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Wednesday, April 07, 2004
Stealing the Presidency, Again
Just because George W. Bush was successful in stealing the presidential election a second time, doesn't retroactively legitimize his stealing of it the first time. Neither does his being illegally "elected" change the fact that he is a liar, a traitor to the armed forces at his command and an international war criminal.
Exposure of troops and civilians to the radiation left by depleted uranium munitions qualifies Bush as a sociopath whose disregard for science is resulting in the death and deformation-at-birth of thousands of Iraqis and Americans.
http://www.iacenter.org/depleted/du.htm
http://www.theage.com.au/articles/2003/04/17/1050172706047.html?oneclick=true
Anyone who believes that Bush was honestly voted into office last Tuesday would do well to read
http://www.commondreams.org/headlines04/1105-25.htm
http://www.commondreams.org/views04/1106-30.htm
How predictable that the cheaters have cheated again. How sad that John Kerry was so easily conciliatory, without waiting for verification of an honest vote.
Americans must insist on accountability in our electoral process and the unlawful activities of our government if we do not wish to be culpable for rampant military/chemical/industrial Imperialism, wreaking havoc in the world, eroding our environment, economy and social evolution.
Checks and balances in our government have been subverted by a dysfunctional process. Rather than sheepishly accepting the recent disingenuous manipulation by an outlaw administration, it is critical for the American public to confirm the veracity of the election results. If it isn't possible to do this, because of the inadequacy of the machines used, then another election is called for, one whose accuracy can be ascertained.
Paul J. von Hartmann
Project P.E.A.C.E.
Planet Ecology Advancing Conscious Economics
http://www.webspawner.com/users/projectpeace
Just because George W. Bush was successful in stealing the presidential election a second time, doesn't retroactively legitimize his stealing of it the first time. Neither does his being illegally "elected" change the fact that he is a liar, a traitor to the armed forces at his command and an international war criminal.
Exposure of troops and civilians to the radiation left by depleted uranium munitions qualifies Bush as a sociopath whose disregard for science is resulting in the death and deformation-at-birth of thousands of Iraqis and Americans.
http://www.iacenter.org/depleted/du.htm
http://www.theage.com.au/articles/2003/04/17/1050172706047.html?oneclick=true
Anyone who believes that Bush was honestly voted into office last Tuesday would do well to read
http://www.commondreams.org/headlines04/1105-25.htm
http://www.commondreams.org/views04/1106-30.htm
How predictable that the cheaters have cheated again. How sad that John Kerry was so easily conciliatory, without waiting for verification of an honest vote.
Americans must insist on accountability in our electoral process and the unlawful activities of our government if we do not wish to be culpable for rampant military/chemical/industrial Imperialism, wreaking havoc in the world, eroding our environment, economy and social evolution.
Checks and balances in our government have been subverted by a dysfunctional process. Rather than sheepishly accepting the recent disingenuous manipulation by an outlaw administration, it is critical for the American public to confirm the veracity of the election results. If it isn't possible to do this, because of the inadequacy of the machines used, then another election is called for, one whose accuracy can be ascertained.
Paul J. von Hartmann
Project P.E.A.C.E.
Planet Ecology Advancing Conscious Economics
http://www.webspawner.com/users/projectpeace
Criminal President, Outlaw Nation
When I enlisted in the United States Marine Corps, in 1974, I was nineteen years young, optimistically idealistic, naïvely patriotic, and ravenous for adventure. I signed up for pilot training, feeling a strong sense of duty to serve the country that had given my parents a home. The Viet Nam war had finally ended and I wanted to know the truth about what I had grown up watching every night on the television news.
The Bolshevik Revolution of 1917 had forced my parent’s families out of Russia. Subsequently the U.S. Marines trained my father in communications electronics during the sixteen years he was with the Third Marine Division, including four years of combat in the South Pacific during World War II. Both my mom and dad raised their kids to appreciate that.
Nevertheless, it didn’t take me long to figure out that I didn’t fit in with the military. Our platoon sergeant came to exemplify the mindset in which I had immersed myself, that I found immediately repugnant. Piggishly fat for a Marine, he laughed when telling us of giving cookies sprayed with WD-40 to kids during his time fighting in Viet Nam, a few years earlier. After finishing the first installment of basic training, I got the hell out of the military, repulsed by the evil ignorance of it.
Having survived my adventurism, I am writing thirty years later with a more mature sense of duty to my country, that has expanded to include all the people of the world, extending through time in both directions.
Respect for the sacrifices made by previous generations, and concern for the future of all life on this planet in the future, compels me to warn people everywhere, against a government that I was brought up to venerate. Attempting to put into words what I see as a fundamental threat, with “extinctionistic” implications, I find myself cutting and pasting pieces of articles, intended to reveal the true character of the predatory military/industrial regime which has usurped control of the U.S. government. The URLs from which I have taken pieces of writing from other journalists (to whom I am writing to request permission to amplify the messages in their important work) are included after each excerpt.
The past thirteen years of my life have been spent challenging the United States government prohibition of the Cannabis plant, which I perceive to be a fundamental issue of essential resource scarcity which relates to many other issues of environment, economics and escalating social conflict. In educating people as to the magnitude of what is at stake, it has been necessary to put into perspective the true character of the government that enforces such a terminally regressive policy as prohibition has long been proven to be.
For me, no other issue demonstrated the horrendous betrayal of American ideals as does prohibition, until I learned of the use of depleted uranium in the first Gulf War.
Since learning about the use of depleted uranium (DU), in munitions used in the Persian Gulf wars, and other “theaters of combat,” my disgust for the U.S. military and the government which empowers it, has grown to active revulsion against what I perceive to be a dangerously degenerate dimension of social evolution. The betrayal of humanity that is inherent to the use of DU is far beyond any limit of reason, justification, or morality. As horrible and unpardonable as the attacks of September 11th are, what the United States has been doing in the Persian Gulf is far more insidious and destructive than crashing a dozen airliners into the World Trade Center.
Contamination from DU continues to cause cancer and birth defects in tens of thousands of people from many countries, including the U.S. The military has known of these effects, yet disregarded the health and safety of people who are apparently considered casually expendable.
“The Army would not identify the soldiers or say whether testing revealed contamination or illness.”
“Army spokeswoman Cynthia O. Smith would not comment Monday on whether other troops have complained of similar ailments or whether the Pentagon would take precautions aimed at preventing future exposure.” http://www.salon.com/news/wire/2004/04/05/uranium/index.html
“When Wheat underwent the biopsy and operation, he asked to have the removed tissue and bone "analyzed by a private research group."His request was denied.” http://www.chugoku-np.co.jp/abom/uran/us_e/000404.html The Chugoku Shimbun, Hiroshima
436 thousand ground soldiers had entered areas where DU munitions were used in Kuwait and Iraq. http://www.chugoku-np.co.jp/abom/uran/special/index3.html#gulfwar
"Army officials believe that DU protective methods can be ignored during battle and other life-threatening situations because DU-related health risks are greatly outweighed by the risks of combat."
Stacy served in a tank unit where his job was loading depleted uranium shells. He went into battle on February 24, 1991, the first day of the ground war against the Iraqi army. During the period when American soldiers were killed or injured by friendly fire, he was rescuing the wounded from tanks and armored vehicles destroyed by depleted uranium shells.
"I knew they were DU shells, but they never told us the radioactivity might make us sick," said Stacy angrily. Even after the cease-fire agreement on March 3, his unit remained in the contaminated desert for about two more months.
