|
We Update
Daily!
Custom Search
Chris S. Kenoyer. Owner &
MMJ Patient,
Medical Activist,
Online Patients Advocate,
Online News Journalist
My
Personal Medical Bio
Follow Us Now On Twitter
@MedicalMMJMan
Email Us Here
olpwebs@yahoo.com
Or
Email Us Securely Here
olpwebs@Safe-mail.net
TV
News Or Press Contact Info
The Website Audio &
Multimedia
Content!
Is Best
Viewed With Internet Explorer Browser!
********************************
Advertise Here
On OnlinePot
Rates As Low As $50 a Year
24/7 365 Days A Year
Of Sales!
********************************
OnlinePot Free Newsletter
The
Latest In MMJ News
Legal
Disclaimer
Guest Book
To translate text or
a web page go
to:
Language Tools
Google
Translations
Website
Submissions & News
Reports
Are Always
Gladly
Accepted Here.
Is CBD? A Possible
Cure For
Breast Cancer?
And All The Other
Many
Forms & Types
Of Cancer?
Learn
More About " CBD" Here
Cancer Cured:
A Cannabis Story
Website Navigational Links
*******************************************
Main
Start Page 2
*******************************************
Parody's
Cartoons US
Government Grown Pot,
Term Papers,
School
Reports, & Thesis's On
Marijuana & Cannabis
*******************************************
Amsterdam
A to Z
*******************************************
Canadian
Marijuana
Websites
*******************************************
Church's
& Pot Cannabis
*******************************************
Co-Ops, Clinics, Dispensary's
******************************************
Marijuana
Doctors & Clinics
*******************************************
Pot
Cooking Recipes
*******************************************
Drug
Testing A To Z
*******************************************
Pot Games
*******************************************
100's
Of Marijuana Grow Guides
*******************************************
Latest
Marijuana News Reports
*******************************************
Hash A- Z
*******************************************
Cannabis
Legal Info, Drug
Lawyers, State, Federal Laws,
State
& Supreme Court Rulings
*******************************************
POW's
Of The MMJ
War!
*******************************************
Other
Marijuana Websites
Websites
Link
Exchange!
*******************************************
Medical
Marijuana
Studies,
Research
Report's, Medical
Cannabis Clinic Study's
*******************************************
Avoiding Online MOM
Scammers
Newly
Re-Updated Info!
*******************************************
The Politics Of
Contraband
Medical Marijuana In The Mail?
*******************************************
The
Hall Of Shame Section
The Online MOM Scammers
*******************************************
Online MOM's Providers Ads
*******************************************
Politicians
&
Voters Rights
*******************************************
Medical
Marijuana, Strains
*******************************************
The OG
Marijuana Strain Guide
*******************************************
800+
FAQ Growing Questions
*******************************************
Marijuana & Pot Songs
Just Updated!
*******************************************
Patients
Spiritual
Guidance,
Free Online
Crisis Help Center
*******************************************
Online
Marijuana Seed Banks
*******************************************
Maximum Security
Section
Just Updated!
Hushmail.com Security Alert!
*******************************************
Traveling
Tips, Guides, B & B's
*******************************************
Vaporizers
A To Z
*******************************************
Online Pot Video's & Movies
*******************************************
Visit Our Sister Websites!
www.OLPInternetRadio.com
The
Reefer Madness
Teaching Museum.org
Listen Right Here Online!
To Original 1930-1950's
Reefer Madness Propaganda
Radio
Shows And Programs
Before TV
There Were "Radio Stars"
Maine
Patients Coalition.org
The
Reefer Madness Teaching Museum.org
1999-2011 Copyright ©
All Rights Reserved.
No part of this site maybe used or
reproduced in whole or in part
without
the written consent of the
Copyright
Owner Chris Kenoyer
www.onlinepot.org
OnlinePot assumes no legal
liability
for
any products, or
information or
news
posted, services
offered,
Or
any contests or give away's offered.
| |
Marinol vs. Marijuana:
Politics, Science, and
Popular Culture
Written by Kambiz. Akhavan
kamy@blaze.ca
Return
Back To Main Medical Reports Page
Marijuana
Marinol
Politics
and Medicine
Groups
favoring marijuana over Marinol
Footnotes
INTRODUCTION
Marijuana has been used as a medicine for millennia by cultures spanning the
globe. Ever since 1937, that medical necessity has fallen in America to
political pressure, and the cannabis plant remains illegal regardless of
intended use. Since then, patients have continued demanding marijuana's
therapeutic effects, thus prompting the pharmaceutical industry to find a
legitimate means of meeting their needs without violating federal law. This
quest for "legal weed" resulted in the introduction of dronabinol (a
synthetic drug commonly referred to by its trade name Marinol), into
contemporary American pharmacopoeia. However, this "solution" to the
medical marijuana question now poses a double standard: whereas, medical
marijuana users still face severe penalties, including loss of property and
mandatory incarceration, for therapeutically using an illegal substance, Marinol
users enjoy the benefits of marijuana's active ingredient, tetrahydracannibidol
(THC), without the criminal penalties or the social stigma. With this paradox in
mind, I intend to examine the vastly different public perceptions of these two
essentially similar substances, marijuana and Marinol, while framing this
complex analysis within a broader historical and theoretical structure. This
examination will focus first on each of these two drugs individually, and will
then illustrate the disparate public discourse in American pop culture
surrounding natural and synthetic THC, respectively. Without taking a definite
position on this hotly debated issue, this analysis will reveal how politics
influence science, how marijuana has garnered such a distinctively negative
reputation, and how Marinol has successfully appeased the anti-marijuana
American public.
