------------------------------------------------------------------- Meth lab cleverly hidden in blackberry thicket near county fairgrounds (The Associated Press characterizes as "clever" a man in Central Point, Oregon, who allegedly built and operated a methamphetamine lab within the confines of the Jackson County Expo Park, the site of the Jackson County Fair.) From: "Bob Owen@W.H.E.N." (email@example.com) To: "_Drug Policy --" (firstname.lastname@example.org) Subject: Meth lab cleverly hidden in blackberry thicket near OR fairgrounds Date: Wed, 11 Nov 1998 20:11:37 -0800 Sender: email@example.com Meth lab cleverly hidden in blackberry thicket near county fairgrounds The Associated Press 11/11/98 4:05 PM Eastern CENTRAL POINT, Ore. (AP) -- People on horseback rode by it. Police officers walked by it. It wasn't until a narcotics officer spotted a Rottweiler known to belong to a man suspected of cooking methamphetamine that they finally found it: the hidden entrance to a 100-foot-long tunnel through a blackberry thicket that led to a plywood shack where the illicit drug was allegedly being made. A door of blackberry vines and cattails concealed the entrance. "There is nothing similar to this," said Jim Anderson, commander of the Jackson County Narcotic Enforcement Team. "Most of the meth labs we find are in a house or an apartment or a building. This is in a jungle." When officers followed the hidden tunnel to the shack, Arlen Eugene Zastera, 42, stepped outside, Anderson said. "A burner was going on the table just outside of the shack," Anderson added. Zastera was held without bail on charges of possession, manufacture and distribution of methamphetamine and probation violation. "He put an incredible amount of effort into clearing this thing out," Anderson said. "I have no idea how he even dragged all that stuff -- like the plywood and everything -- in there." The alleged lab may be within the borders of the Jackson County Expo Park, the site of the Jackson County Fair, and is close to a popular trail along Bear Creek. Fair manager Chris Borovansky said he didn't know where the money might come from to clean up any environmental contamination.
------------------------------------------------------------------- Defense Attorneys Contend That The Cannabis Co-Op Leader Was Entrapped (An Orange County Register update on the trial of Marvin Chavez says Superior Court Judge Thomas Borris changed his mind Tuesday and ruled that the founder of the Orange County Cannabis Co-Op may not invoke Proposition 215 to defend himself against pot-sale charges. Defense lawyers at Chavez's trial plowed on in the wake of the decision by mounting an entrapment defense.) Date: Wed, 11 Nov 1998 18:43:36 -0800 From: firstname.lastname@example.org (MAPNews) To: email@example.com Subject: MN: US CA: Courts: Defense Attorneys Contend That The Cannabis Co-Op Leader Was Entrapped. Sender: firstname.lastname@example.org Reply-To: email@example.com Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: John W. Black Pubdate: Nov 11, 1998 Source: Orange County Register (CA) Contact: firstname.lastname@example.org Website: http://www.ocregister.com/ Copyright: 1998 The Orange County Register Author: John McDonald COURTS: DEFENSE ATTORNEYS CONTEND THAT THE CANNABIS CO-OP LEADER WAS ENTRAPPED. Superior Court Judge Thomas Borris changed his mind Tuesday and ruled that Orange County Cannabis Co-Op co-founder Marvin Chavez may not use Proposition 215, the "medical marijuana initiative," to mount a defense against pot-sale charges. Defense lawyers at Chavez's trial plowed on in the wake of the decision by mounting an entrapment defense. The attorneys got an undercover police officer to admit on the stand that he feigned chronic back pain and provided Chavez with a false driver's license and phony doctor's recommendation in order to obtain small quantities of marijuana from the defendant. "Did you say you would speak to a doctor and it would be no problem getting a letter recommending marijuana for relief of chronic back pain and arthritis in both of your legs?" asked San Francisco lawyer David Nicks. "Yes," answered District Attorney's Office investigator Joseph Moreno, who looks more like a middle-age businessman than an undercover narcotics officer. Chavez rejected a recommendation for Moreno from a phony chiropractor because chiropractors ordinarily do not recommend medication, Moreno said. Moreno later brought Chavez a recommendation that appeared to be from a physician but had been concocted by the District Attorney's Office. Deputy District Attorney Carl Armbrust maintains that marijuana sales are not sanctioned by Prop. 215 and that it is immaterial why Chavez was providing anybody with pot. Chavez has contended that the co-op was attempting to provide marijuana for those in medical need without their having to resort to buying pot from criminal street dealers. Borris said earlier that he was inclined to allow Chavez to use the Prop. 215 defense. Chavez is charged with 10 counts of selling or transporting marijuana to individuals. But after questioning the patient who said Chavez was his "primary caregiver," Borris ruled that Chavez fails to meet the criteria of a "primary caregiver" as defined by Prop. 215. The trial continues Thursday.
------------------------------------------------------------------- The Chavez Trial Defining 'Caregivers' (A staff editorial in The Orange County Register provides more details about the trial of Marvin Chavez, particularly the unresolved issue of who qualifies as a "caregiver" under Proposition 215.) Date: Wed, 11 Nov 1998 18:45:46 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US CA: Editorial:The Chavez Trial Defining 'Caregivers' Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: John W. Black Pubdate: Nov 11, 1998 Source: Orange County Register (CA) Contact: email@example.com Website: http://www.ocregister.com/ Copyright: 1998 The Orange County Register THE CHAVEZ TRIAL DEFINING 'CAREGIVERS' Perhaps the most telling question in the Marvin Chavez marijuana sales trial, which marked its second day yesterday in Division 16 of the court building in Westminster, came from defense attorney David Nick as he was cross-examining undercover officer Joseph Moreno. Mr.Nick, after laying a foundation, asked the officer whether, in all his years as an undercover narcotics officer, he had ever had a suspected drug dealer tell him that he would not provide drugs unless he (the officer posing as a buyer) had a letter from a doctor. Mr. Moreno acknowledged that had never happened to him before. A little later, after establishing that the small bag of marijuana Mr. Chavez furnished to Mr. Moreno had a label with the words "Not for Sale" and the name of the Orange County Patient Doctor Nurse Support Group on it, Mr. Nick asked if Mr. Moreno had ever before encountered a suspected drug dealer who furnished him a bag of drugs with the dealer's name on it. Mr. Moreno also acknowledged that the first time he met with Mr. Chavez - a meeting the prosecution didn't mention - Mr. Chavez first explained his understanding of a patient's rights under Prop. 215, told him that a note from a chiropractor would not be sufficient since chiropractors are not "licensed physicians" authorized to write prescriptions, and explained the forms that would have to be filled out before the support group could help. The defense also grilled Mr. Moreno on some phone calls and investigative procedures that were not recorded and not mentioned in police reports. The line of questioning served to portray Mr. Chavez as someone who tried to implement Prop. 215 conscientiously, as opposed to a conventional drug dealer. Earlier, Judge Thomas J. Borris, presiding in the trial, explored the relationship between Mr. Chavez and Gene Hoffer, a medical patient who did have a recommendation from a licensed physician. The issue troubling the court is whether Mr. Chavez was Mr. Hoffer's "primary caregiver" as defined (rather poorly in our opinion) in Prop. 215, which is now Section 11362.5 of the Health and Safety Code. Deputy District Attorney Carl Armbrust would like the court to adopt a narrow interpretation of the words "primary caregiver" that would exclude virtually anybody but a fulltime caretaker living with the patient or a medical supervisor who also handled housing and feeding a patient. The prosecution would also like to establish that a patient can have only one "primary caregiver" under Section 11362.5, although most disabled people rely on a network of people to support and help them. Issues such as how often Mr. Chavez drive Mr. Hoffer to the store and whether Mr. Chavez could have been the primary caregiver at the first meeting between the two have loomed large. This issue continues to be a legal source of trouble for people who are trying to implement Prop. 215. The proposition was written (for the most part) by the proprietors of the Cannabis Buyers Club in San Francisco, and you would have thought they would have written it to reflect and authorize their own activities. But in the most relevant appeals court decision, Lungren v. Peron, the court ruled that Mr. Peron's San Francisco club did not qualify as a primary caregiver for its customers clients whatever. That decision is on appeal, but could have negative bearing on the Chavez case. Judge Borris will decide later to what extent the defense can claim Mr. Chavez was Mr. Hoffer's cargiver. He will make a similar determination with regard to Shirley Reaves of Chico. Mr. Chavez is alleged to have sent marijuana to Ms. Reaves through the mail. During an evidentiary hearing without the jury present, her physician, Dr. Tod Mikuriya of Berkeley, who more than 20 years ago edited a compilation of scientific studies called "Medical Marijuana Papers," testified to his examinations and ongoing relationship with Ms. Reaves, and affirmed that he had signed a recommendation that she use marijuana. Ms. Reaves said there were no reliable sources of medical marijuana in Chico, that she didn't want to get it on the black market, and that although other clubs were closer, Mr. Chavez's organization was the reliable source she had found for her medication. But the defense would like more than that. It wants to demonstrate that through educational programs, advice, support in times of depression verging on suicidal, and long telephone calls as well as occasional visits by Ms. Reaves to Orange County that Marvin Chavez had more than a transitory or supplier relationship with Ms. Reaves - that he fit the role of primary caregiver. Whether Judge Borris will allow the jury to hear evidence to that effect is yet to be decide; the evidentiary hearing was not complete as of Tuesday afternoon and will resume early Thursday morning. No court today. We'll keep you posted regarding a trial that could be pivotal to implementation of Prop. 215.