Stacy's strength is diminishing as well. Diarrhea, joint and leg pain, general fatigue. A Canadian radiation chemist has tested his urine twice, both times detecting depleted uranium. A private physician in California diagnosed heavy metal contamination based on blood testing.
The Veterans' Administration, however, accept neither of these findings. The disability pension Stacy receives is for PTSD (post-traumatic stress disorder) caused by the war.
"We don't have health insurance or savings, so we're forced to go to the VA, no matter how badly they treat us. All I want is proper treatment for us both. That's it."
http://www.chugoku-np.co.jp/abom/uran/us_e/000406.html
“According to Gina, Jason's unit's main task was to destroy the munitions warehouses that the Iraqi army had erected in the desert. They were believed to contain chemical as well as conventional weapons. They entered contaminated zones scattered with Iraqi tanks and trucks destroyed by DU bullets. They were forced to take pyridostigmine (PB), an insufficiently tested antidote to chemical weapons.
When Gina and her husband visited Jason at his North Carolina base in mid-July, they couldn't believe their eyes. Formerly a muscular 175 pounds (about 79kg), his six-foot (183cm) body was wasted. He walked gingerly, as if protecting his legs. The change in a little over three months was dramatic. Over time, his symptoms-hip and leg pain, gastrointestinal disorder, acute headache-progressively worsened. In April 1992, he was discharged before his four-year term of service was up.
"At the time we had no idea what the reason was. We didn't hear the term 'depleted uranium' until much later."
"He first went to the local veterans' hospital in May, a month after discharge. The doctor pronounced, 'He shouldn't have this sort of serious illness at his age,' and started him in psychological therapy. 'Stress, stress,' that's all they said then.'"
Jason, who had been so positive, suddenly died from a gunshot wound on September 24, 1999. He was 26 years old.
"He didn't leave a suicide note, so it's possible that it was an accident. But the inquest called it a suicide."
The Whitcombs are convinced that if Jason committed suicide, it was because Jason's condition, after eight years of headache, arthritis, stomach pain, and other ailments had become unbearable. After his death, they sent tissue from most of his organs to research organizations.
"It's too late for Jason and 10,000 other veterans of the Gulf War, but if it will help identify the cause..."
If the cause is found, maybe a treatment method will be next. But until that happens, the number of "delayed casualties" like Jason can only increase.
http://www.chugoku-np.co.jp/abom/uran/us_e/000407.html
During the Gulf War, West handled DU shells in an army tank unit. "We always looked inside the destroyed Iraqi tanks to see if there were any survivors. I have no idea how much DU dust I inhaled."
Consulting a genetic scientist
Around April 1991, while he was still stationed in southern Iraq, West's health began to deteriorate. Severe headaches, diarrhea, joint pain - the list goes on. In June he returned to his base in Germany, living there until his discharge in February 1994. During Barbara's pregnancies, she returned to Nashville and lived with her parents so she could take good care of herself.
"Whenever we had sex, Barbara complained that her pelvic area felt like it was on fire. We both thought I must have brought some bad disease back from the Middle East. We had no idea about the real reason."
In 1997, they attended a gathering in Kentucky for veterans of the Gulf War and their families. There, they learned for the first time that many other wives of veterans experience a burning sensation in their vaginas after sex and have had miscarriages and children with congenital defects.
"It was like the scales fell from our eyes. Why didn't the army or the government tell us beforehand about the danger of depleted uranium? We could hardly control our anger."
If West had known, he never would have passed the effects on to his wife and children.
http://www.chugoku-np.co.jp/abom/uran/us_e/000408.html
DU munitions were not the only source of the health problems that emerged after the Gulf War. Many soldiers were given medicines never approved by the Food and Drug Administration (FDA). They were exposed to intense smoke pollution from oil field fires, post-war destruction of Iraqi chemical weapons storehouses, and various toxic substances released during the war. Thus, numerous factors may be involved.
Among the medicines the soldiers took under orders from their officers was an antidote to biological weapons called pyrisdostigmine bromide (PB). They also received a vaccine against botulinum and a drug to protect against anthrax. According to an investigation by the NGWRC, 250 thousand troops took PB, 8,000 received botulinum vaccinations, and150 thousand took the anthrax medicine.
http://www.chugoku-np.co.jp/abom/uran/index_e.html#1_us
There are more than 1,000 uranium mine sites on Navajo land. Of the 110 communities within the reservation, more than one-third are reportedly affected by radioactivity. Even so, neither the former mining companies nor the US government is making any move to clean up the vast amounts of dumped radioactive wastes.
When the dam containing uranium sludge burst in 1979, about 360,000 liters of radioactive substances spilled into a river near a Colorado River tributary. A full 1,100 tons of sludge drifited downstream, creating a zone of contamination that extended to Arizona and Nevada. After a hasty cleanup, United Nuclear Metals also shut down in 1985.
"Already 350 to 400 workers have died from cancer and other diseases. In some communities, the majority of women are widows."
"After the war, the atomic bombs continued to harm the survivors of Hiroshima and Nagasaki. The same is true of the closed uranium mines. There's an increase in the number of newborns with congenital defects. I wish the scientists who say the level is too low to hurt anyone would take this waste home to their own backyards."
http://www.chugoku-np.co.jp/abom/uran/uran_mine_e/index.html
When I enlisted in the United States Marine Corps, in 1974, I was nineteen years young, optimistically idealistic, naïvely patriotic, and ravenous for adventure. I signed up for pilot training, feeling a strong sense of duty to serve the country that had given my parents a home. The Viet Nam war had finally ended and I wanted to know the truth about what I had grown up watching every night on the television news.
The Bolshevik Revolution of 1917 had forced my parent’s families out of Russia. Subsequently the U.S. Marines trained my father in communications electronics during the sixteen years he was with the Third Marine Division, including four years of combat in the South Pacific during World War II. Both my mom and dad raised their kids to appreciate that.
Nevertheless, it didn’t take me long to figure out that I didn’t fit in with the military. Our platoon sergeant came to exemplify the mindset in which I had immersed myself, that I found immediately repugnant. Piggishly fat for a Marine, he laughed when telling us of giving cookies sprayed with WD-40 to kids during his time fighting in Viet Nam, a few years earlier. After finishing the first installment of basic training, I got the hell out of the military, repulsed by the evil ignorance of it.
Having survived my adventurism, I am writing thirty years later with a more mature sense of duty to my country, that has expanded to include all the people of the world, extending through time in both directions.
Respect for the sacrifices made by previous generations, and concern for the future of all life on this planet in the future, compels me to warn people everywhere, against a government that I was brought up to venerate. Attempting to put into words what I see as a fundamental threat, with “extinctionistic” implications, I find myself cutting and pasting pieces of articles, intended to reveal the true character of the predatory military/industrial regime which has usurped control of the U.S. government. The URLs from which I have taken pieces of writing from other journalists (to whom I am writing to request permission to amplify the messages in their important work) are included after each excerpt.
The past thirteen years of my life have been spent challenging the United States government prohibition of the Cannabis plant, which I perceive to be a fundamental issue of essential resource scarcity which relates to many other issues of environment, economics and escalating social conflict. In educating people as to the magnitude of what is at stake, it has been necessary to put into perspective the true character of the government that enforces such a terminally regressive policy as prohibition has long been proven to be.
