Photo by Shelley Neuman

Lindsey Homan sits on the steps of the Capitol after the Global Marijuana March on May 2.  Over 1500 supporters of the legalization of medical marijuana attended the march.

The 2009 legislative session drew to a close without providing patient protection for prescription medical marijuana use. But efforts to support this refiorm remain strong and were active until legislators disbanded in June. A May march highlighted the ongoing struggle between those who try to provide relief to cancer sufferers and those who deny it in the name of law and order. Over 1,500 people turned out for the march to show their support. At issue now is Texas House Bill 164, which protects patients who, on their doctors’ recommendation, use medical marijuana.

Two years ago Alex, critically ill and on intensive chemo therapy, took a plethora of pain medications and eventually developed an allergy to analgesics. Twice a week, he made the four-hour drive to Houston for treatment at the University of Texas MD Anderson Cancer Center. He felt lucky that he could afford the best medical care, but nothing seemed to help.

A doctor noted that if he was giving treatment in another state, he would recommend smoking "a joint." Here in Texas, however, it posed a dilemma for both patient and doctor. Under Texas law the physician would be recommending an illegal activity and subject to disciplinary action, and a patient found with marijuana would be subject to arrest.

“I’m an adult,” Alex said, “and I always try to set a good example for my children.” Alex was not a criminal, but he was in pain and unable to eat. He lost weight. Still, he hesitated. “I didn’t know where to get it. How much I should smoke or how much I should buy.”

But he soon found that this illicit drug helped to alleviate the devastating effects from his therapy.

State Representative Elliott Naishtat hopes that thousands of other Texas patients can also soon benefit from the medicinal properties of marijuana. On November 11, 2008, Naishtat filed HB 164 which allows patients to present a medial marijuana defense to a jury. It includes a clause that protects doctors from disciplinary action for recommending or prescribing it.

Naishtat’s bill reflects opinion at the highest government level. President Barack Obama has stated his support of controlled use of marijuana for medical purposes, just like other pain-control medications. On Feb. 27, U.S. Attorney General Eric Holder said that the Drug Enforcement Agency would end its raids on state-approved marijuana dispensaries. House Bill 164 does not designate any sort of dispensary method.

Local business owner Brad Ernst showed his support by organizing the May 2nd march, the second annual Cannabis Crusade. The march started at Zilker Park, went to Congress Ave. and up to the State Capitol steps. A police escort led Ernst’s crowd and despite the open use of marijuana, on and around the capitol grounds, the Austin Police Department reported no arrests at the event.

Photo by Shelley Neuman

Several speakers, including patients who would benefit from the use of medical marijuana, vocalized their viewpoints on the legalization of medicinal marijuana at the Global Marijuana March.

Since 1996, 13 states have legalized medical marijuana use, but the number of arrests has increased every year. According to the FBI’s yearly Uniform Crime Reports (UCR), over 10 million Americans have been arrested for marijuana possession since 1996. Over 60,000 Texans were arrested just last year for simple marijuana possession according to "Public Crime Report 2007" published by the Department of Public Safety..

Texas HB 164 stops short of legalizing marijuana. It protects doctors from disciplinary action should they discuss the use of marijuana with their patients. This bill differs from other medical marijuana legislation passed by other states which regulate outlets for marijuana patients to obtain their medicine after they receive a written prescription from their doctor.

Anderson officials estimate there are more than 140,000 Texans living with cancer. The legislation would allow doctors to provide another option for their treatment and relief.

However, critics of the bill argue that any medicinal value that might come from marijuana can be matched by legal medications. The only cannabis currently approved by the Food and Drug Administration is a synthetic pharmaceutical called Marinol.

According to Vincent Vinciguerra, in the New York State Journal of Medicine, a study compared inhaled cannabis to the pill Marinol for chemotherapy patients who were unresponsive to standard antiemetic (vomit prevention) agents. Results published in the medical journal Neurology found that "twenty-nine percent of patients who failed oral THC responded to the cigarette form.”

Dr. Vinciguerra also notes the difference in the patients being studied.

“Our results demonstrate that inhalation marijuana [compared to pill digestion] is a far more effective therapy for the treatment of nausea and vomiting due to cancer chemotherapy."

Marino is 99 percent THC, the active ingredient in marijuana, and is usually prescribed in patients with AIDS and for the treatment of nausea and vomiting associated with chemotherapy patients who fail to respond to other treatments.

It lacks several of the therapeutic compounds available in natural cannabis. According to the National Academy of Sciences Institute of Medicine, the chemical compounds in cannabis, known as cannabinoids, are responsible for its numerous therapeutic benefits. Scientists have identified 66 naturally occurring cannabinoids in marijuana.

Also, unlike marijuana, which individuals can grow cheaply, Marinol is produced by pharmaceutical companies that manufacture and distribute it for profit.

Photo by Shelley Neuman

Dr. Thomas Tucker, a local oncologist, supports the use of medicinal marijuana and says he would rather write prescriptions to his patients for marijuana rather than Marinol which is produced by pharmaceutical companies.

Dr. Thomas Tucker, an oncologist whose Austin-based Southwest Regional Cancer Center practice treats local patients from the M.D Anderson Center, began working with severely ill cancer patients almost 20 years ago. He said that he currently prescribes Marinol to his patients, but he would prefer to write a prescription for medical marijuana compared to one for a drug that is more harmful because of its side effects and less effective.

The consumer advisory insert from Roxane Laboratories, the pharmaceutical company that produces Marinol, warns that it elicits “disturbing psychiatric symptoms,” and that even patients on low doses might experience “a full-blown picture of psychosis” The latter phrase has disappeared from recent product inserts, but experts say that those reactions are still possible.

“The problem with Marinol is that a lot of people have negative side effects from it and you can’t moderate the dose like you can with smoking a joint.” said Tucker, “You can smoke it until your symptoms are gone and then stop. Whereas if you take a pill you’ve got the whole thing in you and if that’s too much, well that’s just too bad.”

Most doctors respect the patients’ evaluation of whether or not a drug works for them – the DEA does not. In the government's 1992 decision to ban medical marijuana, a DEA administrator wrote, "Sick people are not objective scientific observers, especially when it comes to their own health." The decision was backed by Robert Bonner, the head of the Public Health Service under President George W. Bush. That July Bonner declared, "There is not a shred of evidence that smoking marijuana assists a person with AIDS."

Photo by Shelley Neuman

Carolina Velasco, Janelle Venuto, and Leah Ortiz gather at the Capitol for the 2009 Global Marijuana March in support of the legalization of medicinal marijuana.  "I knew a woman who had breast cancer," says Ortiz, "and the chemo was killing her.  She asked me one day to get her some weed, and now she's doing a lot better."

Bonner’s statement belies the facts. The Neurology study also found that AIDS patients suffering from debilitating nerve pain got as much or more relief by smoking marijuana as they would typically get from prescription drugs —and with fewer side effects.

Tucker says that he would recommend the use of marijuana to any if not all of his patients feeling the effects of chemo-therapy.

“I sure would like to have that ability,” he said. “I wish there was an outlet in Texas. I’ve had many patients who have confided in me that they do smoke pot and that it does help their symptoms.”