------------------------------------------------------------------- Santa Clara County Approves Pot Clubs With Strict Limits (The San Francisco Chronicle says the Board of Supervisors of Santa Clara County, California, voted 4 to 0 yesterday to extend the county's medical marijuana ordinance indefinitely, after adding more regulations to it. Although no medical marijuana dispensaries now exist in Santa Clara County, officials will allow them in unincorporated areas if they meet strict regulations, and pay more than $6,000 in fees.) Date: Wed, 11 Nov 1998 11:18:06 -0500 To: "DRCTalk Reformers' Forum" (firstname.lastname@example.org) From: email@example.com (Lee T. Neidow) Subject: CA mj club effort Reply-To: firstname.lastname@example.org Sender: email@example.com Wednesday, November 11, 1998 San Francisco Chronicle Santa Clara County Approves Pot Clubs With Strict Limits Todd Henneman Chronicle Staff Writer Although no pot clubs now exist in Santa Clara County, county officials will allow them in unincorporated areas if they meet strict regulations -- including having patients volunteer at the marijuana centers. The Santa Clara County Board of Supervisors voted 4 to 0 yesterday to extend the county's medical marijuana ordinance indefinitely after adding more regulations to it. Board members said they would review it in one year. But club supporters contend that the regulations are too bureaucratic and include too many fees, which would total more than $6,000 for applicants. They also say ill patients should not be expected to work at pot clubs. Supporters add that they doubt whether anyone will try opening a marijuana dispensary in the unincorporated parts of the county. By calling for patients to help cultivate pot or perform other work at the marijuana centers, county officials believe that the pot cooperatives would qualify as legal ``primary caregivers'' allowed to cultivate marijuana under Proposition 215. That proposition authorized the cultivation and use of marijuana for medical purposes. ``Medicinal marijuana dispensaries may be designated as a primary caregiver only when the patient is an active participant in the operation of the facility or in the cultivation of the on-site medicinal marijuana,'' the ordinance says. The ordinance did not define what is meant by an ``active participant.'' The ordinance also requires the county's public health department to verify all doctor recommendations for medical marijuana. Since California voters approved Proposition 215 in 1996, clubs that provide pot to patients have been under assault by Attorney General Dan Lungren and the federal government, which says the sale of the drug is still illegal. Federal actions against medical marijuana have led to the shutdown of pot clubs in San Francisco, Oakland and Santa Cruz. The two pot clubs in San Jose also have closed. Officials who worked on the proposal hope the revised ordinance averts legal problems. ``We think this (ordinance) will work legally,'' said Karyn Sinunu, assistant district attorney. ``But all of this could fail in a second if the feds decide to attack it. That's the reality.'' The county's marijuana ordinance would have expired December 31. It already limited marijuana clubs to commercial and industrial zones and set up an approval process. It has jurisdiction only over unincorporated areas. Several board members said they wanted to extend the ordinance to ensure they had ways of regulating the facilities. ``If you don't have an ordinance, than clubs could pop up anywhere in the county, and we wouldn't have any control,'' Supervisor Don Gage said. Supervisor Joe Simitian urged the one-year review. ``I'm trying to reconcile two obligations,'' Simitian said. ``I'm trying to respect the will of the voters on Proposition 215, and I'm trying to make sure we obey state and federal law. How you do both is not entirely clear.'' But Jesse Garcia and Peter Baez, co-founders of the defunct Santa Clara County Medical Cannabis Center in San Jose, criticized the county's ordinance. ``The county's just not going far enough,'' Baez said. ``This ordinance is just symbolic to appease the voters.'' Baez and Garcia's Cannabis Center opened in early 1997 and closed May 8 after the Santa Clara County district attorney filed seven felony counts against Baez.
------------------------------------------------------------------- County Makes Pot Law Tougher (The San Jose Mercury News version) Date: Thu, 12 Nov 1998 17:22:54 -0800 From: firstname.lastname@example.org (MAPNews) To: email@example.com Subject: MN: US CA: County Makes Pot Law Tougher Sender: firstname.lastname@example.org Reply-To: email@example.com Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Marcus/Mermelstein Family (firstname.lastname@example.org) Pubdate: Wed, 11 Nov 1998 Source: San Jose Mercury News (CA) Copyright: 1998 Mercury Center Contact: email@example.com Website: http://www.sjmercury.com/ Author: Tracey Kaplan COUNTY MAKES POT LAW TOUGHER New Restriction Added To Its Ordinance On Medicinal Marijuana The Santa Clara County Board of Supervisors on Tuesday approved a new medicinal marijuana ordinance that makes it more difficult to set up cannabis dispensaries in unincorporated areas of the county. The county's original ordinance, passed 17 months ago, restricts marijuana dispensaries to commercial and industrial zones of the unincorporated area, and requires operators to obtain a special use permit from the county. No one has applied for a county permit. The new law requires the county Public Health Department to verify each marijuana ``prescription'' with the patient's doctor. The county passed the original ordinance after California voters passed Proposition 215 in 1996, which legalized medicinal use of marijuana. The supervisors approved the ordinance 4-0, with Supervisor Blanca Alvarado absent. Supervisor Don Gage said the new ordinance gives the county better control over a business fraught with potential problems. ``To me, what was important was that if we didn't have an ordinance, a dispensary could go in anywhere, even next to a school,'' said Gage, whose represents the south county. ``I'm confident this ordinance protects areas we want to protect and keeps dispensaries out of high-crime and low-income areas.'' The federal government filed civil lawsuits in January against six Northern California cannabis clubs that provided medicinal marijuana. The lawsuits contend that federal law banning marijuana distribution overrides the California law. Four clubs -- in San Francisco, Santa Cruz, Oakland and San Jose -- have been shut down. Voters last week approved initiatives to legalize the medicinal use of marijuana in Alaska, Arizona, Nevada, Oregon and Washington state.
------------------------------------------------------------------- Medical Marijuana Initiatives Passed (Three letters to the editor of The Los Angeles Times lead with AIDS patient Peter McWilliams' tearful thanks to the newspaper for endorsing the reclassification of cannabis to Schedule II.) Date: Thu, 12 Nov 1998 06:18:49 -0800 From: firstname.lastname@example.org (MAPNews) To: email@example.com Subject: MN: US CA: PUB LTE: Medical Marijuana Initiatives Passed Sender: firstname.lastname@example.org Reply-To: email@example.com Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Jim Rosenfield Source: Los Angeles Times (CA) Contact: firstname.lastname@example.org Website: http://www.latimes.com/ Copyright: 1998 Los Angeles Times. Author: Jonathon Oros, LA Times Fax: 213-237-4712 Pubdate: 11 November 1998 MEDICAL MARIJUANA INITIATIVES PASSED As I read your Nov. 5 editorial supporting medical marijuana, my eyes filled with tears. I was diagnosed with AIDS and cancer in March 1996. For 2 1/2 years I used medical marijuana under my doctors' supervision to successfully counteract the side effects of chemotherapy, radiation and the AIDS combination therapy. Last July, I was arrested by federal authorities on medical marijuana charges. Since then, I have been denied medical marijuana. Without the ability to keep down my anti-AIDS medications, my viral load (a measure of active AIDS virus in the body) is up 200-fold (from less than 20 to nearly 4,000), my T-cells are down 26% and I have lost more than 10% of my body weight. For the first time since my AIDS diagnosis, I fear for my life. This is because the federal government chooses to ignore the will of the people of California. Perhaps now the government will turn at last from its "anachronistic and inhumane" ways. PETER McWILLIAMS Los Angeles *** There is one fundamental problem with the federal government changing any part of its marijuana policy - officials would have to admit they have been lying for decades. CLIFFORD A. SCHAFFER Canyon Country *** After our Nov. 3 elections, the next day the White House said it would ignore the overwhelmingly passed medical marijuana initiatives in five states and Washington, D.C. Wow! I hear now on the propaganda networks, and have since the first grade in public school, that we live in a democracy. I am afraid that's a big lie. The truth is we live in a hypocrisy. After voting Nov. 3, then hearing this news Nov. 4, I questioned my own participation in this fraud of a democracy. Now I understand why less than half of registered voters vote! JONATHON OROS Los Angeles Copyright 1998 Los Angeles Times. All Rights Reserved
------------------------------------------------------------------- Ex-Sheriff Jailed In Drug Case (The Tulsa World says Burlen Glenn, the former sheriff of Latimer County, Oklahoma, remained in Haskell County Jail Tuesday in lieu of $500,000 bail after his arrest last week on charges of arranging to buy one pound of methamphetamine for $10,000 from an undercover prohibition agent.) Date: Wed, 11 Nov 1998 11:29:48 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US OK: Ex-Sheriff Jailed In Drug Case Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Michael Pearson (email@example.com) Pubdate: Wed, 11 Nov 1998 Source: Tulsa World (OK) Contact: firstname.lastname@example.org Website: http://www.tulsaworld.com/ Copyright: 1998, World Publishing Co. Author: Ralph W. Marler World Staff Writer EX-SHERIFF JAILED IN DRUG CASE STIGLER -- Former Latimer County Sheriff Burlen Glenn remained in jail Tuesday after his arrest last week for arranging the purchase of illegal drugs in California. Glenn, 53, is being held in Haskell County Jail in lieu of $500,000 bail set by a Kern County, Calif., judge. He is accused of arranging to buy one pound of methamphetamine for $10,000 from an undercover narcotics officer, said Craig Smith, a Kern County deputy district attorney. Smith said Glenn gave the money to two women who drove to Bakersfield, Calif., to make the purchase last Friday. One woman, Deanne McGuire, 42, lived with Glenn at his home near Keota. The other woman, Donna Coleman, 46, was McGuire's friend who helped drive to California, Smith said. Glenn probably will be transferred to California after cattle theft charges are resolved in Cherokee County, Smith said. Glenn was released on $70,000 bond in August 1997 on cattle theft charges. He and two others were indicted by the Oklahoma multicounty grand jury in May 1997 for racketeering, concealing stolen property and uttering a forged instrument. The indictment said Glenn, ex-wife Christine Glenn and Leslie Moody stole about 100 cattle in May and June 1995 from ranches in the Wilburton area, and sold the cattle at auctions in Arkansas, Texas and Oklahoma. The three used false names to endorse the auction checks and either cashed or deposited them. The cattle sales netted about $25,000, the indictment said. The three defendants are scheduled to appear in January for Cherokee County's criminal jury docket on the cattle thefts. Two of the sales occurred in Cherokee County. Glenn was the Latimer County sheriff during 1981-84. Ralph Marler can be reached at 581-8480.
