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June 13, 1980


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TARGET: DRUGS / Michele Steinberg The Fraud of Marijuana as Medicine

High-technology medicine, or marijuana for cancer victims? Pictured, the CAT scanner for detecting cancerous cells.

The New England Journal of Medicine has published a study purporting to show that marijuana should be used as an antinausea medicine for patients undergoing cancer chemotherapy, a therapy which often induces vomiting. The experiment compares marijuana with Compazine, a standard drug used to control nausea and vomiting, and concludes that marijuana is better than Compazine. Based on this report and several others like it, the Food and Drug Administration has been petitioned to allow doctors to prescribe marijuana to patients legally. But the study is a fraud and, not accidentally, one of the authors of the report is Dr. Norman Zinberg, a member of the advisory board of the National Organization for the Reform of Marijuana Laws (NORML). the main lobby in the U.S. for the decriminalization of marijuana. Not Double-Blind According to the abstract, or summary, of the study, it is a "randomized, double-blind" trial. That is, in keeping with standard experimental procedure, neither the doctor nor the patient knows whether he is receiving the marijuana chemical THC or Compazine until the experiment is over,

thereby eliminating prejudice in evaluating the effect of the substances on the patient. This is especially important in evaluating a subjective complaint such as nausea, or a problem such as vomiting which is strongly psychologically determined. However, the details of the experiment show that it was not double-blind. First of all, patients were selected for the experiment on the basis that "their nausea and vomiting were inadequately controlled by conventional antiemetics, including the phenothiazines (i.e., Compazine)." That is, patients were asked to join a marijuana experiment if they were not happy with their present therapy. Since nausea is a subjective complaint, the doctor has to take the patient's word for it, and it is not surprising that a number of patients, mostly in their 20s and 30s, volunteered for the "experiment." That is to say, there was a motivating factor, the offer of free drugs, enticing patients to say that their conventional therapy was not working and to try the THC. There was nothing in the published report to guard against such fraud. Secondly, the study could not have been double-blind. According to the report, "The antiemetic effect of the THC correlated with the development of a high . . . 32 of 41 courses associated with a high also resulted in a complete response, whereas only 4 of 38 courses without a high resulted in a complete response." Since the patients who felt high therefore knew that they had been given THC, the trial was not double-blind. Additionally, the patients may have been motivated to lie, saying that the THC had a better antiemetic effect than it actually had, since by doing so they would improve the experimental results for THC and increase the likelihood of having it made a standard therapy for them. In another recent study, patients were given THC with no control drug for comparison at all. The requirement for the patient entering the study was failure to control nausea and vomiting with other drugs. This is open to the same problem as the previous study. Decrim Motivation? Why are these incompetent experimental designs being funded by the National Institute of Health? The same kind of incompetence, especially the lack of a control, characterizes the New Mexico state-run experiment, the model for several other states which have passed "medical decrim" bills in

the past two years. Either the researchers are totally incompetent, or they have another purpose in mind. The federal narcotics law explains the puzzle. Marijuana is currently classified under federal law as a Schedule I narcotic, a substance with a high abuse potential and with no proven medical value, so it cannot be prescribed by a physician. Schedule II substances, while still having a high abuse potential, have a proven medical use, and therefore can be prescribed. There is nothing in the law that demands that, for a substance to be changed from Schedule I to II it must be better than existing drugs used for the same medical purpose. The decrim advocates, led by NORML, have been fighting for years to have marijuana reclassified into Schedule II, even though penalties for abuse of Schedule II substances may be as great as for certain Schedule I substances. Why all this medical interest on the part of NORML? The word NORML gives it all away. They want marijuana smoking to be considered "normal," and what better way than to brainwash the public that marijuana is acceptable than by allowing doctors to prescribe it as a medicine. Excerpted from an article by Ned Rosinsky, M.D. to be printed in the July issue of War on Drugs by permission of War on Drugs magazine.