HomeMy WebLinkAboutCOM 0639.013 2008-2010Murashige, Laura
From: stave [szuniga @hawaii.rr corn]
Sent: Monday, January 04, 2010 9.37 AM
To: counciltestimony @co.hawaii.hi us
Subject: Written testimony regarding resolution 281 -09 relating to decriminalization of marijuana
Attachments: To Hawaii County Council Members regarding Hoffman bill 1 4.2010.doc
I apologize for not being able to attend the hearing and submit this written testimony on my behalf.
Respectfully.
Dr. Stephen C. Zuniga
1/5 /2010
Page 1 of 1
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Comm. No. 03q
Ref. To. /Mr'
Ref. Data ' JAN 0 5 ?11111
To Hawaii County Council Members:
It is clear, from published research over the years that use of Marijuana comes with a host of
physical and social problems. At the same time, research shows that there are benefits of using
marijuana in the chronically ill. Perhaps the questions before the council lies not in
decriminalizing marijuana but rather how to manage and set standards which clearly regulate
those who seek to use it for their chronic illnesses.
No one argues that morphine has benefits in managing pain experienced by the terminally ill yet
one does not automatically reach for opiates to deal with pain when someone stubs their toe. For
the first time, I am starting to see individuals showing up for an assessment who were on
probation for use, abuse or selling of illicit drugs but are now stating they are on "medical
marijuana" and that it is legal for them to take this. The referral wants help for a DUI but not their
usage of marijuana. Your actions today not only impact the consumer side but create challenges
on the provider side as well. Are we now on the cusp of introducing into the treatment model
staff who "are on medical marijuana" for their "pain "? Does working along a staff member who
regular smokes marijuana engender a sense of trust and support the program's integrity? Would
you send loved ones to this program? While I cannot speak for the recovery community, many
would argue that there are other intervention methods to be tried before prescribing marijuana.
Are we fully prepared to understand the implications of what it would mean to move to include
medical marijuana under those protected classes under the American Disabilities Act? What
ramifications does this have on Worker's Comp cases and costs? What about compliance with
the Drug Free Workplace Act? Do we now afford protection to pilots, nurses, doctors, teachers,
bus drivers and others in sensitive areas that are on medical marijuana? Again, the real question
is not decriminalization rather how to regulate the benefits of medical marijuana.
Opponents are confusing this issue under the guise of the medical benefits of marijuana. Yet, we
have the means to provide a prescription for `marinol' today. Let's look at the facts:
"Medical" Marijuana - The Facts
(Source: US Drug Enforcement Administration
Link: wwwjustice.gov /dea /ongoing /marinol html)
• Medical marijuana already exists. It's called Marinol.
• A pharmaceutical product, Marinol, is widely available through prescription. It comes in
the form of a pill and is also being studied by researchers for suitability via other delivery
methods, such as an inhaler or patch. The active ingredient of Marinol is synthetic THC,
which has been found to relieve the nausea and vomiting associated with chemotherapy
for cancer patients and to assist with loss of appetite with AIDS patients.
• Unlike smoked marijuana - -which contains more than 400 different chemicals, including
most of the hazardous chemicals found in tobacco smoke - Marinol has been studied and
approved by the medical community and the Food and Drug Administration (FDA), the
nation's watchdog over unsafe and harmful food and drug products. Since the passage of
the 1906 Pure Food and Drug Act, any drug that is marketed in the United States must
undergo rigorous scientific testing. The approval process mandated by this act ensures
that claims of safety and therapeutic value are supported by clinical evidence and keeps
unsafe, ineffective and dangerous drugs off the market.
• There are no FDA - approved medications that are smoked. For one thing, smoking is
generally a poor way to deliver medicine. It is difficult to administer safe, regulated
dosages of medicines in smoked form. Secondly, the harmful chemicals and carcinogens
that are byproducts of smoking create entirely new health problems. There are four times
the levels of tar in a marijuana cigarette, for example, than in a tobacco cigarette.
IVIARINOL -r mcdic rl maeluana
pharmaceutical product
available through prescription
JOINT -n; rnarduann cigarette..'
iitegal'tiatcotic substance"
• Morphine, for example, has proven to be a medically valuable drug, but the FDA does
not endorse the smoking of opium or heroin. Instead, scientists have extracted active
ingredients from opium, which are sold as pharmaceutical products like morphine,
codeine, hydrocodone or oxycodone. In a similar vein, the FDA has not approved
smoking marijuana for medicinal purposes, but has approved the active ingredient -THC-
in the form of scientifically regulated Marinol.
• The DEA helped facilitate the research on Marinol. The National Cancer Institute
approached the DEA in the early 1980s regarding their study of THC's in relieving
nausea and vomiting. As a result, the DEA facilitated the registration and provided
regulatory support and guidance for the study.