------------------------------------------------------------------- Nothing Keeps A Driver And His License Apart For Long (The Tulsa World says the newspaper's review of thousands of DUI cases shows that Oklahoma drunk drivers by law have a right to drive, no matter what the body count, no matter how destructive, and no matter how many times they are caught.) Date: Wed, 11 Nov 1998 18:39:06 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US OK: Nothing Keeps A Driver And His License Apart For Long Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Michael Pearson (email@example.com) Pubdate: Nov 11, 1998 Source: Tulsa World (OK) Contact: firstname.lastname@example.org Website: http://www.tulsaworld.com/ Copyright: 1998, World Publishing Co. Author: David Fallis NOTHING KEEPS A DRIVER AND HIS LICENSE APART FOR LONG No matter the body count, no matter the destruction and no matter the number of the times they are caught, Oklahoma drunk drivers by law have a right to drive. Sometimes they may lose the right for a year, sometimes -- and at the most -- for three, but never forever. ``You certainly don't give the gun back to the felon, but you give the car back to the drunk,'' Tulsa Police Chief Ron Palmer said. In reviewing thousands of DUI cases, the World has found some drivers who, despite their deadly and repeat offenses, have been returned driving privileges, bringing into question revocation practices and state law. ``You would think at some point, we have to draw the line. We just cannot in good conscience license someone who has repeatedly abused the privilege of driving in Oklahoma,'' Rep. James Hager, D-Pawhuska, said. One drunk driver had his driving privilege returned to him 15 months after he killed two people in a crash. He's since had two felony DUIs and had his license revoked twice again. States like Florida, by comparison, have implemented no-nonsense licensing laws: Anyone with three DUI offenses in 10 years may lose his license for 10 years. offenders with four or more convictions or those who kill while driving may lose their licenses for a lifetime. ``To have a sliding scale ultimately resulting in revocation for life, especially when someone is injured or killed, is sound public policy,'' Oklahoma Gov. Frank Keating said. In Oklahoma, only commercial driving privileges can be taken away for a lifetime. But even those drivers may obtain a standard, or class D, driver's license and return to the road. Drivers who are convicted of manslaughter while driving drunk lose their licenses for at least one year but no more than three. In Oklahoma, a first DUI offense -- either failing or refusing to take a blood- alcohol test -- with no prior alcohol violations within five years leads to a revoked license for 180 days. With one prior offense in five years, revocation shall last one year; with two or more prior offenses in five years, revocation lasts three years. But some drunk drivers never lose their ability to drive because the revocation can be modified. About 12 percent of all DUI license revocations -- 1,827 of about 15,800 annually -- are modified by the Department of Public Safety or district courts so that offenders may legally drive, records show. Drunk drivers with modified privileges must install an ignition interlock device that requires the driver to pass a breath test before his car will start. The thief who puts gas in his car and drives off without paying for it faces harsher sanctions -- a six-month or one-year revocation that can't be modified. Bernadette Huber, state executive director of Mothers Against Drunk Driving, favors a mandatory loss of driving privileges for all drivers who are caught drinking. Such used to be the case -- until representatives revised state law. ``But a lot of people don't care if their license is revoked; they drive anyway," Huber said. "This is the argument we face when we try to change this.'' Some people argue that the penalties for driving without a license -- a misdemeanor on conviction, a $500 fine and a year in jail at the most -- are little deterrent. Counties are reluctant to fill jails with illegal drivers, and many chronic drunk drivers have long since lost their licenses, some law enforcement officials said. For repeat drunk drivers, the only ongoing licensing review that DPS conducts aside from standard suspension practices is to classify drivers as "excessive users." This occurs if the driver racks up three drug-or alcohol-related violations or administrative actions in five years. It triggers a review process to determine if he is using alcohol or drugs. DPS officials contend that they are aggressive with licensing issues but under current law have little discretion. ``I will say, I've had enough people out here that seem to fear the loss of a license more than the criminal prosecution. That can disrupt their home life, their employment, more so than paying fines and community service," DPS hearing officer Peggy Farish said. *** Date: Wed, 11 Nov 1998 18:36:16 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US OK: How DUI Was Researched Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Michael Pearson (email@example.com) Pubdate: Nov 11, 1998 Source: Tulsa World (OK) Contact: firstname.lastname@example.org Website: http://www.tulsaworld.com/ Copyright: 1998, World Publishing Co. HOW DUI WAS RESEARCHED The Tulsa World conducted a great deal of research for the four-party series, "Drunk Driving: A Sobering Look." Tulsa World Assistant City Editor David Fallis spent about six months investigating the issue of drunk driving. Fallis joined the World six years ago as a police reporter. A graduate of the University of Oklahoma, he began his journalism career at The Tulsa Tribune and has won numerous awards for his investigative work. The study, in part, analyzed the following records: More than 50,000 computerized district court records since 1988 from Tulsa, Oklahoma and Cleveland counties. Cumulative, computerized conviction data from the Oklahoma Administrative Office of the Courts. Department of Corrections records for nearly 4,000 drunk-driving convicts. Department of Public Safety crash and accident data. Entire driving histories and criminal case files for selected drivers. State Medical Examiner's Office results of blood-alcohol tests in fatal crashes since 1987. Computerized records were organized into databases, which were carefully analyzed and compared with other databases. For example, datasets of drunk-driving convicts were compared to datasets of those convicted of manslaughter to pinpoint chronic drunk drivers who had drunk-driving convictions before and after fatal crashes. When possible, drunk drivers and their victims were contacted. In all, more than 60 interviews were conducted. Ashli Simms, former Tulsa World intern, assisted with research. David Fallis can be reached at 581-8338.
------------------------------------------------------------------- Beyond Rehabilitation? (The Tulsa World says a review by the newspaper of more than 10 years of DUI cases from Tulsa, Oklahoma, and Cleveland counties suggests that court-ordered substance-abuse treatment is the exception, not the rule. Out of more than 50,000 drinking and driving cases in those three counties since 1988, court records indicated that fewer than 1,500 offenders were ordered into treatment programs, even though two out of five drunk drivers supposedly have "chronic drinking problems.") Date: Thu, 12 Nov 1998 19:30:13 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US OK: Beyond Rehabilitation? Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Michael Pearson (email@example.com) Pubdate: 11 Nov. 1998 Source: Tulsa World (OK) Contact: firstname.lastname@example.org Website: http://www.tulsaworld.com/ Copyright: 1998, World Publishing Co. Author: World's own Service BEYOND REHABILITATION? Treatment is "kind of like being nagged into going to church: They get some good out of it, even if it wasn't their idea." He may have been arrested repeatedly for DUI. He may be among the two out of five drunk drivers who have chronic drinking problems. A state-ordered evaluation may recommend aggressive treatment. But he doesn't have to seek the treatment, and Oklahoma courts are reluctant to order it. "If we can identify them the first time around, why wait . . . to get treatment?" asked Paul Inbody, executive director of Human Skills and Resources Inc., a DUI school in Tulsa that offers out-patient therapy and counseling. "You have got to break that cycle" of behavior, he said. A World review of more than 10 years of DUI cases from Tulsa, Oklahoma and Cleveland counties suggests that court-ordered substance-abuse treatment is the exception, not the rule. ``It doesn't happen,'' Tulsa Special Judge Rick Clarke said. For example, out of more than 50,000 drinking and driving cases in those three counties since 1988, court records indicated that fewer than 1,500 offenders were ordered by courts into treatment programs. Ordering treatment requires judges and the courts to conduct follow-up reviews on the defendant, a time-consuming process in light of such crowded dockets, experts note. In Tulsa District Court, caseloads run close to 3,000 cases annually and prevent such extra review, Clarke said. ``It's a simple lack of resources. I can't spend all my time being a probation officer,'' he said. A 1995 statewide ``Impaired Driving Assessment'' was critical: ``The treatment community felt frustrated that offenders with substance-abuse problems were not being mandated to receive treatment,'' the assessment reported. Before sentencing, offenders who are found guilty of drinking and driving must undergo an alcohol education course and an alcohol assessment at a state-sanctioned facility, such as Inbody's. After the assessment, a certificate of evaluation is sent to the Department of Public Safety, which requires proof of it to reinstate driving privileges. Assessment findings are sent to the corresponding court ``for the purpose of assisting the court in its final sentencing determination,'' the law states. But this is the exception in many if not most courts. For example, Special Judge Russell Hall of the Oklahoma County District Court said assessments are ordered at sentencing, and he usually never sees them. "I know it's supposed to be prior (to sentencing), but that's not how it happens," Hall, who handles Oklahoma County DUI cases, said. Hall said he sometimes orders treatment, but "I prefer punishment." Assessments that identify abuse problems may recommend from 72 hours of outpatient treatment to 30 days of inpatient treatment, Inbody said. ``A good assessment doesn't just say he is or isn't an alcoholic. There are levels of severity,'' he said. But nothing more is required of the offender unless it's by a judge. "In Oklahoma, you have to wonder why we make people get assessments if they are not going to do anything with it but prove they had one done," said Dennis Lewelling of the state Department of Mental Health, which oversees the DUI schools and assessments. The small number of offenders who are sent to prison are treated only when and if space opens in the already-crowded prison substance-abuse programs, prison officials said. It's not uncommon for drunk drivers to be freed from prison without treatment even if an assessment recommends it, because offenders often complete their sentence before space in such programs becomes available, officials said. The cost of treatment can also be an issue. Insurance companies rarely pay for more than five days of inpatient treatment, and state funding is limited, officials said. At House of Hope, a nonprofit treatment center in Grove, treatment is based on the 12-step programs embraced and developed by Alcoholics Anonymous or Narcotics Anonymous. Success rates are hard to determine. The center's studies found that 37 percent of clients are clean and sober and staying out of trouble with the law some time later, director George Pilkinton said. But he doubted the accuracy of the phone surveys, noting a 6 percent or 7 percent margin of error. Pilkinton also said that fewer than 3 percent of those who come to his facility believe that they have a problem. Lewelling said that in general there is cynicism about treatment's effectiveness. "A lot of people . . . have heard about people who have been through treatment 10 times," he said. Other states, such as Arkansas, require treatment of DUI offenders as prerequisites to having their driving privileges returned, Inbody said. Some counties with lighter caseloads, such as Washington, Osage and Rogers counties, make treatment a part of the sentencing if the assessment calls for it. "We take that assessment, and if it says treatment, you go do treatment," Osage County District Attorney Larry Stuart said. Other counties, such as Craig and Creek, are turning to fledgling drug courts as a way to handle chronic drunk drivers. Drug courts require that the offender have no prior violent felonies. They force defendants into treatment if it is needed and require them to return to court every two weeks. The trade-off is that criminal charges may be dismissed entirely. ``Simply sending someone to prison for six years, for instance, would not necessarily get rid of the problem,'' Creek County District Attorney Max Cook said. Inbody agreed: "It's kind of like being nagged into going to church: They get some good out of it, even if it wasn't their idea."
