like to respond to two factual inaccuracies that she just stated.

First she said that the politicians and local officials in San Francisco oppose this. That’s wrong. The board of supervisors of San Francisco, the board of supervisors of Oakland, even the district attorney of San Francisco, the top prosecutor, all think that marijuana should be legal for medical use, and when she says that there noise one in the medical establishment that supports this, she’s wrong. The American Nurses Association, which represents 2.6 million nurses, just passed a resolution, and I say, “they support legislation to remove criminal penalties, including arrest and imprisonment for bona fide patients and prescribers of therapeutic marijuana.”

GWEN IFILL: That’s where we’re going to have to leave the debate, whether it’s health, cultural or legal. Tonight, Dr. Andrea Barthwell, and Rob Kampia, thank you very much for joining us.

ROB KAMPIA: Thank you.