For me, no other issue demonstrated the horrendous betrayal of American ideals as does prohibition, until I learned of the use of depleted uranium in the first Gulf War.
Since learning about the use of depleted uranium (DU), in munitions used in the Persian Gulf wars, and other “theaters of combat,” my disgust for the U.S. military and the government which empowers it, has grown to active revulsion against what I perceive to be a dangerously degenerate dimension of social evolution. The betrayal of humanity that is inherent to the use of DU is far beyond any limit of reason, justification, or morality. As horrible and unpardonable as the attacks of September 11th are, what the United States has been doing in the Persian Gulf is far more insidious and destructive than crashing a dozen airliners into the World Trade Center.
Contamination from DU continues to cause cancer and birth defects in tens of thousands of people from many countries, including the U.S. The military has known of these effects, yet disregarded the health and safety of people who are apparently considered casually expendable.
“The Army would not identify the soldiers or say whether testing revealed contamination or illness.”
“Army spokeswoman Cynthia O. Smith would not comment Monday on whether other troops have complained of similar ailments or whether the Pentagon would take precautions aimed at preventing future exposure.” http://www.salon.com/news/wire/2004/04/05/uranium/index.html
“When Wheat underwent the biopsy and operation, he asked to have the removed tissue and bone "analyzed by a private research group."His request was denied.” http://www.chugoku-np.co.jp/abom/uran/us_e/000404.html The Chugoku Shimbun, Hiroshima
436 thousand ground soldiers had entered areas where DU munitions were used in Kuwait and Iraq. http://www.chugoku-np.co.jp/abom/uran/special/index3.html#gulfwar
"Army officials believe that DU protective methods can be ignored during battle and other life-threatening situations because DU-related health risks are greatly outweighed by the risks of combat."
Stacy served in a tank unit where his job was loading depleted uranium shells. He went into battle on February 24, 1991, the first day of the ground war against the Iraqi army. During the period when American soldiers were killed or injured by friendly fire, he was rescuing the wounded from tanks and armored vehicles destroyed by depleted uranium shells.
"I knew they were DU shells, but they never told us the radioactivity might make us sick," said Stacy angrily. Even after the cease-fire agreement on March 3, his unit remained in the contaminated desert for about two more months.
Stacy's strength is diminishing as well. Diarrhea, joint and leg pain, general fatigue. A Canadian radiation chemist has tested his urine twice, both times detecting depleted uranium. A private physician in California diagnosed heavy metal contamination based on blood testing.
The Veterans' Administration, however, accept neither of these findings. The disability pension Stacy receives is for PTSD (post-traumatic stress disorder) caused by the war.
"We don't have health insurance or savings, so we're forced to go to the VA, no matter how badly they treat us. All I want is proper treatment for us both. That's it."
http://www.chugoku-np.co.jp/abom/uran/us_e/000406.html
“According to Gina, Jason's unit's main task was to destroy the munitions warehouses that the Iraqi army had erected in the desert. They were believed to contain chemical as well as conventional weapons. They entered contaminated zones scattered with Iraqi tanks and trucks destroyed by DU bullets. They were forced to take pyridostigmine (PB), an insufficiently tested antidote to chemical weapons.
When Gina and her husband visited Jason at his North Carolina base in mid-July, they couldn't believe their eyes. Formerly a muscular 175 pounds (about 79kg), his six-foot (183cm) body was wasted. He walked gingerly, as if protecting his legs. The change in a little over three months was dramatic. Over time, his symptoms-hip and leg pain, gastrointestinal disorder, acute headache-progressively worsened. In April 1992, he was discharged before his four-year term of service was up.
"At the time we had no idea what the reason was. We didn't hear the term 'depleted uranium' until much later."
"He first went to the local veterans' hospital in May, a month after discharge. The doctor pronounced, 'He shouldn't have this sort of serious illness at his age,' and started him in psychological therapy. 'Stress, stress,' that's all they said then.'"
Jason, who had been so positive, suddenly died from a gunshot wound on September 24, 1999. He was 26 years old.
"He didn't leave a suicide note, so it's possible that it was an accident. But the inquest called it a suicide."
The Whitcombs are convinced that if Jason committed suicide, it was because Jason's condition, after eight years of headache, arthritis, stomach pain, and other ailments had become unbearable. After his death, they sent tissue from most of his organs to research organizations.
"It's too late for Jason and 10,000 other veterans of the Gulf War, but if it will help identify the cause..."
If the cause is found, maybe a treatment method will be next. But until that happens, the number of "delayed casualties" like Jason can only increase.
http://www.chugoku-np.co.jp/abom/uran/us_e/000407.html
During the Gulf War, West handled DU shells in an army tank unit. "We always looked inside the destroyed Iraqi tanks to see if there were any survivors. I have no idea how much DU dust I inhaled."
Consulting a genetic scientist
Around April 1991, while he was still stationed in southern Iraq, West's health began to deteriorate. Severe headaches, diarrhea, joint pain - the list goes on. In June he returned to his base in Germany, living there until his discharge in February 1994. During Barbara's pregnancies, she returned to Nashville and lived with her parents so she could take good care of herself.
"Whenever we had sex, Barbara complained that her pelvic area felt like it was on fire. We both thought I must have brought some bad disease back from the Middle East. We had no idea about the real reason."
In 1997, they attended a gathering in Kentucky for veterans of the Gulf War and their families. There, they learned for the first time that many other wives of veterans experience a burning sensation in their vaginas after sex and have had miscarriages and children with congenital defects.
"It was like the scales fell from our eyes. Why didn't the army or the government tell us beforehand about the danger of depleted uranium? We could hardly control our anger."
If West had known, he never would have passed the effects on to his wife and children.
http://www.chugoku-np.co.jp/abom/uran/us_e/000408.html
DU munitions were not the only source of the health problems that emerged after the Gulf War. Many soldiers were given medicines never approved by the Food and Drug Administration (FDA). They were exposed to intense smoke pollution from oil field fires, post-war destruction of Iraqi chemical weapons storehouses, and various toxic substances released during the war. Thus, numerous factors may be involved.
Among the medicines the soldiers took under orders from their officers was an antidote to biological weapons called pyrisdostigmine bromide (PB). They also received a vaccine against botulinum and a drug to protect against anthrax. According to an investigation by the NGWRC, 250 thousand troops took PB, 8,000 received botulinum vaccinations, and150 thousand took the anthrax medicine.
http://www.chugoku-np.co.jp/abom/uran/index_e.html#1_us
There are more than 1,000 uranium mine sites on Navajo land. Of the 110 communities within the reservation, more than one-third are reportedly affected by radioactivity. Even so, neither the former mining companies nor the US government is making any move to clean up the vast amounts of dumped radioactive wastes.
When the dam containing uranium sludge burst in 1979, about 360,000 liters of radioactive substances spilled into a river near a Colorado River tributary. A full 1,100 tons of sludge drifited downstream, creating a zone of contamination that extended to Arizona and Nevada. After a hasty cleanup, United Nuclear Metals also shut down in 1985.
"Already 350 to 400 workers have died from cancer and other diseases. In some communities, the majority of women are widows."
"After the war, the atomic bombs continued to harm the survivors of Hiroshima and Nagasaki. The same is true of the closed uranium mines. There's an increase in the number of newborns with congenital defects. I wish the scientists who say the level is too low to hurt anyone would take this waste home to their own backyards."
http://www.chugoku-np.co.jp/abom/uran/uran_mine_e/index.html
Published on Tuesday, April 6, 2004 by the Associated Press
Nader Calls for Bush to Be Impeached
by Maura Kelly
CHICAGO - Independent presidential candidate Ralph Nader called Tuesday for President Bush to be impeached for "deceiving the American people night after night after night" about U.S. involvement in Iraq.