MARIJUANA
Marijuana boasts a long and pertinent history of medicinal use, based in the
earliest known civilizations. The first recorded use of medical cannabis dates
back to 2800 B.C., when the Chinese Emperor Shen-nung used it as a muscle
relaxant and painkiller.1 The ancient Egyptians also found medical benefits in
cannabis, as evidenced by their usage of it to quell the pangs of childbirth.
Numerous other civilizations, including the Assyrians, Persians, Zulu,
Spaniards, and countless others, have since established traditional medical
applications of cannabis.2 Underlying this historical trend is the simple fact
that the medical benefits of marijuana have and continue to serve numerous
cultures.
Certainly, the medical use of marijuana was once commonplace in America, as
well. Over one hundred articles recommending cannabis were published between
1840 and 1900 alone. In fact, marijuana was a prominent part of the
pharmacopoeia from 1870 up until 1937, when the Marijuana Tax Act effectively
banned the plant from public consumption regardless of intended use. Employed
primarily as a painkiller during childbirth, as a treatment for asthma and
gonorrhea symptoms, and as a relaxant for anxiety-prone patients, marijuana was
formerly a well-documented drug in standard texts on pharmacology and
therapeutics. When Congress first considered banning the cannabis plant, the
respected American Medical Association (AMA) testified before federal committees
in defense of marijuana's medical applicability.3 Despite the AMA's efforts, the
political motivations behind outlawing the plant far outweighed any medical
considerations, and in 1937, cannabis became illegal. The sudden and severe
public reaction to this "new" drug was surprising, considering that no
one in America had even hear the word "marijuana" until the late
1920s. A closer examination of marijuana's entry into the American public
reveals the source of its stigmatization..
The term "marihuana" (later spelled "marijuana") was
invented in the early 1930s to confuse Americans who had positive associations
with hemp, a major cash crop, and cannabis, a well-known medicine and mild
intoxicant. By ascribing various social ills to the heavily maligned drug
"marihuana," politicians used this term, with which the public was
unfamiliar, to pass legislation banning an otherwise commonly known substance.
Numerous theories exist about the motives behind the sudden vilification of
cannabis; however, I will limit my analysis to those aspects of vilification
which underscore the strange relationship between politics and medicine. For
example, many newspapers reported that "degenerate Mexicans" smuggled
the evil "marihuana" into America, raping Anglo women, or murdering
innocent citizens while under its influence. These newspapers, ranging from
well-known national journals like the Christian Science Monitor and the
Washington Herald to little-known local papers like the Rocky Mountain Times,
contributed heavily to the growing anti-marijuana hysteria, by identifying
marijuana-crazed ethnic minorities as the root cause of crime in America.4 The
Federal Bureau of Narcotics offered this statement to corroborate these claims:
Police officials in cities of those states where it [marihuana] is most
widely used estimate that fifty per cent of the violent crimes
committed in districts occupied by Mexicans, Spaniards,
Latin-Americans, Greeks, or Negroes may be traced to this evil.5
Evidently, the medical necessity of cannabis could not withstand the
onslaught of such negative associations with marijuana, and political motives
ultimately swallowed medical concerns entirely.
Marijuana remained illegal in America for several years, although medical and
recreational use did not disappear whatsoever. Retaining popularity among
American subcultures, such as Black musicians in the 1940s, Beatniks in the
1950s, and Hippies in the 1960s (just to name a few), marijuana remained a
prominent aspect of social life despite its prohibition. In fact, cannabis
consumption reached well beyond the subcultures of these eras and into the
American mainstream. Many people from varying social backgrounds and ideologies
used marijuana at some point, solely for recreation, including current President
Bill Clinton, Vice-President Al Gore, Speaker of the House Newt Gingrich, and
countless doctors, lawyers, professors, and engineers, among others. While
recreational use remained popular, new medical uses for marijuana were also
discovered, prompting many suffering people to illegally medicate themselves.
The treatments of glaucoma, chemotherapy induced nausea, spastic disorders, AIDS
wasting away syndrome, and other less severe illnesses were significantly aided
with the therapeutic use of marijuana. Those same officials who tried the drug
recreationally now subject people with an obvious medical need for marijuana to
the constant threat of arrest for violating U.S. federal law.
Although authorities have perpetuated the vilification of marijuana since its
prohibition in 1937, they nonetheless responded partially to growing demands for
medical marijuana in 1969 by supplying researchers with government-grown
marijuana for scientific experimentation. The "pot farm" at the
University of Mississippi in Oxford raised thousands of cannabis plants (and
still grows them today) behind a 12 foot tall barbed wire fence for the National
Institute of Drug Abuse (NIDA), the federal agency which retains sole rights to
supply marijuana to researchers.6 Barrels of the low-grade marijuana get shipped
to the Research Triangle Institute in Raleigh, North Carolina where the dried
leaves are rolled at a cost of $2 per joint for patients participating in
experimental programs. This system of farming has resulted in a "highly
standardized ...reliable and reproducible method of administering the
drug." according to Dr. Monroe Wall of the Research Triangle Institute.
Thanks to research conducted with government pot acknowledging marijuana's
medical benefits, New Mexico boldly strayed from federal drug policy in 1978 and
passed the first state law recognizing the medical value of marijuana.