• The DEA recognizes the importance of listening to science. That's why the DEA has
registered seven research initiatives to continue researching the effects of smoked
marijuana as medicine. For example, under one program established by the State of
California, researchers are studying the potential use of marijuana and its ingredients on
conditions such as multiple sclerosis and pain. At this time, however, neither the medical
community nor the scientific community has found sufficient data to conclude that
smoked marijuana is the best approach to dealing with these important medical issues.
• The most comprehensive, scientifically rigorous review of studies of smoked marijuana
was conducted by the Institute of Medicine, an organization chartered by the National
Academy of Sciences. In a report released in 1999, the Institute did not recommend the
use of smoked marijuana, but did conclude that active ingredients in marijuana could be
isolated and developed into a variety of pharmaceuticals, such as Marinol.
• In the meantime, the DEA is working with pain management groups, such as Last Acts,
to make sure that those who need access to safe, effective pain medication can get the
best medication available.
If supporters are truly interested in the medical benefits of marijuana as a cause then why are they
not supportive of prescription Marino!? Wouldn't the best intervention control the amount of
chemicals entering your system so that the therapeutic benefits are achieved at the lowest dose as
we all know there are side effects of any drug being used (whether smoked or ingested)? There is
no way to regulate the amount of THC in given plants as they vary considerably and how does
one achieve the least dose required to have a beneficial effect? Smoking opium also relieves pain
but no one supports smoking it. So what is really at the issue of the medical marijuana debate? A
hidden agenda which aims to support widespread recreational use under the guise of medical
need? When is the last time you walked into Borders to pick up "Weedworld" or "High Times"
in the magazine section to see what the real agenda is all about? Check out their websites:
http://hightimcs.com
http. / /www.weedworld.co.uk
http: / /42Omagazine.com
If this doesn't change your view, then perhaps consider that Tobacco companies were sued for
billions for promoting similar advertising. The liquor industry also had their challenges and
where is "Tobacco Free Hawaii" in all of this? They were vocally effective and the Council
sensitive to the issues to the point of passing laws to regulate smoking of tobacco products at the
County beaches and parks. How is the County Council going to regulate smoking of "medical
marijuana" at County Parks and Beaches when that is the delivery method used to introduce it
into the body? Also, how can you regulate where someone takes a so- called "prescription
medicine" when it has been ordered by their physician? Are you opening yourselves up to be
sued for failure to accommodate someone who you've now bestowed certain privileges afforded
to those under the American Disabilities Act? Will you now create medical marijuana zones
within the parks? Do we also accommodate smoking on planes because it is time for the person
to take their "medical marijuana" and they are required under a physician's orders to smoke the
marijuana?
In closin• I leave ou with the followin facts reardin' marijuana:
Studies have demonstrated that tolerance and withdrawal develop with daily use of large doses of
marijuana or THC (Haney et al. 1999a; Jones and Benowitz 1976; Kouri and Pope 2000).
Aboutl5 percent of people who acknowledge moderate -to -heavy use reported a withdrawal
syndrome with symptoms of nervousness, sleep disturbance, and appetite change (Wiesbeck et al.
1996).
Many adults who are marijuana dependent report affective (i.e., mood) symptoms and craving
during periods of abstinence when they present for treatment (Budney et al. 1999). The
contribution of physical dependence to chronic marijuana use is not yet clear, but the existence of
a dependence syndrome is fairly certain. An Epidemiological Catchment Area study conducted in
Baltimore found that 6 percent of people who used marijuana met Diagnostic and Statistical
Manual of Mental Disorders, Fourth Edition (DSM -IV) (American Psychiatric Association
1994), criteria for dependence and 7 percent met DSM -IV criteria for substance abuse (Rosenberg
and Anthony 2001).
Coffey and colleagues (2002) found that persons who use marijuana more than
once a week are at significant risk for dependence. In the 1990s, the number of people who
sought treatment for marijuana dependence more than doubled (Budney et al. 2001). Therefore, a
large group of adults who smoke marijuana is dependent and may need and benefit from
treatment.
People using marijuana who participated in previous treatment studies averaged more than 10
years of near -daily use and more than six serious attempts to quit (Stephens et al. 1994b, 2000).
These individuals had persisted in their use despite multiple forms of impairment (i e., social,
psychological, physical), and most perceived themselves as unable to stop.
Source: Brief Counseling for Marijuana Dependence: A Manual for Treating
Adults (Substance Abuse Mental Health Services Administration ISAMHSAI, 2005)
"3 -4 Cannabis cigarettes a day are associated with the same evidence of acute and
chronic bronchitis and the same degree of damage to the bronchial mucosa as 20 or more
tobacco cigarettes a day.