"When you plunge our country into war on a platform of fabrications and deceptions, and you bring back thousands of American soldiers who are sick, injured or dead, and that war is unconstitutionally authorized to begin with, Mr. Bush's behavior qualifies for the high crimes and misdemeanor impeachment clause of the Constitution," the 2000 Green Party presidential nominee said to applause from about 200 students at Columbia College Chicago.
Nader said President Clinton was impeached for "far less of an offense."
"Lying under oath is not a trivial offense, but it cannot compare with deceiving the American people night after night after night on national television, staging untruths and rejecting the advice of his advisers," he said.
Merrill Smith, a spokeswoman for Bush's re-election campaign, declined to comment.
Nader previously called for Bush's impeachment during an anti-war rally March 20 in the president's hometown of Crawford, Texas, to mark the first anniversary of the U.S.-led invasion of Iraq.
Nader, a longtime consumer advocate, was in Illinois to gather the 25,000 signatures he needs before June 21 to qualify for the state ballot. He failed Monday to qualify for Oregon's ballot, but said he would try again under another option there.
Many Democrats blame Nader for Democrat Al Gore's loss to Republican George W. Bush in 2000, and have urged him not to run this time. They cite the vote Nader captured in close contests in New Hampshire and Florida and argue that Gore would have won if either state had gone to the then-vice president.
But Nader says Gore is to blame for his misfortune, and he rejected the idea that he could draw support away from Massachusetts Sen. John Kerry, the presumptive Democratic presidential nominee.
In Portland, Ore., on Monday, former Democratic presidential contender Howard Dean warned that "a vote for Ralph Nader is the same as a vote for George Bush."
An audience member in Chicago was booed for suggesting something similar.
Nader responded: "What we have to tell the two parties in unmistakable terms is that this country does not belong to two parties."
On the Net:
Ralph Nader: http://www.votenader.org
© 2004 The Associated Press
Nader Calls for Bush to Be Impeached
by Maura Kelly
CHICAGO - Independent presidential candidate Ralph Nader called Tuesday for President Bush to be impeached for "deceiving the American people night after night after night" about U.S. involvement in Iraq.
"When you plunge our country into war on a platform of fabrications and deceptions, and you bring back thousands of American soldiers who are sick, injured or dead, and that war is unconstitutionally authorized to begin with, Mr. Bush's behavior qualifies for the high crimes and misdemeanor impeachment clause of the Constitution," the 2000 Green Party presidential nominee said to applause from about 200 students at Columbia College Chicago.
Nader said President Clinton was impeached for "far less of an offense."
"Lying under oath is not a trivial offense, but it cannot compare with deceiving the American people night after night after night on national television, staging untruths and rejecting the advice of his advisers," he said.
Merrill Smith, a spokeswoman for Bush's re-election campaign, declined to comment.
Nader previously called for Bush's impeachment during an anti-war rally March 20 in the president's hometown of Crawford, Texas, to mark the first anniversary of the U.S.-led invasion of Iraq.
Nader, a longtime consumer advocate, was in Illinois to gather the 25,000 signatures he needs before June 21 to qualify for the state ballot. He failed Monday to qualify for Oregon's ballot, but said he would try again under another option there.
Many Democrats blame Nader for Democrat Al Gore's loss to Republican George W. Bush in 2000, and have urged him not to run this time. They cite the vote Nader captured in close contests in New Hampshire and Florida and argue that Gore would have won if either state had gone to the then-vice president.
But Nader says Gore is to blame for his misfortune, and he rejected the idea that he could draw support away from Massachusetts Sen. John Kerry, the presumptive Democratic presidential nominee.
In Portland, Ore., on Monday, former Democratic presidential contender Howard Dean warned that "a vote for Ralph Nader is the same as a vote for George Bush."
An audience member in Chicago was booed for suggesting something similar.
Nader responded: "What we have to tell the two parties in unmistakable terms is that this country does not belong to two parties."
On the Net:
Ralph Nader: http://www.votenader.org
© 2004 The Associated Press
SUBCOMMITTEE ON CRIME
COMMITTEE ON THE JUDICIARY
U.S. HOUSE OF REPRESENTATIVES
OVERSIGHT HEARING ON
THE MEDICAL MARIHUANA REFERENDA MOVEMENT IN AMERICA
Wednesday, October 1, 1997
Room 2141 Rayburn Building, 9:30 AM
Grinspoon Testimony
Testimony of
Lester Grinspoon, M.D.
Associate Professor of Psychiatry, Harvard Medical School
before the Crime Subcommittee of the Judiciary Committee
U.S. House of Representatives
Washington, D.C.
October 1, 1997
Mr. Chairman and members of the subcommittee, I appreciate the opportunity to appear before you this morning to share my views on the use of marihuana as a medicine.
In September 1928 Alexander Fleming returned from vacation to his laboratory and discovered that one of the petri dishes he had inadvertently left out over the summer was overgrown with staphylococci except for the area surrounding a mold colony. That mold contained a substance he later named penicillin. He published his finding in 1929, but the discovery was ignored by the medical establishment, and bacterial infections continued to be a leading cause of death. Had it aroused the interest of a pharmaceutical firm, its development might not have been delayed. More than 10 years later, under wartime pressure to develop antibiotic substances to supplement sulfonamide, Howard Florey and Ernst Chain initiated the first clinical trial of penicillin (with six patients) and began the systematic investigations that might have been conducted a decade earlier.1
After its debut in 1941, penicillin rapidly earned a reputation as "the wonder drug of the '40s." There were three major reasons for that reputation: it was remarkably non-toxic, even at high doses; it was inexpensive to produce on a large scale; and it was extremely versatile, acting against the microorganisms that caused a great variety of diseases, from pneumonia to syphilis. In all three respects cannabis suggests parallels:
(1) Cannabis is remarkably safe. Although not harmless, it is surely less toxic than most of the conventional medicines it could replace if it were legally available. Despite its use by millions of people over thousands of years, cannabis has never caused an overdose death. The most serious concern is respiratory system damage from smoking, but that can easily be addressed by increasing the potency of cannabis and by developing the technology to separate the particulate matter in marihuana smoke from its active ingredients, the cannabinoids (prohibition, incidentally, has prevented this technology from flourishing). Once cannabis regains the place in the U.S. Pharmacopoeia that it lost in 1941 after the passage of the Marihuana Tax Act (1937), it will be among the least toxic substances in that compendium. Right now the greatest danger in using marihuana medically is the illegality that imposes a great deal of anxiety and expense on people who are already suffering.
(2) Medical cannabis would be extremely inexpensive. Street marihuana today costs $200 to $400 an ounce, but the prohibition tariff accounts for most of that. A reasonable estimate of the cost of cannabis as a medicine is $20 to $30 an ounce, or about 30 to 40 cents per marihuana cigarette. As an example of what this means in practice, consider the following. Both the marihuana cigarette and an 8 mg ondansetron pill -- cost to the patient, $30 to $40 -- are effective in most cases for the nausea and vomiting of cancer chemotherapy (although many patients find less than one marihuana cigarette to be more useful, and they often require several ondansetron pills). Thus cannabis would be at least 100 times less expensive than the best present treatment for this symptom.