------------------------------------------------------------------- Slain Man's Family Wants Police Shooting Re-Examined (According to The Tulsa World, a police officer in Tulsa, Oklahoma, says he was only trying to protect himself when he fatally shot an armed Edwin Levall Vines outside a "drug house" last week. However, the dead man's family, backed by the Tulsa chapter of the National Association for the Advancement of Colored People, wants an investigation by the city's Citizens Review Board because some witnesses said Vines was not armed and had his hands in the air when he was shot.) Date: Wed, 11 Nov 1998 20:08:42 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US OK: Slain Man's Family Wants Police Shooting Re-Examined Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Michael Pearson (email@example.com) Source: Tulsa World (OK) Contact: firstname.lastname@example.org Website: http://www.tulsaworld.com/ Copyright: 1998, World Publishing Co. Pubdate: 11 Nov 1998 SLAIN MAN'S FAMILY WANTS POLICE SHOOTING RE-EXAMINED They say he didn't have gun in confrontation The family of a man who was gunned down by a Tulsa police officer last week is calling for a new investigation into the shooting, saying he was unarmed. Police Chief Ron Palmer said that claim was "ludicrous" and that the officer was only trying to protect himself when he fatally shot Edwin Levall Vines, 31. "We are sorry for their loss," he said. But "I re-reviewed the case and found nothing to indicate that a person was slain in cold blood. It was obvious Vines was armed." Police said Vines, a Fresno, Calif., resident, was outside a reported "drug house" Friday when officers approached. Vines ran, and when officers pursued him, he pointed a 9 mm semiautomatic pistol at Officer Jeff Little, they said. Little shot Vines twice, and he died later that night in a hospital. His family, backed by the Tulsa chapter of the National Association for the Advancement of Colored People, wants an investigation by the city's Citizens Review Board. Palmer said he would welcome an investigation by another law enforcement agency but that he thought a citizens' review would be inappropriate. The slain man's brother, the Rev. Eddie L. Vines, said the family wants another investigation because some witnesses said Vines was not armed and had his hands in the air when he was shot. "My brother was not a saint, but he did not deserve this," the North Carolina minister said. Family members said police were trying to cover up their mistake by saying Vines had a gun, and they hinted that the shooting might have been racially motivated. Vines' father, Elijah Vines, went so far as to call the shooting "murder." Palmer said no witnesses had come forward to back up the family's claim. District Attorney Chuck Richardson declined to file criminal charges against Little. He called the shooting "justified." Palmer said: "The district attorney has reviewed this case and cleared the officer. I stand behind my officer and his decision to make that shot." Richardson encouraged any new witnesses to come forward but said he hadn't seen anything backing the family's claim. The witness statements came from people who "were in the area at the time," Richardson said. "There was nothing in any report or from any witness that said anything about anyone being shot in cold blood. One person said they didn't see the gun, not that there wasn't one." Another witness identified the 9 mm semiautomatic gun that Vines allegedly pointed at Little as a weapon that Vines had been showing to people several days before his death, Richardson said. Vines had been wanted by authorities. Sgt. Wayne Allen said a warrant for his arrest had been issued in a 1997 slaying in Fayetteville, N.C. Vines had also been arrested in another state on numerous complaints, ranging from firearms counts and assaulting a police officer to lascivious and lewd acts with a child under age 14, Allen said. Richardson said he didn't let Vines' criminal record influence his decision.
------------------------------------------------------------------- Sheriff Seeks Outside Probe (According to The Tulsa World, in Oklahoma, Delaware County Sheriff Jim Earp said Tuesday that he had asked a state agency to take over an investigation looking into whether Undersheriff Bill Stout tampered with drug evidence. Stout was suspended last week after three deputies said Stout brought more methamphetamine to a court hearing than what was actually seized.) Date: Thu, 12 Nov 1998 19:30:04 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US OK: Sheriff Seeks Outside Probe Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Michael Pearson (email@example.com) Pubdate: 11 Nov. 1998 Source: Tulsa World (OK) Contact: firstname.lastname@example.org Website: http://www.tulsaworld.com/ Copyright: 1998, World Publishing Co. Author: Rod Walton, World Staff Writer SHERIFF SEEKS OUTSIDE PROBE The OSBI is looking into a drug tampering case involving an undersheriff. JAY -- Delaware County Sheriff Jim Earp said Tuesday that he has asked a state agency to take over an investigation looking into whether his undersheriff tampered with drug evidence. Undersheriff Bill Stout was suspended from his duties last week after three deputies said Stout brought more methamphetamine to a court hearing than what was actually seized during that particular raid on a Grove home. Earp met with Oklahoma State Bureau of Investigation agents this weekend and handed over a report of his own investigation into Stout's handling of the drug evidence. Earp would not comment on the results of his investigation. OSBI spokeswoman Kym Koch said the agency has assigned an investigator to the case. The probe could take several weeks, Koch said. District Attorney Ben Loring said last week that he had doubts whether Earp should have handled the Stout investigation on his own. Loring said he recommended to Earp that the sheriff call in outside investigators. On Tuesday, Earp said he thought Loring understood all along that he would call in the state agency once his own investigation was complete. ``That was my intent from the beginning,'' Earp said. ``We were going to do the investigation and see what was there, what was going on. At that point we wanted an outside independent agency to assist with it and help us get it cleared up.'' Questions about Stout's handling of drug evidence led to the dismissal of felony charges against a couple arrested in the raid on a Grove home in September. Robert and Tammy Phillips, both 26, had been charged with possessing methamphetamine with intent to distribute and misdemeanor charges of possession of marijuana and drug paraphernalia. They will receive deferred sentences and fines after agreeing to plea bargains on the misdemeanors. The September raid turned up a lockbox containing drugs, according to a report. Stout testified at a preliminary hearing last month that he removed the lockbox from the house and found a bag of white powdery substance which he recorded into evidence the next day. After the preliminary hearing the three deputies told officials that the amount of drugs presented at the hearing differed from what they remembered seeing earlier. Stout has been a lawmen for 20 years, the last eight with the Delaware County Sheriff's Office.
------------------------------------------------------------------- Redford slaying probe blasted (The San Antonio Express News says a congressional report to be made public today is critical of a Justice Department investigation into the death of Esequiel Hernandez Jr., the 18-year-old goatherder in Redford, Texas, who was shot last year by camouflaged US Marines on a drug-interdiction mission along the US-Mexico border. "They simply did not do their job," said Rep. Lamar Smith, R-San Antonio, of the Justice Department's investigation. "A number of actions were taken to prevent justice from being carried out.") From: email@example.com Date: Thu, 12 Nov 1998 08:09:31 -0600 (CST) Subject: ART: Redford slaying probe blasted To: "DRCTalk Reformers' Forum" (firstname.lastname@example.org) Cc: email@example.com Reply-To: firstname.lastname@example.org Sender: email@example.com From the 11-11-98 San Antonio Express News http://www.expressnews.com firstname.lastname@example.org AND the 11-12-98 Dallas Morning News http://www.dallasnews.com email@example.com Redford slaying probe blasted By Gary Martin Express-News Washington Bureau WASHINGTON - A congressional report to be made public today on the death of a West Texan who was shot by U.S. Marines is critical of a Justice Department investigation of the incident. "They simply did not do their job," Rep. Lamar Smith, R-San Antonio, said of the Justice Department's investigation of the May 20, 1997, death of Esequiel Hernandez Jr., 18, of Redford. Hernandez was shot by U.S. Marines on an anti-drug patrol along the Rio Grande. "The next step is for the Department of Justice to take some additional actions," said Smith, chairman of the House Judiciary subcommittee on immigration. The report is being released following a 1 1/2-year investigation by the subcommittee. Smith declined to release details until today. No further congressional hearings are planned, he said. "We have done all we can," Smith said. Hernandez family members were notified Wednesday that the congressional probe had ended. Neither federal nor state grand juries returned an indictment against the four Marines who shot Hernandez while he was herding his family's goats. He died at the scene. The Marines claimed Hernandez fired on the patrol, which was heavily camouflaged and hiding on a ridge on the outskirts of Redford, a rural agricultural town in Texas' sparsely populated Big Bend region. Hernandez carried a .22-caliber rifle, and a Marine investigation into the shooting concluded Cpl. Clemente Banuelos fired to protect the life of a member of his patrol. The Marine report also cited a lack of training for troops involved in domestic operations and was critical of the poor radio communication between Immigration and Naturalization Service officials in Marfa and the patrol they were supervising 70 miles away on the border. Banuelos has been honorably discharged from the Marines. The Navy Department, which oversees the Marines, agreed to a $1.9 million, out-of-court settlement with the Hernandez family, which filed a wrongful death claim against the government. "It was a tragic, tragic event," Navy Secretary John Dalton said. "My heart goes out to the family of that young man." A Justice Department investigation following the shooting also cleared the Marine patrol of criminal wrongdoing. Smith launched his subcommittee probe into the incident when federal agencies failed to turn over documents in the case. Texas Rangers also charged military and federal officials hampered the investigation by moving the Marines to out-of-state locations within days of the shooting. Smith said the subcommittee investigation focus was on INS and Justice Department handling of the shooting, and not whether Marines were criminally negligent in the death. "We didn't want to second-guess the grand jury," he said. Smith said his subcommittee report will show that the Justice Department failed to investigate the shooting thoroughly. "In this incident, a number of actions were taken to prevent justice from being carried out," Smith said. The Marine investigation led to reprimands of supervisory personnel. The Justice Department probe produced no punishment for INS or Border Patrol officials, who oversaw the Joint Task Force 6 military missions along the Rio Grande. Smith said the Justice Department investigation contained "glaring omissions" and failed to address policy questions involving training and supervision. Meanwhile, the death of the young goatherd has drawn the attention of human rights groups opposed to militarization of the U.S.- Mexico border to staunch drug smuggling and undocumented immigration. Amnesty International has documented incidents of abuse by U.S. officials against Mexican and American citizens in a recent report, "Human Rights Concerns in the Border Region with Mexico." Nick Rizza, an Amnesty International spokesman in California, said reports of escalating human rights abuses on the border violates standards established by the international community and endorsed by the United States and the United Nations. Wednesday, Nov 11, 1998
------------------------------------------------------------------- Lawyer to depict drug as a weapon (The San Antonio Express-News says prosecutors plan to make a unique legal argument against a man in New Braunfels, Texas, charged with giving cocaine to his 14-year-old daughter. He faces up to 99 years in prison.) From: firstname.lastname@example.org Date: Thu, 12 Nov 1998 08:09:20 -0600 (CST) Subject: ART: Lawyer to depict drug as a weapon To: "DRCTalk Reformers' Forum" (email@example.com) Cc: firstname.lastname@example.org Reply-To: email@example.com Sender: firstname.lastname@example.org Here's one for the "let's see just how far we can go" file. If the law is that broad, then assault with a deadly weapon charge could be made when giving a kid aspirin or any other drug including alcohol and tobacco. About the only thing that couldn't be considered a deadly weapon is marijuana. :) *** From the 11-11-98 San Antonio Express-News http://www.expressnews.com email@example.com Lawyer to depict drug as a weapon By Roger Croteau Express-News Staff Writer NEW BRAUNFELS - Prosecutors plan to make a unique legal argument against a man charged with giving cocaine to his 14-year-old daughter. District Attorney Dib Waldrip said he plans to argue that cocaine is a deadly weapon. Johnny S. Rodriguez, 43, of New Braunfels faces up to 99 years in prison if convicted of injury to a child and endangering a child. If the prosecutor's strategy succeeds, Rodriguez would have to serve at least half his sentence before becoming eligible for parole. "There is a sound factual argument for it," Waldrip said. Waldrip acknowledged his strategy in the case is unique. Carl Lobitz, a San Antonio defense lawyer and former prosecutor in Bexar and Denton counties, agreed. Lobitz said he never had heard of a prosecutor arguing cocaine is a deadly weapon. "That's stretching it," Lobitz said. "But the definition of a deadly weapon is pretty broad. . . . Anything capable of causing death or serious bodily injury can be called a deadly weapon, so I guess you could make an argument for that." To prove injury to a child, the prosecution will have to show that giving the girl cocaine "caused serious mental impairment," Waldrip said. Lobitz said the unique prosecutorial strategy almost guarantees Rodriguez's attorney will appeal, if Rodriguez is convicted. "The facts seem to fit a charge of delivery of cocaine better," Lobitz said. "But it looks like a makeable case, especially in Comal County. Those folks are notoriously conservative." Waldrip said the investigation started when the girl's mother, who is divorced from Rodriguez, became suspicious and brought the girl to the New Braunfels Police Department. The girl gave a statement that implicated her father. A Comal County grand jury Tuesday indicted Rodriguez on charges of injury to a child and endangering a child. Wednesday, Nov 11, 1998
------------------------------------------------------------------- Pot - Medicine Or Malevolence? (The Evansville Courier, in Indiana, is seeking letters to the editor about the advisability of medical marijuana initiatives for Indiana, Kentucky and Illinois. The deadline for submissions is Tuesday.) Date: Wed, 11 Nov 1998 19:48:50 -0800 From: firstname.lastname@example.org (MAPNews) To: email@example.com Subject: MN: US IN: Call for LTEs: Viewpoint - Pot: Medicine Or Malevolence? Sender: firstname.lastname@example.org Reply-To: email@example.com Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: firstname.lastname@example.org (Frank S. World) Source: Evansville Courier (IN) Contact: email@example.com Website: http://courier.evansville.net/ Copyright: 1998 The Evansville Courier Pubdate: 11 Nov 1998 Section: Sunday Soapbox Note: The Evansville Courier is seeking LTEs about med mj initiatives for their Sunday Soapbox. Details follow VIEWPOINT - POT: MEDICINE OR MALEVOLENCE? Voters in five states last week approved measures to allow sick people to smoke marijuana for pain relief. The question was approved in Alaska, Arizona, Nevada, Oregon and Washington state. It was on the ballot in Washington, D.C., but the results have not been announced. It was approved in 1996 in California and Arizona, but Arizona voters raised the question again last week because their legislators put the first vote on hold, pending federal approval. In approving its use in five states, voters rejected opposition arguments that legalizing it for medical purposes would send the wrong message, that it would torpedo the government's war on drugs. Some opponents believe it would lead to legalization of marijuana. The voters did accept the argument that marijuana can provide pain relief to people with such illnesses as cancer, AIDS and glaucoma. WHAT DO YOU THINK? Is this a ballot initiative that should be considered for Indiana, Kentucky and Illinois? Is this an option that should be made available to the ill in our three states, or would it only open the door to further legalization efforts? What message would it send to our young? Send us your letters by Tuesday, and we will publish them Nov. 22 on the Viewpoint page. Keep them short -- no more than 250 words -- sign them, and include a daytime telephone number for verification. Send them by mail to Letters, The Evansville Courier, P.O. Box 268, Evansville, Ind. 47702. Send them by e-mail to firstname.lastname@example.org" Send them by fax to (812)422-8196.