Comparable medical needs around the country prompted over 30 states to enact
similar legislation within the next few years. Glaucoma patient and medical
marijuana user, Robert Randall, remembers, "By the summer of 1980, there
was building pressure on the federal government to provide marijuana through an
experimental program." The most remarkable example of this growing trend
for medical marijuana consumption involved California's request for one million
joints from NIDA. Rather than accept the obvious solution to increase production
at the "pot farm" in order to meet the growing demand (a remedy deemed
"imponderable" by anti-marijuana government officials), bureaucrats
decided to pursue a pharmaceutical alternative. They hoped to encourage the
giant pharmaceutical industry to create a synthetic drug with properties similar
to cannabis.7
The first attempt to synthetically reproduce the medical effects of marijuana
failed miserably. The Eli Lilly pharmaceutical company had responded quickly to
the federal challenge by manufacturing nabilone, otherwise known as Cesamet,
which soon became hailed as the "great white drug" that would replace
marijuana. In 1978, they began double-track testing on cancer patients as well
as animals in order to gain FDA approval quicker; however, their lofty
aspirations came crashing down tragically, when dogs on nabilone suffered
convulsions and dropped dead. The door remained open, anticipating another
pharmaceutical product to fill the marijuana demand.8
MARINOL
In pertinence to the history of medical marijuana, Congress' passing of the
Controlled Substances Act of 1970 added a new dimension to the cannabis as
medicine controversy. Upon ranking the various drugs according to levels of
danger, the Act placed marijuana in Schedule I, the most dangerous category. In
order to attain Schedule I classification, a drug must meet three requirements:
1) high potential for abuse; 2) no accepted safety even under supervision; and
most significantly, 3) no medical use.9 In placing marijuana in Schedule I, the
government not only ignored cannabis' previous medical use in this country, but
also overlooked the numerous experiments proving the drug's therapeutic
efficacy. Still, bureaucrats needed to help severely ill patients without
acknowledging marijuana as a potential therapeutic agent. The government prayed
for a pharmaceutical alternative to marijuana, and with Marinol's entrance into
the medical arena, their prayers were adequately answered.
In 1980, the National Cancer Institute (NCI) began experimental distribution
of a new drug called Marinol, an oral form of THC (the primary active ingredient
in marijuana), to cancer patients in San Francisco. Simultaneously, six states
conducted studies comparing smoked marijuana to oral THC in cancer patients who
had not responded to traditional antivomiting medication. These state-sponsored
studies revealed that thousands of patients found marijuana safer and more
effective than synthetic THC. Meanwhile, the NCI experiments showed that some
patients responded well to Marinol, although one patient reportedly stormed into
her doctor's office and accused him of trying to poison her with the drug (the
doctor later dropped out of NCI's experimental program). Confronted with two
different medical recommendations, the government chose to dismiss the state
studies and give Marinol the green light. In 1981, the government sold the
Marinol patent to a small pharmaceutical company named Unimed based in
Somerville, New Jersey. By 1985, after one unsuccessful attempt at FDA approval,
Marinol was finally approved as a Schedule II drug (a relatively quick approval
by FDA standards). Thus, Unimed, with government backing, began targeting
terminal cancer patients in order to accumulate profit.10
With Marinol's acceptance behind them, executives at Unimed launched a
massive sales enterprise in conjunction with their distributor Roxanne
Laboratories, a subsidiary of pharmaceutical giant Boehringer-Ingelheim. A
combined sales force of about 60 people roamed the country promoting Marinol to
oncologists and AIDS doctors. Building from early profits, Unimed invested money
into testing new uses for Marinol. In 1992, the drug received approval as an
appetite stimulant for patients with AIDS cachexia, otherwise known as wasting
away syndrome. This new use coupled with Marinol's recent approvals in various
international markets, like South Africa (where it is marketed under the trade
name Elevat) with its incredibly high AIDS rate, along with Canada, Puerto Rico,
Israel, and Australia, significantly boosted Unimed's profits and prestige.11
Furthermore, the FDA granted Marinol the highly prized Orphan Drug Status, a
privilege that allowed Unimed exclusive manufacturing rights to Marinol, as well
as protocol assistance, and tax breaks for its investors.12 As a business,
Unimed still specializes primarily in niche pharmaceutical markets, namely AIDS
drugs. However, among the few drugs manufactured by Unimed, Marinol easily
garners the highest profits, drawing in over 90% of total revenues.13 Unimed has
reported greater sales nearly every year since 1985, reaching a high of $9.7
million in 1995. President and CEO Stephen Simes predicted that sales will reach
between $50-100 million by the year 2000.14 Based on their growth rate, this
figure seems unlikely; however, the company clearly has high hopes.
Despite enormous financial backing and rapid FDA approval, few proponents of
Marinol are aware of the intricate, physical processes involved in manufacturing
synthetic THC. Unlike marijuana which requires only light, water, and some
nutrients to grow, Marinol manufacture involves numerous time-consuming steps,
the efforts of several companies, and multiple complex chemical processes.
Unimed contracts Norac Industries in Azusa, California to manufacture the
synthetic THC which is then shipped to Roxanne Laboratories in Columbus, Ohio
where it is encapsulated and sent to pharmacies around the country. Intrigued by
the process of synthetically reproducing a natural psychoactive product, I
interviewed an informant at Norac extensively. Apparently, the basic elements of
delta 9 tetra-hydra-cannibidol, marijuana's primary-though by no means
only-active ingredient, are derived from the compounds tempere olivitol and
paramenthide (PMD). Norac used to purchase olivitol from Aldrich Labs, but opted
to manufacture it themselves in order to save money. Norac also used to acquire
its other raw material, PMD, from the German lab Ferminic until frequent
explosions caused the company to halt its PMD production. As of 1993, Norac was
forced to produce its own PMD as well. My informant at Norac explained that they
too have experienced explosions due to the highly unstable characteristics of
PMD, but that the volatile compound currently remains largely in check. The
final synthetic THC solution is approximately 98% pure-a very high concentration
compared to that of the cannabis plant, where THC amounts normally range between
2% and 10%.15 Since the Orphan Drug Status for chemotherapy related nausea
expired in 1992, I assumed that other pharmaceutical companies would attempt to
infiltrate Marinol's markets by producing their own versions of synthetic THC.
