© Martin Cooke, B.Sc., Dip. Ed. (July 1997)
Introduction
Note: In this paper I hope to show that the current legal ban on the medical use of marijuana (cannabis, or Indian hemp) in Ireland should be withdrawn. The paper is largely a review of the literature concerning the medical status of marijuana.
In June 1997, Mr. Paddy Doyle, well known author of his best-selling autobiography, “The God Squad”, created some controversy in the Irish media. This was due to the fact that his consultant had been refused permission by the then Minister for Health, Michael Noonan, T.D. to prescribe marijuana to help Mr. Doyle fight the symptoms of a debilitating disease from which he has suffered since childhood. The immediate controversy was, in a way, fairly short-lived, possibly due to the fact that the media had their attention diverted somewhat, due to the general election which had just taken place.
The issues surrounding the medical use of marijuana, however, are serious ones, and in this paper I intend to look at them in some detail.
Mr. Doyle suffers from Idiopathic Torsion Dystonia – a painful and incurable condition. He is subject to constant muscle spasms. Mr. Doyle says: “It starts first thing in the morning and continues right through the day. As an American consultant put it – it’s like doing a work out in a gym for 16 hours a day.” Let me use”
There is no known cause for the condition, which, though incurable, may be controlled by a mixture of anti-spasmodic drugs and muscle relaxants. But so far, according to Mr. Doyle, none of these prescribed drugs have worked for him.
Mr. Doyle claims that the only genuine relief he has got from these muscle spasms (apart from that gained by using alcohol which, as he points out, would very likely leave him drunk, and so and incapable of working) has been on two occasions when he had smoked marijuana at parties.
Consequently, Mr. Doyle’s consultant had written to the then Minister for Justice, Mrs Owen, seeking permission to prescribe marijuana to his patient. Mrs. Owen passed the letter on to the then Minister for Health, Mr Noonan.
In his response Mr Noonan said marijuana is a Schedule One controlled drug under the Misuse of Drugs Acts 1977 and 1984 and that it has no recognised medical use. He said clinical research did not support medical claims made in favour of marijuana and that its use could lead to experimentation with other drugs. It was not, the letter concluded, the Government’s stance to change the legal position on any drug including marijuana.
When interviewed about the reply, Mr. Doyle is quoted as saying:
“I wasn’t expecting an overtly compassionate response, but the clinically cold letter I got back surprised me..”
“The letter from Minister Noonan to the consultant is just so callous and cold. And the Department of Justice simply said no. It’s a controlled substance and that’s it.”
In the same Irish Times article Mr. Doyle made the point that he knows of a prominent consultant in the US who notes a ‘definite improvement’ in four dystonia sufferers who were given marijuana, and that the drug has also been licensed for use by people with specified illnesses in some US states.
Several points arise from the Minister’s reply to Mr. Doyle’s consultant. I intend in this paper take some of the statements made and consider them in turn.
I shall also later in the paper consider the suggestion that marijuana is a harmful drug, and possible moral and legal consequences there may be from disallowing Mr. Doyle’s request.
The question of the prohibition of certain drugs for “recreational” use is not really the main purpose of this paper, in which I intend to look just at the current prohibition on the medical prescription of marijuana. Unfortunately, one of the often stated reasons for not removing cannabis from Schedule One is the fact that doing so may “send the wrong signals”, so it is inevitable that the topic will be touched upon later in the paper. For a fuller discussion on the whole question of drug prohibition in Ireland, I would refer the reader to “Drugs, drug prohibition and crime: A response to Peter Charlton”, by Tim Murphy.
“…marijuana is a Schedule One controlled drug…”
Marijuana has only been a Schedule 1 narcotic in the United States since 1970 (later than this in Ireland). It was classified in that year, along with LSD and heroin, as a Schedule 1 narcotic – a drug with no known medical use.
This change in the status of marijuana came about largely as a result of the use of the drug by members of the “hippy” movement of the late 1960’s.
The argument that marijuana should be placed in Schedule 1 because it has no known medical use is dealt with in the next section.
In the U.S. morphine, cocaine and even Marinol – a synthetic derivative of marijuana’s Delta-9-Tetrahydrocannabinol (THC) – are Schedule 2, which means doctors can prescribe them. Medical marijuana advocates, in the U.S. and elsewhere, argue that synthetic derivatives of marijuana, like Marinol, often don’t work as well as the real thing – especially in a vomiting patient – and suggest that the marijuana itself should be moved to Schedule 2.
As a result of pressure by medical marijuana advocates, in the U.S., as many as 87% of the legislators in thirty-four states have voted to end the medical prohibition of marijuana.
As recently as November 1996, voters in California and Arizona approved ballot initiatives which legalised medical access to marijuana
Proposition 215 in California creates a defence to criminal charges if a doctor recommends medical use of marijuana to a patient . Proposition 200 in Arizona, among other things, allows a doctor to prescribe any Schedule I drug if it is supported by another doctor and the medical literature.
In spite of these votes, the Federal Government of the U.S. still puts obstacles in the way of the states who wish to implement these changes.
In private correspondence I have been informed that Swedish Television News (6 June 1997) reported that hospitals in Denmark have begun treating patients with cannabis. The information I received was: “Swedish Television News reported … that Danish doctors have used both natural and synthetic cannabis in large scale treatment programmes. The hospitals carrying out the programme are Rigshospital in Copenhagen and Centralsjukhuset in Esbjerg. Cannabis in pill form is administered to AIDS and cancer patients and according to Dr. Erik Sandberg, Chief Physician at Esbjerg Central Hospital, results are good, cannabis removes sickness, increases appetite and increases the patients well being and will to live.”
Medical use of marijuana is, in fact, legal in the U.S. However, the Federal Drug Agency’s “Compassionate IND program for medical marijuana” was withdrawn in March of 1992, largely as a result of lobbying by “War on Drugs” hard-liners. Hundreds of applications for the Compassionate programme were trashed, denying the patients access to the medical care that their physicians considered that they needed. Only the handful of existing patients under the scheme (there was a total of ten in February, 1992) escaped.
“…it [marijuana] has no medical use…”
I do not intend to try to list all the possible medical uses of cannabis, but the following may be of interest:
* The medical use of marijuana probably predates recorded history. The earliest known written reference is to be found in the fifteenth century BC, Chinese Pharmacopoeia, the Ry-Ya.
* The first Western physician to take an interest in cannabis as a medicine was W. B. O’Shaughnessy, a young professor at the Medical College of Calcutta, who had observed its use in India in the first half of the nineteenth century. After studying the literature on cannabis and talking with contemporary Hindu and Mohammedan scholars O’Shaughnessy tested the effects of various hemp preparations on animals, before attempting to use them to treat humans. Satisfied that the drug was reasonably safe, he administered preparations of cannabis extract to patients, and discovered that it had analgesic and sedative properties. O’Shaughnessy successfully relieved the pain of rheumatism and stilled the convulsions of an infant with the drug. His most spectacular success came when he quelled the wrenching muscle spasms of tetanus and rabies with the “new” drug.
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