------------------------------------------------------------------- Is drug testing students a good idea? (Cityview, in Iowa, recounts the brief history of random urine tests for high school students - a fad begun in Vernonia, Oregon - noting that no school in Iowa currently requires such tests. Randy Aultman, the Vernonia high school principal who instituted the nation's first such program, was in Des Moines Thursday during a nationwide tour advocating student drug testing, and a local audience's response suggests the state will soon require urinalysis of its athletes.) Date: Sun, 22 Nov 1998 08:45:57 -0600 To: "DRCTalk Reformers' Forum" (email@example.com) From: "Carl E. Olsen" (carl@COMMONLINK.NET) Subject: Re: Poll on Drug Testing of Students Reply-To: firstname.lastname@example.org Sender: email@example.com Newshawk: Carl Olsen Source: Cityview (IA) Pubdate: Wed, 11 Nov 98 Author: William Dean Hinton Contact: firstname.lastname@example.org Is drug testing students a good idea? * It's a trend sweeping the nationa. But critics say it's unnecessary and invasive. By William Dean Hinton In the mid 1980s, Vernonia (Ore.) High School had such a bad drug problem that the librarian was finding small marijuana plants growing in her library. It turns out Vernonia's students were throwing pot seeds in with the potted plants. Student athletes were some of the biggest users. And what irked school officials was the way kids flaunted their drugs. "Two of our football players said they used amphetamines during a game," says Randy Aultman, Vernonia's principal at that time. "They really believed there was nothing we could do about it." Aultman tried, though. He used drugsniffing dogs. He brought in pro wrestlers to denounce usage. Nothing worked. So his school began drugtesting student athletes, figuring there would be a trickledown effect since jocks are seen as role models. The change at Vernonia, many people there say, was noticeable almost immediately. "We ran into something that forced us to do something drastic," says Aultman, who was in Des Moines Thursday as part of a national tour advocating student drug testing. Aultman predicts that by the end of the year, every state will have a school district testing its athletes. Iowa currently has none. But judging by the response of Aultman's audience some administrators were calling Aultman a hero the state will soon have schools running urinalysis on its athletes. Pennsylvanian Congressman John Peterson is willing to help. He's introduced a bill that will provide federal funds for schools that test athletes. Aultman, of course, is credited with putting national student drug testing in place. He was in the middle of a 1995 Supreme Court case that allowed testing athletes in schools. A Vernonia 7th grade student named James Acton challenged the policy in court. He wanted to play football for Washington Middle School but refused to be tested on grounds of privacy. Aultman expected Vernonia to lose. But the courts initially decided in the school's favor. The 9th Appeals Court overturned the ruling, setting the stage for the high court's 63 landmark decision. "They said a safe and free school was more important than the individual rights of James Acton," says Aultman, who says Vernonia's school board members are the real heroes for enacting the district's policy. Urine Clear More recently, the 7th Appellate Court ruled that school districts in Indiana, Illinois and Wisconsin can test students involved in all extracurricular activities. Based on Vernonia's case, the judges concluded "successful extracurricular activities require healthy students." While few people would refute that, some school officials say testing is unnecessary. Schools in Iowa have a good conduct policy. If you're busted for drugs or for any violation of school rules you might be kicked off a team or club. If an athlete says he isn't on drugs, ask him to prove it. "Put the burden on them," says Mary Gannon, an attorney for the Iowa Association of School Boards. Since the standard to test and the standard to discipline are the same, it makes no sense especially given the costs of drug testing to require every athlete to take a urinalysis, Gannon says. Additionally, most schools are reporting an alcohol problem not the abuse of opiates, methamphetamine or marijuana. "When they are being bad, it's usually beer," says Kathy Collins of the School Administrators of Iowa, which has no official policy on drug testing. "After school they might get together, then go back to school to watch a volleyball game. That's not to say drugs aren't a problem. But alcohol is probably a problem that's more in need of a fix. And as Aultman pointed out during his seminar, some students at Vernonia felt that users simply turned to harsher but undetectable drugs like LSD. Or athletes were able to pass their tests by drinking Urine Clear or some other masking product. Collins also cautions that the Supreme Court's Vernonia ruling was narrow, meaning Iowa schools will have to show they have severe drug problems and have taken enough measures to try to thwart drug use. "If you're saying that injuries are attributable to drugs in practice and games, do you have indication that kids are taking them?" Collins asks. "Or steroids, for that matter?" Marched off For schools that are using it, drug screening has proven to be effective. "There are two things kids like," says Ron Slinger, former athletic director of Dixon (Calif.) High School, which is 20 miles west of Sacramento. "They love sports and they love to drive their cars. If you threaten either one of these things, you have their attention right away." Slinger implemented drug testing after his football coach reported players smoking pot on the team bus after a game. Dixon spends $15,000 a year on the tests and provides counseling for athletes who test positive. First time offenders are suspended from the team. Third time offenders are kicked off permanently. Like Vernonia, Dixon finds very few students testing positive. Slinger says the program isn't meant to be punitive. Rather, deterrence is the motive. "We are just buying time, helping students make good decisions until they become old enough to make them on their own," says Dixon, who also spoke at the seminar. Good conduct policies are nice, but they're not always effective, many teachers say. The Prairie CityMonroe school district discovered in September how capricious they can be. According to the Newton Daily News, High School Principal Ron Young suspended three football players after police told him they were cited for possessing alcohol at a party in July. The players, Jason Archer, Caleb Sellers and James Timmons, appealed to District Superintendent Oran Teut, who upheld Young's decision. But six school board members overturned Teut's ruling. Since state law protecting juveniles prevented them from reading police reports and since police officers were unable to provide specifics on the citations there wasn't enough evidence to suspend the players. Proof, however, is just what Aultman is selling. A player is much less likely to appeal a urinalysis, he argues. Besides, without a drug test, teachers might appear to be arbitrarily singling some students. "If you just have a belief and no proof, you're going to be in trouble," says Aultman, who was characterized by the Oregonian newspaper as Adolph Hitler because of his protesting stance. At least one Des Moines student thinks testing is a good idea. Tim Kurth, a senior defensive back and captain of North High School's swim team, says students who don't do drugs have little to fear. "Why should it bother me?" asks Kurth, who says it's "just a fact" there's a lot of drug usage on his campus. Then again, he also suggests that testing athletes might actually lead to more abuse. "If they're not playing sports, they will have more time to do it." They'd be simply joining an evergrowing crowd, according to some figures. In a recent survey, 50 percent of all 9th graders said they will try illegal drugs during high school. More than 11 percent of children 12 to 17 reported using drugs or alcohol during the past month. In 1970, the average age of the firsttime user was 17. By 1996, the average age had dropped to 12. Kids today also must look forward to an America where drug testing is normal. More than 80 percent of major companies now require a urinalysis as a preemployment screen. As Thomas Christ, an ACLU lawyer who represented James Acton, said after the Supreme Court ruling, "I think that everyone soon will be marching off to the urinals."