However, my source at Norac explained that manufacturing THC is a very
expensive, and thus cost-prohibitive, process.16 The encapsulation procedure
also requires elaborate and expensive chemical processes that use fairly common
preservatives like methylparaben and propylparaben, as well the whitening agent
titanium dioxide, in a sesame oil capsule.17 The once unstable synthetic THC
compound now has a long shelf-life in the sesame oil capsules, although all
Marinol products are marked with 6 month expiration dates for added safety.18
Obviously, reproducing marijuana's therapeutic effects is no easy task, even
with today's most cutting-edge technologies.
Since marijuana and Marinol derived from two entirely different processes
(arguably polar opposites), it seems ironic that Marinol functions as the only
legal alternative to marijuana. Considering their vastly disparate backgrounds,
one can logically conclude that the therapeutic effects must also differ, but
according to many researchers, the results are essentially the same. In fact,
the two drugs' reported side effects are quite similar, although advocates of
medical marijuana claim that Marinol produces more damaging side effects.
Marinol proponents argue, in turn, that marijuana possesses more undocumented
side effects. Upon analyzing a 1995 product brochure explaining the benefits and
possible effects of using Marinol, I discovered new information that completely
undermined my original assumptions about Marinol.
Considering that Marinol is legal while marijuana is not, I assumed that
Marinol would have far fewer side effects than those attributed to marijuana;
however, this assumption and numerous others proved quite inaccurate. According
to the 1995 product insert, Marinol may be habit forming, a condition commonly
linked with cannabis. In addition, Marinol may cause the following side effects:
feeling "high" (i.e. easy laughing, elation, and heightened
awareness), abdominal pain, dizziness, confusion, depression, nightmares, speech
difficulties, chills, sweating, and even psychological and physiological
dependence.19 Some of these potential side effects seem quite serious for any
legal pharmaceutical. Even less comforting, the 1992 product insert explains
what to do in case of accidental overdose:
A potentially serious oral ingestion, if recent, should be managed with gut
decontamination. In unconscious patients with a secure airway, instill activated
charcoal via a nosagastric tube. A saline cathartic or sorbitol may be
added to the first dose of activated charcoal. Patients experiencing depressive,
hallucinatory or psychotic reactions should be placed in a quiet area
and offered reassurance.20
Considering the enormous sales of Marinol, patients must desperately need
medication to risk such potentially severe reactions. While marijuana may
produce such side effects as: euphoria, laughter, anxiety, dry mouth, red eyes,
sleepiness, clumsiness, increased appetite; these conditions pale in comparison
to those attributed to Marinol. A 1985 edition of The Medical Letter listed the
side effects of Marinol as "disorientation, depression, paranoia,
hallucinations, and manic psychosis." A 1986 Marinol product insert
explains that even patients on low doses of the drug may experience "a
full-blown picture of psychosis;" this reference was conspicuously dropped
from their later product inserts.21 Given the intensity of Marinol's side
effects, marijuana appears less dangerous than its synthetic Schedule II
counterpart.
Many patients believe that the much higher THC content in Marinol produces
these more extreme side effects. Robert Randall, a glaucoma patient who
currently receives a legal supply of marijuana from the government, describes
his experiences with Marinol, "It was way too psychoactive. When I took
Marinol, I found it anxiety-provoking and intense, like I had wandered into a
short story by Flannery O'Connor." He further explains, "I talked to
hundreds of AIDS patients, and only one preferred Marinol to marijuana. It's not
just that marijuana helps them gain weight-it's that Marinol is so scary."
Dr. Robert Gorter, a San Francisco AIDS expert, corroborated Randall's anecdotal
conclusions in the Journal of the Physicians Association for AIDS where he
stated, "Again and again patients have testified that they preferred
marijuana above dronabinol [the scientific term for Marinol]..."22 Further
evidence citing the potential dangers of Marinol exists in the 1995 Marinol
product insert itself, which warns against giving dronabinol to children and to
the elderly (although Unimed is currently in Phase III testing for approval of
Marinol in the treatment of Alzheimer's patients) because of the drug's
"psychoactive effects."23 It seems odd that Marinol supposedly
functions better as a medicine than marijuana, a substance casually consumed by
millions of Americans without such debilitating side effects.
Hoping to discover specific patient complaints against Marinol, and not just
potential side effects or anecdotal information, I contacted the Food and Drug
Administration (FDA) for more information on adverse effects caused by Marinol.
I was told that this information was confidential, and that only by using the
Freedom of Information Act (and enclosing a check for $70) could I attain
limited access to this knowledge, and even then, certain details would remain
censored.24 By contrast, if I needed information on marijuana's adverse effects,
I could contact hundreds of sources (including elected officials, rehabilitation
centers, law enforcement, internet sites, parent groups, local libraries,
pharmacies, etc.) from whom I could receive a deluge of free information.
Another medical paradox exposing the sharp contrast between the popular
conception of marijuana and Marinol involves carcinogenic studies.