Cannabis smoking is likely to weaken the immune system. Infections of the lung are due
to a combination of smoking- related damage to the cells lining the bronchial passage and
impairment of the principal immune cells in the small air sacs caused by cannabis."
-- British Lung Foundation*
"Smoking Gun: The Impact of Cannabis Smoking on Respiratory Health,"
a publicly disseminated report
Noy. 2002
Smoked marijuana damages the brain, heart, lungs, and immune system. It impairs
learning and interferes with memory, perception, and judgment. Smoked marijuana
contains cancer - causing compounds and has been implicated in a high percentage of
automobile crashes and workplace accidents."
-- John Wailers*
Director, Office of National Drug Control Policy
Syndicated editorial
Mar. 2002
Marijuana versus Marinol
Marinol differs from the crude plant marijuana because it consists of one pure, well - studied, FDA - approved
pharmaceutical in stable known dosages. Marijuana is an unstable mixture of over 400 chemicals including
many toxic psychoactive chemicals which are largely unstudied and appear in uncontrolled strengths "
-- Califirma Narcotics Officers .Association*
Official policy statement "The Use of Marijuana as a Medicine"
Oct 31, 2005
Exposing the Myth of Smoked Medical Marijuana
Marijuana: The Facts (US Drug Enforcement Administration)
Q: Does marijuana pose health risks to users?
• Marijuana is an addictive drug with significant health consequences to its users
and others. Many harmful short-term and long -term problems have been
documented with its use:
• The short term effects of marijuana use include: memory loss, distorted
perception, trouble with thinking and problem solving, loss of motor skills,
decrease in muscle strength, increased heart rate, and anxiety = .
• In recent years there has been a dramatic increase in the number of emergency
room mentions of marijuana use. From 1993 -2000, the number of emergency
room marijuana mentions more than tripled.
• There are also many long -term health consequences of marijuana use. According
to the National Institutes of Health, studies show that someone who smokes five
joints per week may be taking in as many cancer - causing chemicals as someone
who smokes a full pack of cigarettes every day.
• Marijuana contains more than 400 chemicals, including most of the harmful
substances found in tobacco smoke. Smoking one marijuana cigarette deposits
about four times more tar into the lungs than a filtered tobacco cigarette.
• Harvard University researchers report that the risk of a heart attack is five times
higher than usual in the hour after smoking marijuana.
• Smoking marijuana also weakens the immune system and raises the risk of lung
infections.' A Columbia University study found that a control group smoking a
single marijuana cigarette every other day for a year had a white- blood -cell count
that was 39 percent lower than normal, thus damaging the immune system and
making the user far more susceptible to infection and sickness.'
• Users can become dependent on marijuana to the point they must seek treatment
to stop abusing it. In 1999, more than 200,000 Americans entered substance abuse
treatment primarily for marijuana abuse and dependence.
• More teens are in treatment for marijuana use than for any other drug or for
alcohol. Adolescent admissions to substance abuse facilities for marijuana grew
from 43 percent of all adolescent admissions in 1994 to 60 percent in 1999.
• Marijuana is much stronger now than it was decades ago. According to data from
the Potency Monitoring Project at the University of Mississippi, the
tetrahydrocannabinol (THC) content of commercial -grade marijuana rose from an
average of 3.71 percent in 1985 to an average of 5.57 percent in 1998. The
average THC content of U.S. produced sinsemilla increased from 3.2 percent in
1977 to 12.8 percent in 1997.-
Q. Does marijuana have any medical value?
• Any determination of a drug's valid medical use must be based on the best
available science undertaken by medical professionals. The Institute of Medicine
conducted a comprehensive study in 1999 to assess the potential health benefits of
marijuana and its constituent cannabinoids. The study concluded that smoking
marijuana is not recommended for the treatment of any disease condition. In
addition, there are more effective medications currently available. For those
reasons, the Institute of Medicine concluded that there is little future in
smoked marijuana as a medically approved medication.
• Advocates have promoted the use of marijuana to treat medical conditions such as
glaucoma. However, this is a good example of more effective medicines already
available. According to the Institute of Medicine, there are six classes of drugs
and multiple surgical techniques that are available to treat glaucoma that
effectively slow the progression of this disease by reducing high intraocular
pressure.
• In other studies, smoked marijuana has been shown to cause a variety of health
problems, including cancer, respiratory problems, increased heart rate, loss of
motor skills, and increased heart rate. Furthermore, marijuana can affect the
immune system by impairing the ability of T -cells to fight off infections,
demonstrating that marijuana can do more harm than good in people with already
compromised immune systems.
• In addition, in a recent study by the Mayo Clinic, THC was shown to be less
effective than standard treatments in helping cancer patients regain lost
appetites. o
• The DEA supports research into the safety and efficacy of THC (the major
psychoactive component of marijuana), and such studies are ongoing, supported
by grants from the National Institute on Drug Abuse.