------------------------------------------------------------------- Cocaine Is Found On Military Plane (The Washington Times version of yesterday's news about the seizure in Florida of 1,639 pounds of cocaine aboard a Colombian air force plane) Date: Wed, 11 Nov 1998 18:42:16 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: Cocaine Is Found On Military Plane Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Patrick Henry (email@example.com) Pubdate: Wed, 11 Nov 1998 Source: Washington Times (DC) Copyright: 1998 News World Communications, Inc. Contact: firstname.lastname@example.org Website: http://www.washtimes.com/ Author: Jerry Seper COCAINE IS FOUND ON MILITARY PLANE A Colombian Air Force C-130 cargo plane carrying 1,639 pounds of cocaine has been seized at an airport in Florida, U.S. Customs Service officials said yesterday. The Customs agents' discovery, which took place Monday after the military plane's arrival at Fort Lauderdale International Airport, prompted Air Force Chief Gen. Manuel Sandoval of Colombia to offer his resignation. "In this case, as commander, I assume the responsibility," Gen. Sandoval said at a press conference in Bogota. "I have submitted my resignation to the president of the republic." Also yesterday, customs agents in Seattle announced they have seized 14 tons of hashish destined for Canada aboard two ships, one of which was being unloaded in British Columbia. The seizure of cocaine in Florida comes two weeks after Colombian President Andres Pastrana visited Washington and pledged to "de-narcoticize our relations" by fighting drug trafficking. Colombia's poor record of controlling drug smuggling has strained relations between the two nations. The United States stripped Mr. Pastrana's predecessor, Ernesto Samper, of his tourist visa after he was accused of accepting $6 million in drug money to fund his 1994 election campaign. Customs officials said the C-130 arrived at Fort Lauderdale at about 2:30 p.m. Monday carrying a flight crew of six, a family of five as passengers and a small amount of cargo. Shortly after its arrival, customs inspectors were invited to board the aircraft to conduct a routine search. Agents said some large metal pallets aboard the aircraft contained unusual rivets, and inspectors smelled fresh glue. A Customs Service drug-sniffing dog was brought in and alerted agents to the presence of the cocaine. Customs officials said that agents drilled into the pallets and discovered a white powder that field-tested positive for cocaine. They then dismantled the pallets and discovered the cocaine within four of them. The aircraft's crew and passengers were questioned and released. No arrests have been made. Customs agents are continuing their investigation into the smuggling incident with assistance of the Colombian government. In the past, customs inspectors have searched the Colombian military's regular C-130 flight without incident. In Washington, U.S. Customs Commissioner Raymond W. Kelly said: "While the facts of this case are disturbing, I am particularly pleased with the way customs officers and Colombian government officials are working together." Last week, three junior Colombian Air Force officers were sentenced in Colombia to prison terms for an incident in September 1996, when 4 kilograms of heroin were found aboard Colombia's presidential jet shortly before it was to fly Mr. Samper to New York for a meeting at the United Nations. The judge in the case said evidence showed senior Air Force officers were involved in drug trafficking. He referred to the existence of a so-called "blue cartel," a reference to the color of Colombian Air Force uniforms. Colombia is the world's leading cocaine producer and an increasingly important supplier of the heroin sold on U.S. streets. The hashish was seized Nov. 5 from the Ansare II, a 60-foot fishing vessel, and the "mother ship," the Blue Dawn, an 86-foot fishing vessel registered in Pakistan. Agents found 11 tons of hashish on the Ansare as it was being unloaded in Fanny Bay, about 100 miles north of Victoria on Vancouver Island. Another three tons was found aboard the Blue Dawn after being intercepted by the Coast Guard cutter Active 300 miles off the Canadian coast. "This investigation would not have been successful without the close cooperation of the over 200 U.S. and Canadian law enforcement officers who worked this case," said agent Shelley Altenstadter, who heads the customs office in Seattle.
------------------------------------------------------------------- Protesters Demand Marijuana Vote Tally (The Washington Post says about 50 people protested yesterday outside the DC Board of Elections and Ethics offices, demanding the release of results from last week's vote on legalizing marijuana for medical purposes.) Date: Wed, 11 Nov 1998 19:24:08 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: US DC: MMJ: Protesters Demand Marijuana Vote Tally Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Patrick Henry (email@example.com) Pubdate: Wed, 11 Nov 1998 Source: Washington Post (DC) Contact: http://washingtonpost.com/wp-srv/edit/letters/letterform.htm Website: http://www.washingtonpost.com/ Copyright: 1998 The Washington Post Company Section: Page B03 PROTESTERS DEMAND MARIJUANA VOTE TALLY About 50 people protested yesterday outside the D.C. Board of Elections and Ethics offices demanding the release of results from last week's vote on legalizing marijuana for medical purposes. The demonstrators -- including D.C. Council member-elect Phil Mendelson (D-At Large) -- chanted "push the button now" outside the board offices at 441 Fourth St. NW. On Monday, attorneys for the District told a U.S. District Court judge that elections officials have not pressed one button that would calculate the results of the vote on the initiative. Election officials have said they have been unable to certify the vote because a congressional amendment to the D.C. budget prohibits the city from spending any money on the initiative. On Monday, the judge said he would wait a month before deciding, to give the federal government a chance to weigh in on the matter. An exit poll paid for by supporters of the initiative showed that it passed overwhelmingly.
------------------------------------------------------------------- Seven Deadly Sins - the student stoner dilemma (An op-ed in Salon magazine by a senior at Virginia Commonwealth University protests the provision in the Higher Education Act of 1998 which prohibits non-violent drug offenders - particularly pot smokers - from receiving federal loans or other financial aid.) Date: Thu, 12 Nov 1998 13:11:37 EST Errors-To: firstname.lastname@example.org Reply-To: email@example.com Originator: firstname.lastname@example.org Sender: email@example.com From: Remembers@webtv.net (Genie Brittingham) To: Multiple recipients of list (firstname.lastname@example.org) Subject: Salon Ivory Tower | Seven deadly sins: The student stoner dilemma Seven Deadly Sins BeBe Maddux the student stoner dilemma THE UNIVERSITY'S HYPOCRITICAL STANCE AGAINST MARIJUANA CAN PREVENT EVEN THE BEST OF STUDENTS FROM GETTING AN EDUCATION. There is a poster in my college stating that 71 percent of students don't binge drink. There are black and white pictures of five students underneath this statistic who are smiling and have balloons coming out of their heads that say, "I don't binge drink!" Underneath these photos somebody scrawled in a black permanent marker, "But 100 percent smoke pot!" I laughed the first time I saw the altered poster in the ladies bathroom and thought what a true statement that was. I have smoked marijuana more times than I can count and most of my friends over the years have smoked it. I've found it to be a fairly harmless drug with fewer side effects than alcohol, and less addictive for me. I have known some people who got so wrapped up in the drug culture that marijuana did lead to harder drugs. They had wasted lives spent in basements watching bad Japanese movies and smoking whatever weed they could lay their hands on. Those pot addicts were the exception to the rule, however, and I have never worried if a pot smoker moved into the apartment underneath me or if the guy across the street is dealing it to his friends. But the financial office at your local university does. When I receive my financial aid each year I sign a document that says I agree with their drug policies and I am informed that if I am convicted of a drug offense I may lose my right to any future funding. The actual law is that if you are convicted of a misdemeanor or felony drug charge and the judge specifies in the sentencing that you are on a "drug hold," you are ineligible for financial aid for the rest of your life. The restriction against financial aid does not apply to other felonies or misdemeanors. In other words, serial killers and child molesters, once released from prison, can rake in all the Pell Grants and Stafford Loans they can get their hands on, but a convicted marijuana user can never have access to a federally funded education. President Clinton has admitted to trying to inhale pot; and Al Gore has admitted to smoking it several times while in college. Many people in this country have experimented with this fairly harmless and sometimes medicinal drug despite the fact that some states have mandatory prison terms for marijuana use. The enforcement of United States drug laws is filling up the prisons and making felons of nonviolent offenders. Since the 1970s, when lawmakers declared the war on drugs, the population in prisons has risen five-fold and the United States has the largest amount of adults incarcerated in the industrialized world except for Russia, which is undergoing political and economic turmoil. But according to a recent study by the same federal government that is making these laws, rehabilitation is more effective in treating drug offenders than prison. How many of us had our first joint around the age of 18? If I would've been caught that first time in the mall parking lot with my best friend, I never would've gone to college. I can't say what I would be doing if I couldn't receive any grants or loans from the government to continue my education. I have a friend named John who got busted for having a bowl in his car with some residue of pot inside the bowl. He didn't receive any jail time; he just got a $600 fine. He was lucky that he didn't get the "drug hold" but he never did go back to finish his degree. The fine set him back quite a bit financially and he had to work full time at his waiter job so he could pay his rent. The college can admit on a poster that 29 percent of all students have a drinking problem and the campus community realizes that all those people need is some counseling. No one would ever suggest or seriously believe that making alcohol illegal and putting binge drinkers in jail would ever solve the problem of alcoholism. I don't really laugh when I see those posters in the ladies room anymore. I just wait for the poster that says, "90 percent of all college students do not get stoned every day!" And I can have my black and white photo with the balloon coming out of my head declaring with obvious pride on my face, "I don't get stoned every day!" Until then I will just keep my dirty little secret out of the court system and hope that the financial aid office never finds out. SALON MAGAZINE | Nov. 11, 1998 Bebe Maddux is a senior at Virginia Commonwealth University majoring in English.
------------------------------------------------------------------- TV Has Become Drug Companies Medium (The Associated Press says that just a year after the federal government relaxed restrictions on prescription drug advertising to consumers, the industry spent $306 million on television advertisements during the first half of 1998, or $5 million more than it spent in all of 1997. Television now accounts for 48 percent of drug company's direct-to-consumer advertising, compared to 44 percent for magazines and 8 percent for newspapers. Advertising is said to be causing demand for drugs to soar - while spending nationwide on health care grew by 4.8 percent in 1997, the lowest rate since 1960, spending on pharmaceuticals increased 14.1 percent on top of a 13.2 percent the year before, the federal goverment reported Tuesday.) From: "Bob Owen@W.H.E.N." (email@example.com) To: "_Drug Policy --" (firstname.lastname@example.org) Subject: TV Has Become Drug Companies Medium Date: Thu, 12 Nov 1998 18:29:35 -0800 Sender: email@example.com Newshawk: firstname.lastname@example.org Source: The Wire Pubdate: NOVEMBER 11, 1998 Online: http://wire.ap.org/?PACKAGEID=BIZdrugs TV Has Become Drug Companies Medium By PHIL GALEWITZ AP Business Writer NEW YORK (AP) - Starting to feel inundated by all drug advertising on television? There's good reason. Just a year after the federal government relaxed restrictions on prescription drug advertising to consumers, television has become the medium of choice for the pharmaceutical industry. The industry spent $306 million on TV ads during the first half of 1998, or $5 million more than it spent in all of 1997, according to figures released Wednesday by IS America. Television now accounts for 48 percent of drug company's direct-to-consumer advertising, compared to 44 percent for magazines. The balance goes largely to newspapers. Schering-Plough Corp. spent $29.2 million on TV advertising in the first six months of the year to sell its allergy drug Claritin, the most heavily advertised drug on the air. Two other allergy medications - Pfizer's Zyrtec and Hoechst Marion Roussel's Allegra - were also among the top five promoted drugs on TV, according to IMS. Rounding out the top five TV sellers were Bristol-Myers Squibb's cholesterol drug Pravachol and Prilosec, the heartburn medication made by Astra Pharmaceuticals. Overall, the pharmaceutical industry spent $631 million in consumer advertising in the first half of 1998, up 16 percent from a year ago. Despite the increase in direct to consumer advertising, drug makers still spend the lion's share of their advertising budgets, or $2.5 billion last year, in marketing directly to doctors. Drug companies will continue to fill the airwaves with ads because the ads work, analysts say. In the next few months, Pfizer expects to start television advertising for its anti-impotence Viagra drug. And Dupont Pharmaceuticals is waiting for government clearance to puts its HIV drug Sustiva in TV ads. The federal Food and Drug Administration in August 1997 relaxed the rules governing TV and radio drug commercials, prompting a flurry of ads in the typically more expensive mediums. All the advertising is causing demand for drugs to soar. Though national health care spending grew by 4.8 percent in 1997, the lowest rate since 1960, spending on pharmaceuticals increased 14.1 percent on top of a 13.2 percent the year before, the federal goverment reported Tuesday.