Anti-marijuana government studies had very tentatively linked marijuana smoke
(and not ingested marijuana) with lung cancer in an unpublished report (although
a recent panel of scientists re-examined that report and found that marijuana
was actually found to prevent malignancies not cause them).25 Despite the
presence of THC, common to both marijuana and Marinol, no carcinogenic studies
have been performed on Marinol.26 Culturally, marijuana continues to face
vilification while Marinol enjoys legitimacy and government backing. Sick people
face harsh criminal penalties for self-medicating with natural THC, while
patients using synthetic THC get insurance coverage and freedom from persecution
and prosecution. The influential role that politics plays in science and
medicine can explain the enormous rift in the cultural perception of these two
essentially similar substances. Only a close examination of political influence
in medicine can explain popular culture's polarity regarding marijuana and
Marinol perception.
POLITICS AND
MEDICINE
Medicine may seem like a domain completely outside of political debate, but
the information garnered in this examination thus far suggests otherwise.
Scientists and medical researchers compete for funding from government agencies
and private business. If the government has strong anti-marijuana policies, then
logically, the studies which they fund will attempt to further indict marijuana.
John Falk, a researcher from Rutgers University, explains,
Policy can be a closed, self-validating system, almost impervious to
scientific facts: While science considers new facts and alternative
explanations and rejects them on logical or empirical grounds, policy
can be dismissive of facts and alternatives simply on the grounds that
they are distasteful.27
Governments regularly accept or reject scientific studies based on their
relation to desired policies. For example, President Richard Nixon hand-picked a
federal commission to determine an improved marijuana policy. After several
years of research, the commission concluded that decriminalization of marijuana
was the best drug policy option. Since this result was intolerable to the drug
warrior Nixon, he ignored the recommendations of his own counsel.28 Another
example of government ignoring science involves the Compassionate Investigative
New Drug (IND) program which supplied government grown medical marijuana to a
handful of patients from 1978 until 1992. Due to a rising number of applications
from AIDS patients, President George Bush terminated the program, not because it
harmed people or led to increased drug abuse, but because he wanted a
"zero-tolerance" stance towards all illegal substances in his War on
Drugs, and because the legal pot might "send the wrong message" to
children. Only eight patients (known as the Acapulco Eight) continue to receive
medication under that program thanks to a hard-fought grandfather clause; the
rest have already died. 29
The terminology spouted by politicians in the War on Drugs further
illuminates the often subtle (or not so subtle) relationship between politics
and medicine. From the popular phrase of the 1930s referring to marijuana as the
"assassin of youth," to contemporary use of such militaristic phrases
as "war on drugs" or "combating the drug menace," such
highly dramatic linguistic manipulation reveals an underlying attempt to
influence the uncritical American public.30 In the 1930s, marijuana intoxication
was popularly referred to as "reefer madness," implying insanity,
unpredictability, and hyperactivity. Today, the terminology for that same state
of intoxication has shifted 180 degrees to "amotivational syndrome,"
implying indolence and slovenliness. The complete inversion of negative
accusations maligning marijuana only reveal how arbitrary and unfounded the
indictments really are.31 Continuing the semantic war after the passage of
Proposition 215 in California and Proposition 200 in Arizona, federal
bureaucrats, including "Drug Czar" Barry McCaffrey, quickly claimed
that voters were "duped" by wealthy "potheads" promoting
"Cheech and Chong medicine."32 Anti-marijuana rhetoric continued
streaming from the lips of politicians and from newspaper presses despite the
majority approval of both propositions. Like medical authority, Stanton Peele,
remarked, "To put it simply, saying bad things about drugs is never
questioned, and disconfirming information never requires revision of original
claims."33 Medical issues lay dormant under the political cloud raised by
vociferous opponents of marijuana, while advocates only prayed that a strong
grassroots effort would influence public opinion to the extent of changing
policy. Even though voters approved both propositions, the Clinton
administration announced that physicians prescribing marijuana were still
subject to criminal punishment, proving that neither medical arguments, nor
voter approval, can change an entrenched government policy.
During these medical marijuana debates, Marinol remained elusive, yet
ever-present. Newspapers and magazines loosely referred to dronabinol as a legal
alternative to smoked marijuana, although very few reporters commented on
Marinol's numerous side effects, or on patient claims that marijuana worked much
better than synthetic THC. Unimed's National Sales Director, Brian Jennings,
explained to me in a telephone interview that Unimed knew about the propositions
before hand but chose not to officially participate, because they felt medicine
should remain outside of the political sphere. Jennings stated, "It is not
for us to determine what should be medicine and what shouldn't." When asked
if Unimed had received thank you mail from recovering patients, Jennings
exuberantly responded, "Yes! But you won't hear that on the media,"
meaning positive representations of Marinol allegedly pale in comparison to
those of marijuana, a favorite topic of journalists. Based on this telephone
interview, it seemed as if Unimed was sincerely interested in helping sick
people, and not in fanning the flames of marijuana hysteria, or simply in making
larger and larger profits. 34 However, after carefully reading their roughly 200
page investor portfolio, only one mention was made of assisting sick people in
need. The bulk of their literature focused on profits, plans, and bottom
lines.35
To guarantee that they lost no precious profits to decriminalized marijuana,
Unimed hired a top public relations firm during the West Coast medical marijuana
debates. This publicity company sent news releases to every major newspaper in
America explaining the existence of Marinol and its benefits over marijuana.36
Although Unimed's National Sales Director informed me that his company preferred
not to participate in the debates, he neglected to mention that they had hired
someone to participate for them. In these press releases, much of the
information was exactly accurate; however, several statements were simply
untrue. Unimed claimed that "patients using Marinol do not experience a
'high' and are thus able to work and perform normal daily functions
unimpaired."37 This claim directly contradicts Marinol's 1995 product
insert which explains that "dose-related 'high' has been reported by
patients receiving Marinol..."38 Evidently, Unimed hoped to draw a clear
distinction between Marinol and marijuana, and although numerous differences
already exist, they chose to create false ones, hoping to capitalize on the
further maligning of cannabis. Other examples of Unimed's attempt to infiltrate
mainstream media with marijuana lies include the blatantly false claim that
Marinol pills are taken only once per day, while marijuana must be smoked
several times per day, thereby causing inconvenience, lung damage, and other
more serious complications.39 The user directions on Marinol's product insert
specifically state that two capsules per day are required as a starting dosage,
after which more daily capsules are suggested.40 In addition, medical marijuana
consumers self-medicate as needed; which, for patients using cannabis to prevent
the nausea associated with chemotherapy, equals about one cigarette every few
weeks.41
Although the Unimed press release cites the absence of controlled clinical
studies proving marijuana's safety and effectiveness, such studies remain
impossible to conduct because of NIDA's refusal to grant cannabis to researchers
who support medical marijuana. Dr. Donald Abrams of the San Francisco Community
Consortium gained authorization from the FDA and the National Institute of
Health (NIH) to study marijuana and Marinol's effects in AIDS cachexia.42
Unfortunately, NIDA denied him access to their pot supplies. They claimed that
if they granted marijuana to Dr. Abrams then they might become deluged by other
research proposals requiring marijuana.43 This bureaucratic entanglement
represents one aspect of drug policy in popular culture; however, to fully
explore the scope of this issue, one must examine the debate through more
mainstream media sources.
