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Show Local doctors disagree with survey Marijuana high could benefit cancer patients The national survey figures, pur lished in the Annals of Internal Medicine, led cancer physicians in Utah to ask what for them is an ob- " 'I I A ( ; t ' 4 if . J - r T7 By MARK EDDINGTON ; Staff Writer f I I SALT LAKE CITY Despite a national survey which found j many cancer specialists recommend smoking marijuana to alleviate i chemotherapy nausea, Utah on cologists are not very supportive of the idea. A survey of 2,403 cancer specialists, conducted by Mark Kleiman, a public policy lecturer, and Rick Doblin, a graduate student at Harvard's John F. Kennedy School of Government, found more than 40 percent of oncologists have advised patients to smoke marijuana mari-juana to relieve nausea and 48 percent per-cent would prescribe the drug were it legal. Many local cancer physicians have had patients who smoked marijuana for nausea relief, but unlike many oncologists nation-i nation-i wide, have stopped short of recom mending the drug. "I've known of people who have smoked marijuana as an anti-nauseant, anti-nauseant, I don't recommend it but I don't turn them in either," said one oncologist, who requested anonymity. physicians in pharmaceutical form about 1 0 years ago by the National Cancer Institute after many cancer patients claimed smoking marijuana helped them to control nausea and vomiting, two common side-effects of chemotherapy treatment. The active ac-tive ingredient in both marijuana and Marinol is "delta-9-tetrahydrocannabinol," which research re-search has found to be effective in alleviating nausea and vomiting in up to 40 percent of patients undergoing chemotherapy. Although the drug has been found to be beneficial in some cases, many older patients are disturbed by the "spacey" feelings or dizziness and lightheadedness of the drug and prefer other alternative drugs such as "Reglan or "Zoforan," which have proved to be more effective in many cases. Cancer physician, Ross E. Morgan, has prescribed Marinol for several patients over the years. He said he found Marinol to be helpful for younger patients in some instances. in-stances. "Typically a younger patient with previous marijuana experience will find Marinol to be helpful. Marijuana naive people or people without experience, don't find it as beneficial and feel uncomfortably odd from the drug," he said. While Morgan and other oncologists on-cologists say Marinol has a place in the arsenal of anti-nausea drugs, they feel smoking marijuana to help with nausea is problematic. When marijuana is obtained on the street, there is no guarantee of the potency of the drug, which might vary greatly because of the climate and location where the marijuana is grown, as well as other factors. "At least in Marinol you know what you're getting and it's a consistent con-sistent dose each and every time," Morgan said. Drew Moren, special agent in charge over the state office of the Drug Enforcement Agency, expressed puzzlement over why any physician would recommend a patient to break the law. "I would hope our medical profession pro-fession would be more responsible than that," he said. Under the 1968 Controlled Substances Act, marijuana is labeled label-ed a Schedule I drug-the category given for drugs judged to have no medicinal value and a very high potential for abuse. Asked whether the DEA had any plans to change the drug's classification, Moren said, "absolutely not!" Marinol is a Schedule II drug, judged to have known medical use but a high probability of abuse. The drug can be obtained legally by a prescription obtained by a doctor with a DEA number, a regulatory number which allows federal authorities au-thorities to monitor the practice. Prescription of the drug was fairly fair-ly routine when the drug was first introduced to the market. But problems prob-lems with expense, side effects and the appearance of other drugs have since made Marinol less common. "It was kind of interesting when the drug first came out. All of us wondered if we were going to be beseiged with requests for Marinol, but frankly I have found very few people who really get the kind of high one might expect of marijuana," mari-juana," Hensleigh said. Independent clinical studies of Marinol show about 24 percent of patients taking the drug report euphoric feelings of easy elation or heightened awareness. At 48 percent, per-cent, drowsiness was another common com-mon feeling. Anxiety, muddled thinking and brief periods of muscular impairment, were also common. Local cancer specialists say the use of Marinol is an effectiveness issue rather than an ethical issue. Some oncologists report they have not prescribed Marinol for years. Others say they prescribe it in limited lim-ited cases. "As a general rule if we didn't have it, I don't think it would be a great loss. There isn't anything magic about Marinol. We have other drugs we can use," said Clyde Ford, another practicing cancer specialist. Of all the local oncologists questioned, ques-tioned, not one supported smoking marijuana as a means of controlling nausea or for pain relief. The national questionnaire was distributed to 2,430-about a third-members third-members of the American Society of Clinical Oncologists. The participants par-ticipants were selected at random. About 43 percent of the recipients of the survey responded. Some drug experts in the Bush administration have called into question the study's results and methodology. For example, it has been suggested sug-gested that those physicians who recommended marijuana smoking for patients might have been more willing to respond than those physicians physi-cians who had not. vious question: Why would a physician advise a patient to break the law if they can already obtain a derivative of the drug legally? "It's really kind of humorous because a marijuana derivative called "Marinol" has been legally available as a prescription drug for years now," said Darrell Hensleigh, an oncologist practicing in Salt Lake City. Marinol was made available to |