Pot Shots

After he heard that the lead character on the CBS sitcom Murphy Brown would be smoking marijuana to relieve the side effects of chemotherapy, Drug Enforcement Administrator Thomas Constantine accused the show of "pandering to the libertarian supporters of an 'open society.' "

An open society, as defined by the philosopher Karl Popper, is one that encourages free inquiry and vigorous debate, based on the recognition that no one has a monopoly on the truth. Constantine clearly thinks an open society–like, say, unwed motherhood–is a bad thing. Given the quality of his arguments, it's no wonder.

Constantine said Murphy Brown was "doing a great disservice" by "trivializing drug abuse." In fact, the episode did not deal with drug abuse at all. It showed Murphy Brown smoking pot to alleviate the nausea and vomiting caused by cancer chemotherapy. It also showed her friend Jim, the straight-laced news anchor who bought the marijuana for her, taking a few puffs from Murphy's joint.

None of this qualifies as "drug abuse," unless we are prepared to say that any use of an illegal substance is drug abuse, regardless of the consequences. And if Murphy Brown trivialized drug abuse by ignoring it, then every series that shows two friends having a drink without showing a drunk driving accident or a patient dying from cirrhosis of the liver should be condemned for "trivializing" alcoholism.

Constantine also said it was wrong to "portray marijuana as a medicine," because "it is not a medicine." Yet the government's leading marijuana expert, Mahmoud ElSohly, says, "There is no question about the use of cannabis for certain conditions. It does have a history. It does have utility."

In fact, as Harvard researchers Lester Grinspoon and James Bakalar show in their recently revised book, Marihuana, the Forbidden Medicine (Yale University Press), the medical use of cannabis goes back thousands of years. U.S. physicians stopped prescribing marijuana after the federal government effectively banned it in 1937, but interest in the therapeutic properties of cannabis revived in the 1960s, when large numbers of Americans began to use the drug recreationally.

Although systematic research has been hampered by the federal prohibition, substantial evidence supports the use of marijuana to treat glaucoma, AIDS wasting syndrome, and other serious conditions. The best-established medical use of marijuana is the one depicted on Murphy Brown.

Many cancer patients have obtained dramatic relief with marijuana. Their experiences were reflected in a 1990 survey of oncologists in which 44 percent said they had recommended marijuana to at least one patient, 48 percent said they would prescribe it if it were legal, and 54 percent said it should be legally available as a medicine.

In addition to such clinical evidence–which, though "anecdotal," cannot plausibly be attributed to mass delusion–studies conducted by half a dozen states in the late 1970s and early '80s confirmed marijuana's effectiveness in treating the side effects of chemotherapy. Furthermore, studies rigorous enough to satisfy the Food and Drug Administration have shown that delta-9 tetrahydrocannabinol (THC), marijuana's main active ingredient, is effective for this purpose.

Those studies preceded FDA approval of Marinol, a gelatin capsule containing synthetic THC, which opponents of medical marijuana say is an adequate substitute. Many patients and doctors disagree. For people suffering from severe nausea, a capsule that must be swallowed has obvious drawbacks. Even if a patient can manage the capsule, smoked marijuana takes effect more quickly, the dosage is easier to control, and it's less expensive than Marinol. Finally, other ingredients in marijuana may contribute to its therapeutic effect.

As for safety, if government-funded research aimed at proving the hazards of marijuana has shown anything, it's that cannabis is remarkably safe, especially when compared to many pharmaceuticals. In 1988 the DEA's own administrative law judge, Francis L. Young, called it "one of the safest therapeutically active substances known to man." In 1995, the editors of the respected British medical journal The Lancet concluded that "the smoking of cannabis, even long term, is not harmful to health."

Constantine's real fear about medical marijuana seems to be that if thousands of patients across the country were openly using it, the drug would be harder to demonize. It's a reasonable fear. In an open society, there's always the risk that the truth will come out.