• As a result of such research, a synthetic THC drug, Marinol, has been available to
the public since 1985. The Food and Drug Administration has determined that
Marinol is safe, effective, and has therapeutic benefits for use as a treatment for
nausea and vomiting associated with cancer chemotherapy, and as a treatment of
weight loss in patients with AIDS, However, it does not produce the harmful
health effects associated with smoking marijuana.
• Furthermore, the DEA recently approved the University of California San Diego
to undertake rigorous scientific studies to assess the safety and efficacy of
cannabis compounds for treating certain debilitating medical conditions.
• It's also important to realize that the campaign to allow marijuana to be used as
medicine is a tactical maneuver in an overall strategy to completely legalize all
drugs. Pro - legalization groups have transformed the debate from decriminalizing
drug use to one of compassion and care for people with serious diseases. The New
York Times interviewed Ethan Nadelman, Director of the Lindesmith Center, in
January 2000. Responding to criticism from former Drug Czar Barry McCaffrey
that the medical marijuana issue is a stalking -horse for drug legalization, Mr.
Nadelman did not contradict General McCaffrey. "Will it help lead toward
marijuana legalization ?" Mr. Nadelman said: "I hope so."
Q. Does marijuana harm anyone besides the individual who smokes it?
• Consider the public safety of others when confronted with intoxicated drug users:
• Marijuana affects many skills required for safe driving: alertness, the ability to
concentrate, coordination, and reaction time. These effects can last up to 24 hours
after smoking marijuana. Marijuana use can make it difficult to judge distances
and react to signals and signs on the road. 1 i
• In a 1990 report, the National Transportation Safety Board studied 182 fatal truck
accidents. It found that just as many of the accidents were caused by drivers using
marijuana as were caused by alcohol -- 12.5 percent in each case.
• Consider also that drug use, including marijuana, contributes to crime. A large
percentage of those arrested for crimes test positive for marijuana. Nationwide, 40
percent of adult males tested positive for marijuana at the time of their arrest.
Q. Is marijuana a gateway drug?
• Yes. Among marijuana's most harmful consequences is its role in leading to the
use of other illegal drugs like heroin and cocaine. Long -term studies of students
who use drugs show that very few young people use other illegal drugs without
first trying marijuana. While not all people who use marijuana go on to use other
drugs, using marijuana sometimes lowers inhibitions about drug use and exposes
users to a culture that encourages use of other drugs.
• The risk of using cocaine has been estimated to be more than 104 times greater
for those who have tried marijuana than for those who have never tried it»
In Summary:
• Marijuana is a dangerous, addictive drug that poses significant health threats to
users.
• Marijuana has no medical value that can't be met more effectively by legal drugs.
• Marijuana users are far more likely to use other drugs like cocaine and heroin than
non- marijuana users.
• Drug legalizers use "medical marijuana" as red herring in effort to advocate
broader legalization of drug use.
Herbert Kleber, Mitchell Rosenthal, "Drug Myths from Abroad: Leniency is Dangerous, not
Compassionate" Foreign Affairs Magazine, September /October 1998. Drug Watch International "NIDA
Director cites Studies that Marijuana is Addictive " "Research Finds Marijuana is Addictive," Washington
Tunes, July 24, 1995.
'National Institute of Drug Abuse, Journal of the American Medical Association, Journal of Clinical
Pharmacology, International Journal of Clinical Pharmacology and Therapeutics, Pharmacology Review.
i "Marijuana and Heart Attacks" Washington Post, March 3, 2000
I. B. Adams and BR Martin, "Cannabis: Pharmacology and Toxicology in Animals and Humans"
Addiction 91: 1585 -1614. 1996.
5 National Institute of Drug Abuse, "Smoking Any Substance Raises Risk of Lung Infections" NIDA Notes,
Volume 12, Number 1, January/February 1997.
° Dr. James Dobson, "Marijuana Can Cause Great Harm" Washington Tunes, February 23, 1999.
2000 National Drug Control Strategy Annual Report, page 13.
"Marijuana and Medicine. Assessing the Science Base," Institute of Medicine, 1999.
See footnotes in response to question 4 regarding marijuana's short and long term health effects.
10 iMarijuana Appetite Boost Lacking in Cancer Study" The New York Times, May 13, 2001.
I 'Marjuana . Facts Parents Need to Know, National Institute on Drug Abuse, National Institutes of Health.
12 Maryuana Facts Parents Need to Know, National Institute on Drug Abuse, National Institutes of Health.
I thank the County Council for their time and cannot support the bill under consideration
to decriminalize marijuana.
Dr. Stephen C. Zuniga
Hawaii State Certified Substance Abuse Counselor and Program Administrator