Americans consistently support medical marijuana in polls, but that majority
seems to disappear in the public sphere. While Rolling Stone magazine contends
that the war on marijuana exists for political purposes completely outside of
medical considerations, the New Republic argues that Proposition 215 serves as a
front for drug legalization advocates and that medical cannabis clubs are
populated by a "sorry lot of smokers who are not sick."44 This
disparity in public opinion mirrors itself regularly throughout popular American
culture. For example, a Los Angeles Times Column Right author, Charles
Krauthammer, angrily exclaimed, "The cannabis clubs are a sham, an
invitation to every teenager with a hangnail to come in and zone out."45 In
contrast, the Los Angeles gay magazine 4Front ran a cover article titled,
"Clinton/McCaffery Declare War on People With AIDS!!!," wherein they
vehemently declare, "This two bit General [McCaffery] has declared war on
people with AIDS. It's outrageous that the President who 'didn't inhale' is
denying sick and dying people the relief that medical marijuana
provides."46
Further examples of the public polarizing around this issue abound throughout
American pop culture. For instance, Newsweek magazine claimed that, "The
problem with Marinol is that is doesn't always work as well as smoking
marijuana.", while my local newspaper, The Daily Breeze, printed an article
claiming that, "With smoked pot, the dosage varies substantially, so it is
usually a lot easier to prescribe a pill."47 Gary Trudeau, creator and
cartoonist of Doonesbury, also joined the cultural melee by creating a Sunday
comic strip about Proposition 215. When the main character, Zonker Harris,
learns about California Attorney General Dan Lungren's massive raid on the San
Francisco Cannabis Buyer's Club, he incredulously asks, "What country are
we living in? Germany? Russia? Idaho?" Lungren must have realized that a
major act of aggression against a medical supplier to severely ill patients
would not earn him much popularity; however, Trudeau's biting comic strip
angered him so much that he demanded Doonesbury's distributor, Universal Press
Syndicate, to promptly remove the comic. Much to his chagrin, they refused.48
Even advice columnist Ann Landers joined in the cannabis debate by stating,
"I do believe that medical marijuana should be available for medical needs,
since this serves a humane purpose." Although other contributors to her
column challenged her position, citing marijuana's alleged "gateway"
effect leading to harder drugs. One respondent from La Grange, Illinois,
sarcastically commented, "[the] idea of releasing marijuana prisoners is
great, but...doesn't go far enough. Let's release all of the murderers
too...Free the rapists. Then, put all the child molesters back on the
streets." Clearly, passion underlines all opinions, but consensus seems
hopeless.
The medical marijuana versus Marinol debate rages among medical practitioners
as well. After DEA Associate Chief Counsel Steven Stone suggested that only a
fringe group of oncologists accepted marijuana as an antiemetic, two Harvard
scholars conducted a poll to verify that statement, and discovered a vastly
different reality. They sent detailed questionnaires to over 2,000 registered
oncologists, and found that 44% of respondents think that marijuana is safe and
efficacious, and would prescribe it regardless of legality. Nearly 90% of
respondents accepted the medical use of Marinol, thereby leaving dozens of
doctors who reject its use. Interestingly, respondents who graduated from
medical school during the "Just Say No" Reagan era were significantly
less likely to favor medical marijuana, while those who graduated in the 50s,
60s, and 70s had higher rates of approval. Based on these findings, the study's
authors concluded that smoked marijuana remains superior to oral THC because:
The bioavailability of THC absorbed through the lungs has been shown to be
more reliable than that of THC absorbed through the gastrointestinal tract,
smoking offers patients the opportunity to self-titrate dosages to realize
therapeutic levels with a minimum of side effects, and there are active agents
in the crude marijuana that are absent from pure synthetic THC.49
The two essential points that greater bodily absorption and greater
self-medicating control are possible with medical marijuana use (and not Marinol
use) cannot even be denied by much hyped anti-marijuana studies, like those of
the notorious Dr. Gabriel Nahas.50 The argument that marijuana contains more
than one active ingredient, thereby implying that Marinol cannot possibly
replicate all of marijuana's medical effects, finds favor among many physicians
and physicians' groups. Arthur Leccese of Gambier College further explains this
sentiment, "Consideration of the basic pharmacology of marijuana reveals
the error of public policy that denied therapeutic benefit to those who might
profit from inhalation, or oral consumption of more than one psychoactive
component of the crude marijuana plant."51 Since marijuana is composed of
hundreds of compounds, it seems arbitrary for U.S. medical policy to only accept
one of those compounds as medically valid. Many other respected organizations
share this disapproval of current U.S. drug policy.For
example, the following medical groups and journals favor medical marijuana over
Marinol: National Academy of Sciences, American Public Health Association,
California Academy of Family Physicians, San Francisco Medical Society,
Federation of American Scientists, Psychopharmacology, and most recently, the
New England Journal of Medicine.52 Although these organizations normally carry
tremendous influence, the current government drug policy disfavors medical
marijuana to such an extent, that even these organizations lose their voice.
