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One week out -- testimony to the TN legislature for medical marijuana

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One week out : Testimony in support of re-establishing a medical marijuana program in Tennessee to the House and Senate Heath Committees of the Tennessee Legislature

Bernard H. Ellis, Jr., MA,MPH

I appreciate this opportunity to address you to support the re-establishment of a medical marijuana program in our state. By profession, I am a public health epidemiologist with my undergraduate degree from Vanderbilt, my graduate degrees from the University of Texas and the University of California, and additional graduate training at Vanderbilt and Stanford. As a state and national public health official, I have followed the medical marijuana research literature since the late 1970s when I was at the National Cancer Institute and my colleagues there documented marijuana’s superior performance over pharmaceutical alternatives in controlling chemotherapy-induced nausea. Since the late 1980s, I have used marijuana, with the awareness and approval of my physicians, to control symptoms associated with fibromyalgia and degenerative joint disease. During that same time, I have provided medical marijuana to persons with cancer, HIV/AIDS, multiple sclerosis and other chronic and debilitating conditions in our state. As a result, I am in the midst of a four year federal probation sentence for growing marijuana for that purpose, and I
remain at risk of losing my 187 acre farm in Maury county for the same offense.

I am thankful that the Tennessee legislature is actively considering the re-establishment of a medical marijuana program in our state, a program that ran without incident from 1983-92. Allowing seriously ill patients to obtain the many benefits available from this medically useful substance is something that the majority of Americans support and that a large number of health professionals in our state also support.

This support has grown in recent years as the scientific evidence for the beneficial uses of marijuana continues to expand. Every national study commissioned by the U.S. federal government from the presidencies of Richard Nixon through Bill Clinton has recommended that we reclassify marijuana to a less restrictive medicinal category. Every U.S. state that has placed a medical marijuana referendum before its citizenry has seen that referendum approved, with the margins of victory ranging from 10% to 30%. So far, eight states have passed a medical marijuana referendum (four red and four blue), as has the District of Columbia, whose initiative passed by a 38% margin of victory (only to have the implementation of its medical marijuana program blocked by Congress.) In addition, four other states have also authorized the establishment of medical marijuana programs through legislative action, with New Mexico being the latest state to approve their program last month. Today, one in every five Americans lives in a state that has an approved medical marijuana program for use by its sick citizens. At present, ten other states are considering the establishment or re-establishment of similar programs.

Virtually all U. S. medical organizations that have studied the medical marijuana issue have recommended its availability as medicine. These include the American Academy of Family Physicians, American Cancer Society, American Medical Association, American Nurses Association, American Public Health Association, Congress of Nursing Practice, Federation of American Scientists, the National Academy of Sciences’ Institute of Medicine, National Nurses Society on Addictions, the National Institutes of Health and the New England Journal of Medicine. Medical organizations at the state level have made the same recommendation, including organizations in Alaska, California, Colorado, Florida, Hawaii, Mississippi, New Jersey, New Mexico, New York, North Carolina, Virginia and Wisconsin. Similar recommendations have been made by medical organizations in other countries, including Australia, Belgium, Canada, France, Israel, the Netherlands, Spain and the United Kingdom.

Every state that has an existing medical marijuana program has approved its use for persons with cancer, HIV/AIDS, multiple sclerosis, glaucoma and chronic pain. In addition, patients with over forty other medical conditions have been shown by research and clinical experience to benefit from cannabis use, including persons with anorexia, arthritis, asthma, Crohns Disease, chronic nausea, colitis, epilepsy, fibromyalgia, neuropathy, Parkinson’s Disease and sleep apnea. I strongly recommend that you review the materials that we have provided you that document how marijuana operates to ease the pain and suffering of persons with these diseases. I also recommend that you hear from physicians and other medical scientists who have direct laboratory and clinical experience to attest to marijuana’s value as medicine.

At the same time that marijuana’s medical benefits have been well-documented, its safety has also been well established. In 1937, when the federal government first passed laws against marijuana, they did so over the strong objections of the American Medical Association. Dr. William Woodward, testifying on behalf of the AMA, told Congress that “the AMA knows of no evidence that marijuana is a dangerous drug...”. Instead, the AMA viewed marijuana as a substance that had clear potential for many beneficial medical uses. Unlike the hundreds of people who have died just in Tennessee alone in recent years from overdoses from opiates and other pharmaceuticals, there has never been a single documented overdose death from marijuana use in recorded history. Even the Drug Enforcement Administration’s own administrative law judge, Francis L. Young, ruled after over two years of extensive hearings that “ ... marijuana, in its natural form, is one of the safest therapeutically active substances known to man. It would be unreasonable, arbitrary and capricious for the (government) to continue to stand between (seriously ill persons) and the benefits of this substance.”

Existing state medical marijuana programs are working well. A 2002 report from the U.S. Government Accounting Office, which reviewed the medical marijuana programs in four states, found that these programs were running smoothly, that many patients were benefiting from these programs and that there had been no increase in illicit drug use in these states associated with the establishment of these programs. If anything, the GAO report concluded that these programs were currently under-utilized and that many more persons with serious diseases could benefit from these programs than were enrolled at the time of the study.

Even Tennessee’s own experience with a medical marijuana program, from 1983 to 1992, documented the benefits of inhaled marijuana over Marinol, a synthetic medicine containing only one of the almost 100 medically useful substances found in marijuana. Our own program documented a 23% greater benefit of inhaled marijuana over Marinol for controlling nausea in cancer patients. There are many reasons for this greater effect, including the faster onset of relief from inhaling the substance over taking it in pill form and the greater ability to titrate or control the dosage to obtain maximum benefit with minimal side-effects.

For any of you who may be concerned about the potential medical risks from smoking marijuana, recent research has shown that devices called vaporizers, which heat marijuana to release its beneficial substances without burning the material, can provide all of the medically beneficial substances without the tars and carbon monoxide that accompany smoking. In addition to vaporizers, patients can derive medical benefits by consuming marijuana in foods and teas, in tinctures and even in salves prepared from this substance.

In conclusion, Tennessee citizens would be well served to once again be able to access medical marijuana under controlled conditions and under the supervision of their health care providers for a number of serious and debilitating medical conditions. Please allow your sick and dying neighbors, friends and family members once again to access this medically useful and medically safe substance. Please substitute compassion and common sense for our current criminal justice approach to medical marijuana. The vast majority of Tennesseans will support your actions, just as the weight of history and the volumes of medical evidence for marijuana’s beneficial effects will buttress your decision. Thank you for this opportunity to address you today and I will be happy to entertain any questions.

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