------------------------------------------------------------------- Alternative medicine moves into mainstream (The Miami Herald says Tuesday's special edition of the Journal of the American Medical Association focusing on alternative medicine includes a new study by David Eisenberg of Boston's Beth Israel Deaconess Medical Center, which says four out of 10 Americans used alternative medicine last year to treat mainly chronic conditions, spending an estimated $27 billion out of pocket. There were more visits in 1997 to alternative medicine practitioners than to primary care physicians, and more money was spent on alternative medicine than on patients' expenses for hospitalizations.)From: "Bob Owen@W.H.E.N." (email@example.com) To: "_Drug Policy --" (firstname.lastname@example.org) Subject: Alternative medicine moves into mainstream Date: Wed, 11 Nov 1998 20:17:48 -0800 Sender: email@example.com Published Wednesday, November 11, 1998, in the Miami Herald Alternative medicine moves into mainstream By JAMES A. DUFFY Miami Herald Washington Bureau WASHINGTON -- Four out of 10 Americans used alternative medicine last year to treat mainly chronic conditions, spending an estimated $27 billion out of pocket for alternative therapies, according to a new study released Tuesday. There were more visits in 1997 to alternative medicine practitioners than to primary care physicians, and more money was spent on alternative medicine than on patients' expenses for hospitalizations. But many patients were reluctant to tell their doctors about their use of alternative therapies, such as herbal medicines, biofeedback, homeopathy, hypnosis, massage and acupuncture. About 15 million Americans used prescription drugs and herbal remedies at the same time, said David Eisenberg of Boston's Beth Israel Deaconess Medical Center, who prepared the study. Eisenberg reported his findings in the Journal of the American Medical Association (JAMA), the bible of mainstream medical practice, which includes many articles on the topic in its latest issue. The JAMA articles reflect a growing recognition by mainstream medical practitioners that the use of alternative medicine is a genuine trend that may have positive consequences for society and for medicine. Still, many doctors see dangers in the public's acceptance of nontraditional therapies. ``Of course, there are some physical dangers to this,'' said Dr. Wallace Sampson, who, until his recent retirement, taught a Stanford University course that challenged alternative medicine. ``Some people don't [tell their doctors] because they know they're not doing the right thing. They're not following their doctor's instructions and that's all it is. It's an irreparable problem.'' One in five adults who take prescription medication as well as herbs or high-dose vitamins may be at risk for adverse reactions, Eisenberg reported. But bridging the communication gap between patient and caregiver can lead to more responsible use of alternative medicines, Eisenberg said. ``I think the American public does not wish to seek this [treatment] in a clandestine or secretive way,'' he said. ``They want to seek it in conjunction with their physicians, but some patients are fearful their doctor will disapprove.'' Surveys questioned Indeed, critics like Sampson insist that not as many Americans are using new-age healing methods as surveys indicate. ``What [the researchers] have done is include a number of procedures that are already included in society as part of everyday life in this country,'' Sampson said. ``They've inflated the importance of them and the prevalence of them.'' But data collected from the burgeoning herbal drug industry and from research conducted by the Office of Alternative Medicine at the National Institutes of Health indicate that growing numbers of Americans, frustrated by long-term, debilitating problems like back pain or serious diseases like cancer, are seeking nontraditional help. In the latest study of alternative medicine use in America, the researchers compared results from a 1997 telephone study of 2,055 adults with questions asked in a similar 1990 survey of 1,539 adults. The results showed that over those seven years, use of 16 alternative therapies increased 25 percent, and visits to alternative therapy practitioners rose 47 percent, from 427 million in 1990 to 629 million last year. Women likely users The researchers found that women are more likely than men to use alternative medicine and that blacks and other racial minorities were less likely to use alternatives. The survey was limited to people older than 18 who speak English. ``This is a conservative study,'' Eisenberg said Tuesday. ``People who don't speak English are apt to use more alternative medical therapies.'' There must be ``separate, rigorous, authoritative'' alternative therapy studies conducted on African Americans, Asians and Hispanics, he added. Careful study of alternative medicine practices could lead to cures for illnesses that conventional medicine cannot treat, Eisenberg said, adding that Australia and Great Britain are also dealing with the alternative medicine phenomenon. ``We suggest the federal government take a more proactive role here,'' Eisenberg said. ``We need more science and education for the consumer and also for the caregiver, who is dedicated to do no harm. We need to open communication between patients and doctors . . . including engagement of the skeptics.'' Cooperation urged In fact, the National Institutes of Health recently launched a greatly expanded effort to assess the effects of an array of alternative medical techniques in treating serious conditions ranging from AIDS to cardiovascular disease to cancer. Eisenberg also called for closer contact between medical schools and pharmaceutical companies to buttress research and understanding of alternative medicine. More than half of the 125 accredited medical schools in the United States have at least one class that deals with alternative medicine or they include the fundamental principles of Chinese or Indian Ayurvedic medicine in required courses, JAMA reported in September. Of the 117 schools that responded to a JAMA survey, 75 offered classes on acupuncture or chiropractic and homeopathic care, some of the therapies most commonly used by Americans.
------------------------------------------------------------------- Police say hashish bust biggest ever in BC (According to the Associated Press, Royal Canadian Mounted Police said Tuesday that the seizure last week of 12 metric tons of hash on a fishboat, and another 2.8 metric tons on a mother ship, in Fanny Bay, northwest of Victoria, British Columbia, was the biggest interdiction of its type in provincial history.) From: "Bob Owen@W.H.E.N." (firstname.lastname@example.org) To: "_Drug Policy --" (email@example.com) Subject: B.C. Police say hashish bust biggest ever Date: Wed, 11 Nov 1998 20:12:26 -0800 Sender: firstname.lastname@example.org Police say hashish bust biggest ever in B.C. The Associated Press 11/11/98 3:24 PM Eastern NORTH VANCOUVER, British Columbia (AP) -- A hashish bust off the west coast of Vancouver Island was described Tuesday as the largest seizure of its type in British Columbia history. Last week 12 metric tons was discovered on a fishboat in Fanny Bay northwest of Victoria. A search of the mother ship revealed another 2.8 metric tons of hash, Royal Canadian Mounted Police said. Three vessels were seized -- the Ansare II at Fanny Bay, its mother ship Blue Dawn, which was escorted to North Vancouver to be searched, and Miss Terri. Police said the amount of hashish seized is a record for the province. The drugs are believed to have come from the India-Pakistan region and were bound for central Canada, police said. Charges were laid against two more people, bringing to 14 the number charged because of the seizure. All have been charged with importing a controlled substance and other counts. The seizure and charges were the result of a lengthy investigation involving Canadian and U.S. authorities. The investigation began in March 1997 when RCMP officers in Halifax, Nova Scotia, members of a coastal watch program, were notified that residents of British Columbia had bought the Blue Dawn and were embarking on a venture that didn't make any economic sense. Police began monitoring the ship, RCMP Staff Sgt. Kim Marsh said. When the Blue Dawn sailed out of Halifax last fall, RCMP kept an eye on it as it sailed across the Atlantic, through the Mediterranean, the Suez Canal, and across the Indian Ocean to southeast Asia. Police continued to monitor the ship as it crossed the South China Sea into the north Pacific, on its way to the West Coast. Defense Department air crews then flew surveillance and patrol missions from Vancouver Island, using electric sensors to track the Blue Dawn and the Ansare II. In the meantime, RCMP in Courtenay and Nanaimo on Vancouver Island had been conducting separate investigations. "It wasn't until later we determined they were connected," Marsh said. RCMP officers taking part in the drug raid at Fanny Bay feared the Ansare II fishing boat was rigged with dynamite, he said. "There were indications (the ship) had been wired to sink so we took all precautions," Marsh said. "We sent in our explosive experts, which we do when we try a boarding and they have an opportunity to scuttle it. But it didn't happen." The boat wasn't rigged with dynamite and no weapons were found on board. "It went down very smoothly," Marsh said. "We're now in the process of sorting through evidence obtained from the searches. "Other people have surfaced and we have to determine whether there is sufficient evidence to charge them."
------------------------------------------------------------------- Mexican Authorities Link Massacre Of 19 To Drug Gang (According to an Associated Press article in The Orange County Register, the Mexican attorney general's office said Tuesday that the massacre of 19 people near the northern city of Ensenada Sept. 17 has been linked to the Arellano Felix brothers, who run Mexico's most violent drug gang.) Date: Wed, 11 Nov 1998 17:16:41 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: Mexico: Mexican Authorities Link Massacre Of 19 To Drug Gang Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: John W. Black Pubdate: Wed, 11 Nov 1998 Source: Orange County Register (CA) Contact: email@example.com Website: http://www.ocregister.com/ Copyright: 1998 The Orange County Register Author: Adolfo Garza, AP MEXICAN AUTHORITIES LINK MASSACRE OF 19 TO DRUG GANG LED BY 4 BROTHERS Three Suspects Are In Custody And 10 Others Sought In The Killing Of Villagers North Of Ensenada. Mexico City-The massacre of 19 people in a small Indian community near the northern city of Ensenada has been linked to the Arellano Felix brothers, who run Mexico's most violent drug gang, the attorney general's office said Tuesday. In one of the bloodiest drug-related massacres in Mexico, an alleged drug trafficker and 18 members of his extended family were roused from their beds Sept. 17 by gunmen who lined them up against a wall and shot them with automatic weapons. The gunmen's target, a Pei Pei Indian named Fermin Castro, died two weeks later of complications from two bullet wounds he received in the attack. The gunmen were members of a gang led by a man known by his associates as Lino Quintana, whose gang "is an armed group that works for Ramon Arellano Felix," said Gen. Guillermo Alvarez, who coordinates anti-drug efforts at the judicial police. Alvarez and federal prosecutors said Quintana's gang killed Castro to keep his marijuana-trafficking operation from growing into a potential competitor. They said three suspects were under arrest and arrest warrants have been issued for 10 other. Alvarez said Quintana's gang had used green military-style uniforms that apparently were bought in the United States, and insisted Mexican soldiers were not involved in the massacre, as local media have speculated. Ramon Arellano Felix was placed on the FBI's Ten Most Wanted List last year and U.S. federal authorities have offered a $2 million reward for information leading to his arrest. He and three of his brothers are fugitives who control major routes funneling cocaine, marijuana and other drugs into the United States across the California-Mexico border, authorities said. Mexican authorities have sought the brothers since 1993.