With prominent medical organizations and journals being ignored by federal
policy makers, and with many mainstream magazines and newspapers creating a
general uproar over the medical marijuana issue, the recent furor in America
sparked by the passage of Propositions 200 and 215 truly highlights the
relationship between science and politics. Dennis Peron, the driving force
behind Proposition 215, wonders, "What in the world is a retired Army
general doing telling doctors what to do?"53 Regardless of their position
on synthetic vs. natural THC, most doctors agree that government does not belong
in their medical affairs. Some oncologists find it extremely hypocritical that
someone can acquire terminal cancer by smoking cigarettes, yet they cannot
medicate themselves with marijuana. Cancer specialist, Elizabeth Lowenthal,
writes about this paradox in the Journal of the American Medical Association,
It is ironic to inform cancer patients that they cannot partake of marijuana
to relieve their metastatic lung cancer associated anorexia and cachexia
acquired from years of partaking in 'the only consumer product sold legally in
the United States that is unequivocally carcinogenic when used as directed.'54
Prominent medical marijuana expert Lester Grinspoon, author of Marihuana: The
Forbidden Medicine, illuminates another paradox in U.S. drug policy, stating
that, "Cocaine and morphine, for example, have always been available as
prescription drugs, but no one believes that availability is a significant cause
of illicit use."55 Both cocaine and morphine have maintained Schedule II
classification since the Controlled Substances Act began in 1970. Marinol also
rests in Schedule II, although Brian Jennings, National Sales Director for
Unimed, informed me, "I think it is well known that we are trying to place
Marinol in Schedule III."56 By dropping down to Schedule III, Unimed can
sell Marinol without completing the mandatory DEA paperwork required of all
Schedule II drugs. In essence, it would remove another level of bureaucratic
interference from sales, and it would make their product seem less potentially
harmful. All of these sorts of medical, governmental, theoretical, policy-based,
complex issues sit squarely in the borderlands shared between science and
politics.
Having extensively analyzed the Marinol versus marijuana debate from a
popular culture perspective, and within a historical and theoretical context, it
is now apparent just how differently America treats two essentially similar
substances. Marinol enjoys cultural and medical legitimacy from society, as well
as tax breaks and open market privileges from the government. Marijuana users
still risk incarceration and social marginalization, while simultaneously
suffering from debilitating illnesses. Despite the wealth of scientific
information and the bevy of organizational support illustrating marijuana's
numerous medical benefits, the federal government chooses to validate the
inferior Marinol medication, and to continue its war on drugs and drug users.
Considering America's history of vilifying marijuana, and given the American
penchant to promote pharmaceuticals over all other medicines, the current drug
policy should not shock us, but it should disappoint us.
1 Mikuriya, Todd H., Ed. Marijuana: Medical Papers
(1839-1972). Oakland: Medi-Comp Press, 1973. p. i.
2 Bonnie, Richard and Charles Whitebread II. The Marihuana Conviction: A
History of Marihuana Prohibition in the United States. Charlottesville:
University Press of Virginia, 1974. p. 1-2.
3 Bonnie, Richard and Charles Whitebread II. p. 54, 64.
4 Ibid. p. 92.
Musto, David. The American Disease: Origins of Narcotic Control. Oxford:
Oxford University Press, 1973. pp. 219-223.
Walker, William III. Drug Control in the Americas. Albuquerque: University of
New Mexico Press, 1981. p. 99-117.
5 Bonnie, Richard and Charles Whitebread II. p. 100.
6 Meyer, Eugene. "Uncle Sam's Farm." Los Angeles Times. 11 December
1995: E1
7 Scott, Elsa. "Marinol: The Little Synthetic That Couldn't."
http:www.hightimes.com/ht/tow/med/marinol.html. passim.
8 Ibid.
9 International Narcotics Control and United States Foreign Policy: A
Compilation of Laws, Treaties, Executive Documents, and Related Materials.
Prepared for the Committee on Foreign Affairs, U.S. House of Representatives.
Washington, D.C." U.S. Government Printing Office, 1994. p. 119.
10 Scott, Elsa. passim.
FDA Consumer. September 1985. p. 35.
Grabowski, Henry and John Vernon. The Regulation of Pharmaceuticals:
Balancing the Risks and Benefits. Washington, D.C.: American Enterprise
Institute for Public Policy Research, 1983. p. 23.
11 Unimed Investor Portfolio, 1997.
12 Ibid.
Doblin, Rick. "MDMA Patentability and Orphan Drug Designation."
Multi-Disciplinary Association for Psychedelic Studies. 1995.
13 John G. Kinnard & Co. Research Report. 08/27/96. Unimed
Pharmaceuticals, Inc. p. 2.
14 Unimed Investor Portfolio, 1997.
15 Interview with informant at Norac Industries. 03/03/97.
Scott, Elsa. passim.
16 Interview with informant at Norac Industries. 03/03/97.
Scott, Elsa. passim.