(3) Cannabis is remarkably versatile. Let me review briefly some of the symptoms and syndromes for which it is useful.
Cancer Treatment
Cannabis has several uses in the treatment of cancer. As an appetite stimulant, it can help to slow weight loss in cancer patients.2 It may also act as a mood elevator. But the most common use is the prevention of nausea and vomiting of cancer chemotherapy. About half of patients treated with anticancer drugs suffer from severe nausea and vomiting, which are not only unpleasant but a threat to the effectiveness of the therapy. Retching can cause tears of the esophagus and rib fractures, prevent adequate nutrition, and lead to fluid loss. Some patients find the nausea so intolerable they say they would rather die than go on. The antiemetics most commonly used in chemotherapy are metoclopramide (Reglan), the relatively new ondansetron (Zofran), and the newer granisetron (Kytril). Unfortunately, for many cancer patients these conventional antiemetics do not work at all or provide little relief.
The suggestion that cannabis might be useful arose in the early 1970s when some young patients receiving cancer chemotherapy found that marihuana smoking reduced their nausea and vomiting. In one study of 56 patients who got no relief from standard antiemetic agents, 78% became symptom-free when they smoked marihuana.3 Oral tetrahydrocannabinol (THC) has proved effective where the standard drugs were not.4,5 but smoking generates faster and more predictable results because it raises THC concentration in the blood more easily to the needed level. Also, it may be hard for a nauseated patient to take oral medicine. In fact, there is strong evidence that most patients suffering from nausea and vomiting prefer smoked marihuana to oral THC.2
Oncologists may be ahead of other physicians in recognizing the therapeutic potential of cannabis. In the spring of 1990, two investigators randomly selected more than 2,000 members of the American Society of Clinical Oncology (one-third of the membership) and mailed them an anonymous questionnaire to learn their views on the use of cannabis in cancer chemotherapy. Almost half of the recipients responded. Although the investigators acknowledge that this group was self-selected and that there might be a response bias, their results provide a rough estimate of the views of specialists on the use of Marinol (dronabinol, oral synthetic THC) and smoked marihuana.
Only 43% said the available legal antiemetic drugs (including Marinol) provided adequate relief to all or most of their patients, and only 46% said the side effects of these drugs were rarely a serious problem. Forty-four percent had recommended the illegal use of marihuana to at least one patient, and half would prescribe it to some patients if it were legal. On average, they considered smoked marihuana more effective than Marinol and roughly as safe.6
Glaucoma
Cannabis may also be useful in the treatment of glaucoma, the second leading cause of blindness in the United States. In this disease, fluid pressure within the eyeball increases until it damages the optic nerve. About a million Americans suffer from the form of glaucoma (open angle) treatable with cannabis. Marihuana causes a dose-related, clinically significant drop in intraocular pressure that lasts several hours in both normal subjects and those with the abnormally high ocular tension produced by glaucoma. Oral or intravenous THC has the same effect, which seems to be specific to cannabis derivatives rather than simply a result ofsedation. Cannabis does not cure the disease, but it can retard the progressive loss of sight when conventional medication fails and surgery is too dangerous.7
Seizures
About 20% of epileptic patients do not get much relief from conventional anticonvulsant medications. Cannabis has been explored as an alternative at least since 1975 when a case was reported in which marihuana smoking, together with the standard anticonvulsants phenobarbital and diphenylhydantoin, was apparently necessary to control seizures in a young epileptic man.8 The cannabis derivative that is most promising as an anticonvulsant is cannabidiol. In one controlled study, cannabidiol in addition to prescribed anticonvulsants produced improvement in seven patients with grand mal convulsions; three showed great improvement. Of eight patients who received a placebo instead, only one improved.9 There are patients suffering from both grand mal and partial seizure disorders who find that smoked marihuana allows them to lower the doses of conventional anticonvulsant medications or dispense with them altogether .2
Pain
There are many case reports of marihuana smokers using the drug to reduce pain: post-surgery pain, headache, migraine, menstrual cramps, and so on. Ironically, the best alternative analgesics are the potentially addictive and lethal opioids. In particular, marihuana is becoming increasingly recognized as a drug of choice for the pain that accompanies muscle spasm, which is often chronic and debilitating, especially in paraplegics, quadriplegics, other victims of traumatic nerve injury, and people suffering from multiple sclerosis or cerebral palsy. Many of them have discovered that cannabis not only allows them to avoid the risks of other drugs, but also reduces muscle spasms and tremors; sometimes they are even able to leave their wheelchairs.10
One of the most common causes of chronic pain is osteoarthritis, which is usually treated with synthetic analgesics. The most widely used of these drugs -- aspirin, acetaminophen (Tylenol), and nonsteroidal antiinflammatory drugs (NSAIDs) like ibuprofen and naproxen -- are not addictive, but they are often insufficiently powerful. Furthermore, they have serious side effects. Stomach bleeding and ulcer induced by aspirin and NSAIDs are the most common serious adverse drug reactions reported in the United States, causing an estimated 7,000 deaths each year. Acetaminophen can cause liver damage or kidney failure when used regularly for long periods of time; a recent study suggests it may account for 10% of all cases of end-stage renal disease, a condition that requires dialysis or a kidney transplant.11,12 Marihuana, as I pointed out earlier, has never been shown to cause death or serious illness.
AIDS
More than 300,000 Americans have died of AIDS. Nearly a million are infected with HIV, and at least a quarter of a million have AIDS. Although the spread of AIDS has slowed among homosexual men, the reservoir is so huge that the number of cases is sure to grow. Women and children as well as both heterosexual and homosexual men are now being affected; the disease is spreading most rapidly among intravenous drug abusers and their sexual partners. The disease can be attacked with anti-viral drugs, of which the best known are zidovudine (AZT) and protease inhibitors. Unfortunately, these drugs sometimes cause severe nausea that heightens the danger of semi-starvation for patients who are already suffering from nausea and losing weight because of the illness -- a condition sometimes called the AIDS wasting syndrome.
Marihuana is particularly useful for patients who suffer from AIDS because it not only relieves the nausea but retards weight loss by enhancing appetite. When it helps patients regain lost weight, it can prolong life. Marinol has been shown to relieve nausea and retard or reverse weight loss in patients with HIV infection, but most patients prefer smoked cannabis for the same reasons that cancer chemotherapy patients prefer it: it is more effective and has fewer unpleasant side effects, and the dosage is easier to adjust.
These are the symptoms and syndromes for which cannabis is most commonly used today, but there are others for which clinical experience provides compelling evidence. It is distressing to consider how many lives might have been saved if penicillin had been developed as a medicine immediately after Fleming's discovery. It is equally frustrating to consider how much suffering might have been avoided if cannabis had been available as a medicine for the last 60 years. Initial enthusiasm for drugs is often disappointed after further investigation, but this is hardly likely in the case of cannabis, since it is not a new medicine at all. Its long medical history began 5,000 years ago in China and extended well into the twentieth century. Between 1840 and 1900, more than one hundred papers on its therapeutic uses were published in American and European medical journals. It was recommended as an appetite stimulant, muscle relaxant, analgesic, sedative, anticonvulsant, and treatment for opium addiction. As late as 1913, the great Sir William Osler cited it as the best remedy for migraine in a standard medical textbook.
