Vol. XX, No. 4, Fall 2012
By Larry Fox
The long-running debate concerning the legalization of marijuana for medical purposes has surfaced anew in the Commonwealth. There’s a movement to include a special question on this issue on the November ballot and State Senator Dan Wolf (D-Cape Cod) is sponsoring a bill calling for legislative legalization.
The idea of legalization was greeted with some skepticism by members of the Advisory Board of To Your Good Health, A Health Care Newsletter, during its most recent meeting at Cape Cod Community College.
Even some of those who approved the concept were concerned that there were potential loopholes in the bill as written.
One of the skeptics was Ray Tamasi, an addiction expert and president/CEO of the Gosnold on Cape Cod treatment center in Falmouth.
“From my addiction treatment perspective, I have some concern,” he declared. “The bill as written has some holes in it. It gives too much flexibility to physicians to prescribe the drug to people who may claim to have a particular medical problem and includes a vague reference to ‘…and other medical conditions.’”
Mr. Tamasi said he didn’t think the bill “should be completely abandoned,” but he did point to problems in California, which has allowed medical use of marijuana for several years and where “some of the dispensaries have been less than ethical.”
Many have called marijuana a gateway drug, the slippery slope to hard-core substance abuse.
“I’ve seen 100,000 addictive patients and 98 percent of them have marijuana progressions in their addiction,” Mr. Tamasi said, “And I’ve seen too much really serious impairment of young people who are long-time marijuana smokers.”
Dr. Arthur Bickford, co-founder of the Duffy Clinic, was worried that any extended marijuana use was a difficult habit to break. “I once worked in a clinic that treated drug addicts and the two biggest causes of relapse were marijuana and alcohol. I don’t think we’re going to take alcohol off the market, but we should jolly well not put marijuana out there on the market, either.”
As for prescribing marijuana for older or terminal patients to ease their discomfort, Dr. Bickford noted “for years we’ve been managing with morphine.”
Dr. Herbert Mathewson, medical director at the VNA of Cape Cod, brought another troubling insight to the question. “Marijuana may or may not be a ‘gateway’ drug,” he said, “But I can remember when methadone was accepted as useful in getting people off heroin. And they ended up with a new set of addictions. You’d have these huge methadone clinics where they’d just say, ‘Hello, here’s your dose and goodbye.’ That’s when we ended up with all those methadone babies [born addicted to mothers undergoing the treatment]. You get a lot of unintended consequences in these things.
“The Massachusetts Medical Society voted by a two-thirds majority to oppose medical use of marijuana pending more study and I would not feel comfortable prescribing it,” he concluded.
Jim Lyons, retired founding president/CEO of Cape Cod Healthcare, recalled the methadone days when he was running a hospital in Fall River and the drug was not available on the Cape. “I can remember so many Cape Cod patients making their way to Fall River and how so many of them didn’t survive. They’d fall off the wagon.”
Sue Madigan, dean of Health Sciences, Social Sciences and Human Service at Cape Cod Community College, said the question was still unresolved. “What we need are some good double blind studies,” she said, before posing another question. “What do you do if it’s legal in one state and not in another and somebody comes onto a public campus (with the prescription)? It’s a problem that Maine has struggled with for some time involving students from California.”
Rosemary Dillon, Ms. Madigan’s predecessor at the college, also had some questions, “Is it necessary? What’s the impact on the immune system? They have all kinds of other medications, so is it worth it?” she asked.
Carol Vigliano, a nurse and care management consultant, was even stronger in opposition. “I’ve been dealing with addiction (cases) since 1958 and addiction is addiction,” she said. “There are so many more alternatives and marijuana is just another drug as far as I’m concerned.”
Seth Rolbein, Senator Wolf’s top legislative aide, acknowledged the concerns about the bill being “too loose,” but he countered, “If we understand the dangers of drugs—like Oxycontin—and how they can be prescribed and then abused, that doesn’t necessarily mean that they will be abused. So, if there is efficacy from marijuana, why not give doctors the prerogative to prescribe it? Just as we do with other drugs.