Marijuana: Therapeutic Access Threatened

In 1978 the Food and Drug Administration (FDA) approved a compassionate use program to make marijuana (Cannabis sativa) available to people diagnosed with glaucoma, multiple sclerosis or cancer. Outside of this access, of course, the government has made possession of marijuana a crime and a target of its war on drugs. A few years ago the FDA was pressured, over the objections of the Drug Enforcement Administration, into expanding marijuana access to people with HIV. But over the past several weeks, the news media have carried reports of the FDA's intentions to reverse this access.

Among those actively involved in this saga is the Marijuana AIDS Research Service (MARS), a project of the Alliance for Cannabis Therapeutics (ACT). MARS has helped many people with AIDS and their physicians obtain and complete the labyrinthine forms required by the FDA for compassionate release of marijuana.

We spoke to Robert Randall, the president of ACT and the first person to obtain marijuana for treating glaucoma. Robert told us that the FDA received more requests for marijuana in the first six months of 1991 than in the entire previous 13 years of the program's existence.

Dronabinol is a pharmaceutical version of marijuana's active agent THC, and is available by prescription under the trade name Marinol. Robert has been told by many people that dronabinol is not as effective for them as marijuana, for several reasons. For one, smoking marijuana can bring relief from nausea or poor appetite almost immediately, while dronabinol is an oral medication which may not take effect for over an hour. For another, marijuana consumption is easy to control, since it is smoked, while dronabinol is only available in specifically-dosed capsules. The Nursing 91 Drug Handbook cautions that dronabinol's effects may persist for days after the drug is taken.

In addition to relief from nausea attributed to both dronabinol and marijuana, some people have also reported to MARS increased emotional well-being and relief from neuropathy with marijuana use.

Theoretically, access for HIV use is still in place, but only for people already accepted into the program. Robert has heard various reasons for this move, mostly involving disputes within the government about the politics of admitting that marijuana has important medical value. The DEA in particular has long argued that marijuana holds no therapeutic benefits. But last year, the U. S. Court of Appeals ordered the DEA to reconsider its position.

MARS continues to assist physicians with completing the compassionate-use forms. Only physicians can apply to the FDA, and only for patients who present with nausea, vomiting or rapid weight loss. A donation of $15 is appreciated but not required for help from MARS. Interested persons can call 202/328-6391, or write to MARS, P. O. Box 21210, Kalorama Station, Washington, D. C., 20009.