In the United States, what remained of marihuana's medical use was effectively eliminated by the Marihuana Tax Act of 1937, which was ostensibly designed to prevent nonmedical use but made cannabis so difficult to obtain that it was removed from standard pharmaceutical references. When the present comprehensive federal drug law was passed in 1970, marihuana was officially classified as a Schedule I drug: a high potential for abuse, no accepted medical use, and lack of safety for use under medical supervision.
But in the 1970s the public began to rediscover its medical value, as letters appeared in lay publications from people who had learned that it could relieve their asthma, nausea, muscle spasms, or pain and wanted to shared that knowledge with readers who were familiar with the drug. The most effective spur to the movement for medical marihuana came from the discovery that it could prevent the AIDS wasting syndrome. It is not surprising that the Physicians Association for AIDS Care was one of the medical organizations that endorsed the California initiative prohibiting criminal prosecution of medical marihuana users. The mid-1980s had already seen the establishment, often by people with AIDS, of cannabis buyers' clubs, organizations that distribute medical marihuana in open defiance of the law. These clubs buy marihuana wholesale and provide it to patients at or near cost, usually on the written recommendation of a physician. Although a few of the clubs have been raided and closed, most are still flourishing, and new ones are being organized. Some of them may gain legal status as a result of the initiative.
Until the recent vote in California, efforts to change the laws had been futile. In 1972 the National Organization for the Reform of Marijuana Laws (NORML) entered a petition to move marihuana out of Schedule I under federal law so that it could become a prescription drug. It was not until 1986 that the Drug Enforcement Administration (DEA) finally agreed to the public hearings required by law. During two years of hearings, many patients and physicians testified and thousands of pages of documentation were introduced. In 1988 the DEA's Administrative Law Judge, Francis L. Young, declared that marihuana fulfilled the requirement for transfer to Schedule II. In his opinion he described it as "one of the safest therapeutically active substances known to man." His order was overruled by the DEA.
Nevertheless, a few patients have been able to obtain medical marihuana legally in the last twenty years. Beginning in the 1970s, thirty-five states passed legislation that would have permitted medical use of cannabis but for the federal law. Several of those states actually established special research programs, with the permission of the federal government, under which patients who were receiving cancer chemotherapy would be allowed to use cannabis. These projects demonstrated the value of both smoked marihuana and oral THC. The FDA then approved oral THC as a prescription medicine, but ignored the data that suggested that smoked marihuana was more useful than oral THC for some patients. With the approval of Marinol, this research came to an end. In 1976, the federal government introduced the Individual Treatment Investigational New Drug program (commonly referred to as the Compassionate IND), which provided marihuana to a few patients whose doctors were willing to undergo the paperwork-burdened and time-consuming application process. About three dozen patients eventually received marihuana before the program was discontinued in 1992, and eight survivors are still receiving it -- the only persons in the country for whom it is not a forbidden medicine. It is safe to say that a significant number of the more than ten million American citizens arrested on marihuana charges in the last thirty years were using the drug therapeutically. The Schedule I classification persists, although in my view and the view of millions of other Americans, it is medically absurd, legally questionable, and morally wrong.
Opponents of medical marihuana often object that the evidence of its usefulness, although strong, comes only from case reports and clinical experience. It is true that there are no double-blind controlled studies meeting the standards of the Food and Drug Administration, chiefly because legal, bureaucratic, and financial obstacles have been constantly put in the way. The situation is ironical, since so much research has been done on marihuana, often in unsuccessful efforts to show health hazards and addictive potential, that we know more about it than about most prescription drugs. In any case, individual therapeutic responses are often obscured in group experiments, and case reports and clinical experience are the source of much of our knowledge of drugs. As Dr. Louis Lasagna has pointed out, controlled experiments were not needed to recognize the therapeutic potential of chloral hydrate, barbiturates, aspirin, insulin, or penicillin.13 Nor was that the way we learned about the use of propranolol for hypertension, diazepam for status epilepticus, and imipramine for enuresis. All these drugs had originally been approved for other purposes.
In the experimental method known as the single patient randomized trial, active and placebo treatments are administered randomly in alternation or succession. The method is often used when large-scale controlled studies are inappropriate because the disorder is rare, the patient is atypical, or the response to treatment is idiosyncratic.14 Several patients have told me that they assured themselves of marihuana's effectiveness by carrying out such experiments on themselves, alternating periods of cannabis use with periods of abstention. I am convinced that the medical reputation of cannabis is derived partly from similar experiments conducted by many other patients.
Some physicians may regard it as irresponsible to advocate use of a medicine on the basis of case reports, which are sometimes disparaged as merely "anecdotal" evidence which counts apparent successes and ignore apparent failures. That would be a serious problem only if cannabis were a dangerous drug. The years of effort devoted to showing that marihuana is exceedingly dangerous have proved the opposite. It is safer, with fewer serious side effects, than most prescription medicines, and far less addictive or subject to abuse than many drugs now used as muscle relaxants, hypnotics, and analgesics.
Thus cannabis should be made available even if only a few patients could get relief from it, because the risks would be so small. For example, as I mentioned, many patients with multiple sclerosis find that cannabis reduces their muscle spasms and pain. A physician may not be sure that such a patient will get more relief from marihuana than from the standard drugs baclofen, dantrolene, and diazepam -- all of which are potentially dangerous or addictive -- but it is almost certain that a serious toxic reaction to marihuana will not occur. Therefore the potential benefit is much greater than any potential risk.
During the past few years, the medical uses of marihuana have become increasingly clear to many physicians and patients, and the number of people with direct experience of these uses has been growing. Therefore the discussion is now turning from whether cannabis is an effective medicine to how it should be made available. It is essential to relax legal restrictions that prevent physicians and patients from achieving a workable accommodation that takes into account the needs of suffering people. H.R. 1782 (the Medical Use of Marihuana Act) is a worthwhile move in that direction because it gets the federal government out of the way and allows the states to experiment with their own solutions to the problem. I strongly urge that you pass this law.
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COMMITTEE ON THE JUDICIARY
U.S. HOUSE OF REPRESENTATIVES
OVERSIGHT HEARING ON
THE MEDICAL MARIHUANA REFERENDA MOVEMENT IN AMERICA
Wednesday, October 1, 1997
Room 2141 Rayburn Building, 9:30 AM
Grinspoon Testimony
Testimony of
Lester Grinspoon, M.D.
Associate Professor of Psychiatry, Harvard Medical School
before the Crime Subcommittee of the Judiciary Committee
U.S. House of Representatives
Washington, D.C.
October 1, 1997
Mr. Chairman and members of the subcommittee, I appreciate the opportunity to appear before you this morning to share my views on the use of marihuana as a medicine.