17 Interview with UCLA Department of Chemistry pharmaceutical expert.
03/03/97.
Unimed Investor Portfolio, 1997.
18 Interview with informant at Norac Industries. 03/03/97.
19 Marinol product insert. Published by Roxanne Laboratories. 1995.
20 Scott, Elsa. passim.
21 Ibid.
22 Ibid.
23 Marinol product insert. Published by Roxanne Laboratories. 1995.
Unimed Investor Portfolio, 1997.
24 Interview with a legal expert at the Food and Drug Administration.
02/24/97.
25 Knox, Richard. "Study may undercut marijuana opponents - Report says
THC did not cause cancer" Boston Globe. 30 January 1997: A1.
Scott, Elsa. passim.
26 Ibid.
Marinol product insert. Published by Roxanne Laboratories. 1995.
27 Falk, John. "Environmental Factors in the Instigation and Maintenance
of Drug Abuse." Bickel, Warren and Richard DeGrandpre, Eds. Drug Policy and
Human Nature: Psychological Perspectives on the Prevention, Management, and
Treatment of Illicit Drug Abuse. New York: Plenum Press, 1996. p. 4.
28 Musto, David. pp. 262-263.
29 Meyer, Eugene. P. E4-E5.
30 Heath, Dwight B. "War on Drugs as a Metaphor." Bickel, Warren
and Richard DeGrandpre, Eds. Drug Policy and Human Nature: Psychological
Perspectives on the Prevention, Management, and Treatment of Illicit Drug Abuse.
pp. 279-280.
Walker, William III. p. 99.
31 Heath, Dwight B. p. 287.
DeGrandpre, Richard. "Socially Constructed Knowledge and Drug
Policy." Bickel, Warren and Richard DeGrandpre, Eds. Drug Policy and Human
Nature: Psychological Perspectives on the Prevention, Management, and Treatment
of Illicit Drug Abuse. p. 316.
32 Gorman, Peter. "Feds Fly Anti-Pot-Doc Balloon" High Times. April
1997. p. 20.
33 Peele, Stanton. ""Drugs and the Marketing of Drug Policy."
Bickel, Warren and Richard DeGrandpre, Eds. Drug Policy and Human Nature:
Psychological Perspectives on the Prevention, Management, and Treatment of
Illicit Drug Abuse. p. 201.
34 Interview with Unimed National Sales Director, Brian Jennings. 02/24/97.
35 Unimed Investor Portfolio, 1997.
36 Interview with National Organization for the Reform of Marijuana Laws
representative. 02/20/97.
Unimed Investor Portfolio, 1997.
37 Ibid.
38 Marinol product insert. 1995.
39 Unimed Investor Portfolio, 1997.
40 Marinol product insert. 1995.
41 Grinspoon, Lester and James Bakalar. "Marijuana as Medicine."
Journal of the American Medical Association. December 20, 1995. p. 1838.
42 Voelker, Rebecca. "Medical Marijuana: A Trial of Science and
Politics." Journal of the American Medical Association. June 1, 1994. p.
1645.
43 Brookhiser, Richard. "Lost in the Weed." U.S. News and World
Report. January 13, 1997. P. 9.
44 Nadelmann, Ethan A. and Michael Simmons. "Reefer Madness 1997: the
New Bag of Scare Tactics." Rolling Stone. February 20, 1997. pp. 51-55.
Rosin, Hanna. "The Return of Pot: California Gears Up for a Long Strange
Trip." New Republic. February 17, 1997. pp. 18-25.
45 Krauthammer, Charles. "Pot Lovers Are Hiding Behind the Terminally
Ill." Los Angeles Times. 11 January 1997: B7.
46 "Clinton/McCaffery Declare War on People With AIDS!!!" 4Front.
January 22, 1997. pp. 19.
47 Adams, Emily and Lee Peterson. "Hazy Future for Legal
Marijuana." The Daily Breeze. 18 November 1996: A4.
Conant, Marcus. "This Is Smart Medicine" Newsweek. February 3,
1997. p. 26.
48 Weinberg, Bill. "The California Medical-Marijuana Rebellion."
High Times. April 1997. p. 48.
49 Doblin, Rick and Mark A.R. Kleiman. "Marijuana as Antiemetic
Medicine: A Survey of Oncologists' Experiences and Attitudes." Journal of
Clinical Oncology. July 1991. pp. 1314-1319.
50 Nahas, Gabriel and Colette Latour, Eds. Cannabis: Physiopathology,
Epidemiology, Detection. Boca Raton, Florida: CRC Press, 1993. p. 6.
51 Leccese, Arthur P. "Pharmacology of Psychoactive Drugs." Bickel,
Warren and Richard DeGrandpre, Eds. Drug Policy and Human Nature: Psychological
Perspectives on the Prevention, Management, and Treatment of Illicit Drug Abuse.
pp. 240-241.
52 "About Medical Marijuana" Published by National NORML.
www.norml.com.
Chait, L.D. and James P. Zacny. "Reinforcing and Subjective Effects of
Oral Delta 9 THC and Smoked Marijuana in Humans." Psychopharmacology.
Spring 1992. pp. 255-262.
53 Condor, Bob. "Marijuana's Therapeutic Value Impresses the Ill."
Chicago Tribune. 5 January 1997: A1.
54 Lowenthal, Elizabeth A. "Marijuana as Medicine." Journal of the
American Medical Association. December 20, 1995. p. 1837.
55 Grinspoon, Lester and James Bakalar. p. 1838.
56 Interview with Unimed National Sales Director, Brian Jennings. 02/24/97.
Return
Back To Main Medical Reports Page
|
Button Ad
Spaces 