In September 1928 Alexander Fleming returned from vacation to his laboratory and discovered that one of the petri dishes he had inadvertently left out over the summer was overgrown with staphylococci except for the area surrounding a mold colony. That mold contained a substance he later named penicillin. He published his finding in 1929, but the discovery was ignored by the medical establishment, and bacterial infections continued to be a leading cause of death. Had it aroused the interest of a pharmaceutical firm, its development might not have been delayed. More than 10 years later, under wartime pressure to develop antibiotic substances to supplement sulfonamide, Howard Florey and Ernst Chain initiated the first clinical trial of penicillin (with six patients) and began the systematic investigations that might have been conducted a decade earlier.1
After its debut in 1941, penicillin rapidly earned a reputation as "the wonder drug of the '40s." There were three major reasons for that reputation: it was remarkably non-toxic, even at high doses; it was inexpensive to produce on a large scale; and it was extremely versatile, acting against the microorganisms that caused a great variety of diseases, from pneumonia to syphilis. In all three respects cannabis suggests parallels:
(1) Cannabis is remarkably safe. Although not harmless, it is surely less toxic than most of the conventional medicines it could replace if it were legally available. Despite its use by millions of people over thousands of years, cannabis has never caused an overdose death. The most serious concern is respiratory system damage from smoking, but that can easily be addressed by increasing the potency of cannabis and by developing the technology to separate the particulate matter in marihuana smoke from its active ingredients, the cannabinoids (prohibition, incidentally, has prevented this technology from flourishing). Once cannabis regains the place in the U.S. Pharmacopoeia that it lost in 1941 after the passage of the Marihuana Tax Act (1937), it will be among the least toxic substances in that compendium. Right now the greatest danger in using marihuana medically is the illegality that imposes a great deal of anxiety and expense on people who are already suffering.
(2) Medical cannabis would be extremely inexpensive. Street marihuana today costs $200 to $400 an ounce, but the prohibition tariff accounts for most of that. A reasonable estimate of the cost of cannabis as a medicine is $20 to $30 an ounce, or about 30 to 40 cents per marihuana cigarette. As an example of what this means in practice, consider the following. Both the marihuana cigarette and an 8 mg ondansetron pill -- cost to the patient, $30 to $40 -- are effective in most cases for the nausea and vomiting of cancer chemotherapy (although many patients find less than one marihuana cigarette to be more useful, and they often require several ondansetron pills). Thus cannabis would be at least 100 times less expensive than the best present treatment for this symptom.
(3) Cannabis is remarkably versatile. Let me review briefly some of the symptoms and syndromes for which it is useful.
Cancer Treatment
Cannabis has several uses in the treatment of cancer. As an appetite stimulant, it can help to slow weight loss in cancer patients.2 It may also act as a mood elevator. But the most common use is the prevention of nausea and vomiting of cancer chemotherapy. About half of patients treated with anticancer drugs suffer from severe nausea and vomiting, which are not only unpleasant but a threat to the effectiveness of the therapy. Retching can cause tears of the esophagus and rib fractures, prevent adequate nutrition, and lead to fluid loss. Some patients find the nausea so intolerable they say they would rather die than go on. The antiemetics most commonly used in chemotherapy are metoclopramide (Reglan), the relatively new ondansetron (Zofran), and the newer granisetron (Kytril). Unfortunately, for many cancer patients these conventional antiemetics do not work at all or provide little relief.
The suggestion that cannabis might be useful arose in the early 1970s when some young patients receiving cancer chemotherapy found that marihuana smoking reduced their nausea and vomiting. In one study of 56 patients who got no relief from standard antiemetic agents, 78% became symptom-free when they smoked marihuana.3 Oral tetrahydrocannabinol (THC) has proved effective where the standard drugs were not.4,5 but smoking generates faster and more predictable results because it raises THC concentration in the blood more easily to the needed level. Also, it may be hard for a nauseated patient to take oral medicine. In fact, there is strong evidence that most patients suffering from nausea and vomiting prefer smoked marihuana to oral THC.2
Oncologists may be ahead of other physicians in recognizing the therapeutic potential of cannabis. In the spring of 1990, two investigators randomly selected more than 2,000 members of the American Society of Clinical Oncology (one-third of the membership) and mailed them an anonymous questionnaire to learn their views on the use of cannabis in cancer chemotherapy. Almost half of the recipients responded. Although the investigators acknowledge that this group was self-selected and that there might be a response bias, their results provide a rough estimate of the views of specialists on the use of Marinol (dronabinol, oral synthetic THC) and smoked marihuana.
Only 43% said the available legal antiemetic drugs (including Marinol) provided adequate relief to all or most of their patients, and only 46% said the side effects of these drugs were rarely a serious problem. Forty-four percent had recommended the illegal use of marihuana to at least one patient, and half would prescribe it to some patients if it were legal. On average, they considered smoked marihuana more effective than Marinol and roughly as safe.6
Glaucoma
Cannabis may also be useful in the treatment of glaucoma, the second leading cause of blindness in the United States. In this disease, fluid pressure within the eyeball increases until it damages the optic nerve. About a million Americans suffer from the form of glaucoma (open angle) treatable with cannabis. Marihuana causes a dose-related, clinically significant drop in intraocular pressure that lasts several hours in both normal subjects and those with the abnormally high ocular tension produced by glaucoma. Oral or intravenous THC has the same effect, which seems to be specific to cannabis derivatives rather than simply a result ofsedation. Cannabis does not cure the disease, but it can retard the progressive loss of sight when conventional medication fails and surgery is too dangerous.7
Seizures
About 20% of epileptic patients do not get much relief from conventional anticonvulsant medications. Cannabis has been explored as an alternative at least since 1975 when a case was reported in which marihuana smoking, together with the standard anticonvulsants phenobarbital and diphenylhydantoin, was apparently necessary to control seizures in a young epileptic man.8 The cannabis derivative that is most promising as an anticonvulsant is cannabidiol. In one controlled study, cannabidiol in addition to prescribed anticonvulsants produced improvement in seven patients with grand mal convulsions; three showed great improvement. Of eight patients who received a placebo instead, only one improved.9 There are patients suffering from both grand mal and partial seizure disorders who find that smoked marihuana allows them to lower the doses of conventional anticonvulsant medications or dispense with them altogether .2
Pain
There are many case reports of marihuana smokers using the drug to reduce pain: post-surgery pain, headache, migraine, menstrual cramps, and so on. Ironically, the best alternative analgesics are the potentially addictive and lethal opioids. In particular, marihuana is becoming increasingly recognized as a drug of choice for the pain that accompanies muscle spasm, which is often chronic and debilitating, especially in paraplegics, quadriplegics, other victims of traumatic nerve injury, and people suffering from multiple sclerosis or cerebral palsy. Many of them have discovered that cannabis not only allows them to avoid the risks of other drugs, but also reduces muscle spasms and tremors; sometimes they are even able to leave their wheelchairs.10
One of the most common causes of chronic pain is osteoarthritis, which is usually treated with synthetic analgesics. The most widely used of these drugs -- aspirin, acetaminophen (Tylenol), and nonsteroidal antiinflammatory drugs (NSAIDs) like ibuprofen and naproxen -- are not addictive, but they are often insufficiently powerful. Furthermore, they have serious side effects. Stomach bleeding and ulcer induced by aspirin and NSAIDs are the most common serious adverse drug reactions reported in the United States, causing an estimated 7,000 deaths each year. Acetaminophen can cause liver damage or kidney failure when used regularly for long periods of time; a recent study suggests it may account for 10% of all cases of end-stage renal disease, a condition that requires dialysis or a kidney transplant.11,12 Marihuana, as I pointed out earlier, has never been shown to cause death or serious illness.
AIDS
More than 300,000 Americans have died of AIDS. Nearly a million are infected with HIV, and at least a quarter of a million have AIDS. Although the spread of AIDS has slowed among homosexual men, the reservoir is so huge that the number of cases is sure to grow. Women and children as well as both heterosexual and homosexual men are now being affected; the disease is spreading most rapidly among intravenous drug abusers and their sexual partners. The disease can be attacked with anti-viral drugs, of which the best known are zidovudine (AZT) and protease inhibitors. Unfortunately, these drugs sometimes cause severe nausea that heightens the danger of semi-starvation for patients who are already suffering from nausea and losing weight because of the illness -- a condition sometimes called the AIDS wasting syndrome.
Marihuana is particularly useful for patients who suffer from AIDS because it not only relieves the nausea but retards weight loss by enhancing appetite. When it helps patients regain lost weight, it can prolong life. Marinol has been shown to relieve nausea and retard or reverse weight loss in patients with HIV infection, but most patients prefer smoked cannabis for the same reasons that cancer chemotherapy patients prefer it: it is more effective and has fewer unpleasant side effects, and the dosage is easier to adjust.
These are the symptoms and syndromes for which cannabis is most commonly used today, but there are others for which clinical experience provides compelling evidence. It is distressing to consider how many lives might have been saved if penicillin had been developed as a medicine immediately after Fleming's discovery. It is equally frustrating to consider how much suffering might have been avoided if cannabis had been available as a medicine for the last 60 years. Initial enthusiasm for drugs is often disappointed after further investigation, but this is hardly likely in the case of cannabis, since it is not a new medicine at all. Its long medical history began 5,000 years ago in China and extended well into the twentieth century. Between 1840 and 1900, more than one hundred papers on its therapeutic uses were published in American and European medical journals. It was recommended as an appetite stimulant, muscle relaxant, analgesic, sedative, anticonvulsant, and treatment for opium addiction. As late as 1913, the great Sir William Osler cited it as the best remedy for migraine in a standard medical textbook.
In the United States, what remained of marihuana's medical use was effectively eliminated by the Marihuana Tax Act of 1937, which was ostensibly designed to prevent nonmedical use but made cannabis so difficult to obtain that it was removed from standard pharmaceutical references. When the present comprehensive federal drug law was passed in 1970, marihuana was officially classified as a Schedule I drug: a high potential for abuse, no accepted medical use, and lack of safety for use under medical supervision.
But in the 1970s the public began to rediscover its medical value, as letters appeared in lay publications from people who had learned that it could relieve their asthma, nausea, muscle spasms, or pain and wanted to shared that knowledge with readers who were familiar with the drug. The most effective spur to the movement for medical marihuana came from the discovery that it could prevent the AIDS wasting syndrome. It is not surprising that the Physicians Association for AIDS Care was one of the medical organizations that endorsed the California initiative prohibiting criminal prosecution of medical marihuana users. The mid-1980s had already seen the establishment, often by people with AIDS, of cannabis buyers' clubs, organizations that distribute medical marihuana in open defiance of the law. These clubs buy marihuana wholesale and provide it to patients at or near cost, usually on the written recommendation of a physician. Although a few of the clubs have been raided and closed, most are still flourishing, and new ones are being organized. Some of them may gain legal status as a result of the initiative.
Until the recent vote in California, efforts to change the laws had been futile. In 1972 the National Organization for the Reform of Marijuana Laws (NORML) entered a petition to move marihuana out of Schedule I under federal law so that it could become a prescription drug. It was not until 1986 that the Drug Enforcement Administration (DEA) finally agreed to the public hearings required by law. During two years of hearings, many patients and physicians testified and thousands of pages of documentation were introduced. In 1988 the DEA's Administrative Law Judge, Francis L. Young, declared that marihuana fulfilled the requirement for transfer to Schedule II. In his opinion he described it as "one of the safest therapeutically active substances known to man." His order was overruled by the DEA.
Nevertheless, a few patients have been able to obtain medical marihuana legally in the last twenty years. Beginning in the 1970s, thirty-five states passed legislation that would have permitted medical use of cannabis but for the federal law. Several of those states actually established special research programs, with the permission of the federal government, under which patients who were receiving cancer chemotherapy would be allowed to use cannabis. These projects demonstrated the value of both smoked marihuana and oral THC. The FDA then approved oral THC as a prescription medicine, but ignored the data that suggested that smoked marihuana was more useful than oral THC for some patients. With the approval of Marinol, this research came to an end. In 1976, the federal government introduced the Individual Treatment Investigational New Drug program (commonly referred to as the Compassionate IND), which provided marihuana to a few patients whose doctors were willing to undergo the paperwork-burdened and time-consuming application process. About three dozen patients eventually received marihuana before the program was discontinued in 1992, and eight survivors are still receiving it -- the only persons in the country for whom it is not a forbidden medicine. It is safe to say that a significant number of the more than ten million American citizens arrested on marihuana charges in the last thirty years were using the drug therapeutically. The Schedule I classification persists, although in my view and the view of millions of other Americans, it is medically absurd, legally questionable, and morally wrong.
Opponents of medical marihuana often object that the evidence of its usefulness, although strong, comes only from case reports and clinical experience. It is true that there are no double-blind controlled studies meeting the standards of the Food and Drug Administration, chiefly because legal, bureaucratic, and financial obstacles have been constantly put in the way. The situation is ironical, since so much research has been done on marihuana, often in unsuccessful efforts to show health hazards and addictive potential, that we know more about it than about most prescription drugs. In any case, individual therapeutic responses are often obscured in group experiments, and case reports and clinical experience are the source of much of our knowledge of drugs. As Dr. Louis Lasagna has pointed out, controlled experiments were not needed to recognize the therapeutic potential of chloral hydrate, barbiturates, aspirin, insulin, or penicillin.13 Nor was that the way we learned about the use of propranolol for hypertension, diazepam for status epilepticus, and imipramine for enuresis. All these drugs had originally been approved for other purposes.
In the experimental method known as the single patient randomized trial, active and placebo treatments are administered randomly in alternation or succession. The method is often used when large-scale controlled studies are inappropriate because the disorder is rare, the patient is atypical, or the response to treatment is idiosyncratic.14 Several patients have told me that they assured themselves of marihuana's effectiveness by carrying out such experiments on themselves, alternating periods of cannabis use with periods of abstention. I am convinced that the medical reputation of cannabis is derived partly from similar experiments conducted by many other patients.
Some physicians may regard it as irresponsible to advocate use of a medicine on the basis of case reports, which are sometimes disparaged as merely "anecdotal" evidence which counts apparent successes and ignore apparent failures. That would be a serious problem only if cannabis were a dangerous drug. The years of effort devoted to showing that marihuana is exceedingly dangerous have proved the opposite. It is safer, with fewer serious side effects, than most prescription medicines, and far less addictive or subject to abuse than many drugs now used as muscle relaxants, hypnotics, and analgesics.
Thus cannabis should be made available even if only a few patients could get relief from it, because the risks would be so small. For example, as I mentioned, many patients with multiple sclerosis find that cannabis reduces their muscle spasms and pain. A physician may not be sure that such a patient will get more relief from marihuana than from the standard drugs baclofen, dantrolene, and diazepam -- all of which are potentially dangerous or addictive -- but it is almost certain that a serious toxic reaction to marihuana will not occur. Therefore the potential benefit is much greater than any potential risk.
During the past few years, the medical uses of marihuana have become increasingly clear to many physicians and patients, and the number of people with direct experience of these uses has been growing. Therefore the discussion is now turning from whether cannabis is an effective medicine to how it should be made available. It is essential to relax legal restrictions that prevent physicians and patients from achieving a workable accommodation that takes into account the needs of suffering people. H.R. 1782 (the Medical Use of Marihuana Act) is a worthwhile move in that direction because it gets the federal government out of the way and allows the states to experiment with their own solutions to the problem. I strongly urge that you pass this law.
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