------------------------------------------------------------------- Mexican Authorities Link Massacre To Violent Drug Gang (A different Associated Press version) Date: Wed, 11 Nov 1998 20:01:11 -0800 From: firstname.lastname@example.org (MAPNews) To: email@example.com Subject: MN: Mexico: Wire: Mexican Authorities Link Massacre To Violent Sender: firstname.lastname@example.org Reply-To: email@example.com Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Patrick Henry (firstname.lastname@example.org) Pubdate: 11 Nov 1998 Source: Associated Press Author: Adolfo Garza, Associated Press Copyright: 1998 Associated Press. MEXICAN AUTHORITIES LINK MASSACRE TO VIOLENT DRUG GANG MEXICO CITY (AP) - Nineteen people have been slain in drug-related violence in a small northern town in Mexico, officials say. An alleged drug trafficker and 18 members of his extended family - including eight children - were roused from their beds Sept. 17 by gunmen who lined them up against a wall and shot them with automatic weapons, officials said Tuesday. The massacre took place near the northern coastal resort of Ensenada. The gunmen's target, a Pei Pei Indian named Fermin Castro, died two weeks later of complications from two bullet wounds. Deputy Attorney General Jose Luis Ramos Rivera said three suspects had been arrested, and warrants have been issued for 10 others - one of whom may be hiding in the United States. The gunmen were members of a gang led by a man known as "Lino Quintana,'' who works for drug lord Ramon Arellano Felix, said Gen. Guillermo Alvarez, who coordinates anti-drug efforts at the judicial police. Ramon Arellano Felix was placed on the FBI's 10 most wanted list last year, and U.S. federal authorities have offered a $2 million reward for information leading to his arrest. He and three of his brothers are fugitives who control major routes funneling cocaine, marijuana and other drugs into the United States across the California-Mexico border, authorities say. Mexican authorities have sought the brothers since 1993. Alvarez and federal prosecutors said Quintana's gang killed Castro to keep his marijuana-trafficking operation from growing into a potential competitor. Authorities said they solved the case after two people were murdered Oct. 29 by gunmen wearing the same military-style uniforms as those worn in the September massacre near the northern coastal resort of Ensenada. Descriptions gathered from survivors of the two attacks led to the arrest of Armando Villegas, who said he was present during both slayings. Villegas directed authorities to a ranch in Rosarito, Baja California, where investigators found guns and uniforms allegedly used by the gunmen. Alvarez said the gunmen in Ensenada were especially brutal because they consumed large amounts of alcohol and cocaine prior to the attack. He said Quintana's gang had used military uniforms apparently bought in the United States, and insisted that Mexican soldiers were not involved in the massacre, as local media have speculated. He said five soldiers who had been under house arrest during the investigation had been cleared of any involvement in the killings and released.
------------------------------------------------------------------- Tijuana Massacre Traced To Drug Deal Gone Bad Between Rival Gangs (The Houston Chronicle version) Date: Wed, 11 Nov 1998 19:31:29 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: Mexico: Tijuana Massacre Traced To Drug Deal Gone Bad Between Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: email@example.com Pubdate: Wed, 11 Nov 1998 Source: Houston Chronicle (TX) Contact: firstname.lastname@example.org Website: http://www.chron.com/ Copyright: 1998 Houston Chronicle Author: ANDREW DOWNIE TIJUANA MASSACRE TRACED TO DRUG DEAL GONE BAD BETWEEN RIVAL GANGS MEXICO CITY -- Gunmen linked to the Tijuana drug cartel shot and killed 19 people near the U.S. border earlier this fall because one of the victims, a rival drug dealer, owed them marijuana and was refusing to pay up, Mexican judicial officials said Tuesday. Gang leaders were angry at local trafficker Fermin Castro Ramirez because Castro had stolen 800 kilos of their marijuana, officials said. In a bid to get their drugs back, armed men, some of whom may have worked as gunmen for Tijuana cartel boss Ramon Arellano Felix, went to Castro's ranch outside Ensenada in the early hours of Sept. 17. But after an argument, they systematically gunned down Castro and his family, said Jose Luis Chavez, the attorney general's representative in Baja California state, where the massacre took place. At least 19 people died in the massacre, including a baby and six youngsters. "They went to get their 800 kilos," Chavez told a news conference Tuesday. "After a fierce argument they started to get the family members from the ranch and line them up on the ground face down." One of the gang members "then gave the order to shoot." At least a dozen people took part in the killing and many of them were intoxicated or had taken drugs before going to the ranch, Chavez said. Three suspects are under arrest charged with murder, kidnapping and drug-related crimes. Arrest warrants have been issued for another ten suspects, at least one of whom is believed to be in the United States, Chavez added. Only two people -- a young girl and Castro -- were thought to have initially survived the attack. Castro, however, succumbed to his wounds two weeks later. The girl was instrumental in helping authorities with their investigation, officials said. Officials have described Castro, a 38-year-old Paipai Indian and former schoolteacher who had recently become wealthy, as one of the local smugglers who has made Ensenada an increasingly key spot in the area's drug trade. The region north of Ensenada leading toward the U.S. border is a key corridor for Mexican narcotics traffickers attempting to take drugs into the United States. Each year, dozens of tons of Mexican marijuana, heroin and methamphetamines, as well as cocaine, heroin and marijuana from Colombia, Africa and the Far East, are smuggled through Baja California on their way to the United States, American and Mexican anti-narcotics officials agree. That traffic hit a peak in the mid-1990s, but renewed customs efforts along the United States' border has stemmed the flow somewhat. A crackdown in Mexico against the Arellano Felix family has also played a significant role in limiting the flow, and the drug experts said the brothers have moved east along the Mexican border in search of new trafficking routes. One of the brothers, the notoriously violent Ramon Arellano, was last year placed on the FBI's Ten Most Wanted List. Authorities say the new round of murders could be the result of fighting among heirs eager to take over the lucrative Tijuana corridor which Ramon and his siblings left behind. At least 292 people have been killed in Tijuana this year, police and news reports said.
------------------------------------------------------------------- Mexico Nabs Three Ensenada Drug Massacre Suspects (The Reuters version) Date: Wed, 11 Nov 1998 20:15:33 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: Mexico: Wire: Mexico Nabs Three Ensenada Drug Massacre Suspects Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Patrick Henry Source: Reuters Copyright: 1998 Reuters Limited. Pubdate: 11 Nov 1998 MEXICO NABS THREE ENSENADA DRUG MASSACRE SUSPECTS MEXICO CITY (Reuters) - Three gang members linked to Mexico's bloodthirsty Arellano Felix cocaine cartel have been arrested in connection with the massacre of 19 members of two families in September, police said Tuesday. Authorities said the victims, dragged from their beds at night and executed near the northern port city of Ensenada, were probably killed because one had tried to carve out a narcotics business in the Tijuana-based cartel's turf, across the U.S.-Mexico border from San Diego. The victims of one of the most gruesome examples of Mexico's growing drug-related violence included a 1-year-old, four other children and an eight-months-pregnant woman. Two family members who survived the attack, including a girl who hid under a bed while the massacre took place, gave police information that led to the arrests. Mexico's Attorney General's Office identified the arrested men as Armando Villegas Santacruz, Trinidad Medina Perez and Ismael Estrada Ramos. The three were members of a gang that robbed or taxed smaller drug gangs, the office said. It did not provide ages or additional information. It said arrest orders had been issued for 10 other members of the gang, including the two masterminds of the massacre, Arturo Martinez Gonzalez and Lino Portillo Salazar, who were still at large. The office said Martinez and Portillo led a gang that robbed shipments of marijuana or levied taxes on smaller drug gangs that had formed in the area, seeking to ensure that they did not grow too big and threaten the Arellano Felix brothers, Mexico's most wanted criminals. Police said that on the night of the massacre, some 10 gang members high on cocaine and alcohol sneaked into the families' ranch complex to steal 1,800 pounds of marijuana and collect on a debt owed by family member Fermin Castro Rodriguez. "They went to get the 800 kilos. ... After a heated discussion, they started to round up the family member from the ranch and line them up on the ground face down. (Lino Portillo) gave the order to shoot," Jose Luis Chavez Garcia, the attorney general's representative in Baja California state, told a news conference in Mexico City. Castro allegedly met small aircraft carrying drugs into the state of Baja California and loaded them onto specially converted vehicles with false bottoms for shipment across the U.S.-Mexico border. One of his shipments had been stolen recently by Villegas, the authorities explained. The survivors' descriptions allowed police to arrest him and obtain information on the gang's hideaways, where police found guns they said matched those used in the crime. The gang used to wear military-style outfits or federal police uniforms and carry high-powered weapons such as AK-47s and Uzi submachine guns, police said. They said initial reports of links between the gang and the local military had been investigated and had proved "totally false." Witnesses said the gang worked for the Arellano Felix brothers, known as Mexico's most brutal cocaine cartel. One of the brothers, Ramon, is on the FBI's Ten Most Wanted list.
------------------------------------------------------------------- New Laws For Police To Search Cars (According to The Daily Telegraph, in Australia, last week's drive-by shooting at the police station in Lakemba has prompted the state government to announce it would introduce legislation into State Parliament this week allowing police the power to erect road blocks, pull over drivers, search their vehicles and demand IDs.) Date: Wed, 11 Nov 1998 20:11:32 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: Australia: New Laws For Police To Search Cars Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Russell.Ken.KW@bhp.com.au (Russell, Ken KW) Source: Daily Telegraph (Australia) Contact: email@example.com Pubdate: Wed, 11 Nov 1998 Our Newshawk notes: It is the possible abuses of this law that are most important. NEW LAWS FOR POLICE TO SEARCH CARS POLICE will be allowed to erect road blocks, pull over drivers, search their vehicles and demand IDs in response to last week's drive-by attack at Lakemba. In a win for Police Commissioner Peter Ryan, the State Government yesterday announced it would introduce legislation into State Parliament this week allowing police the extra powers. Police Minister Paul Whelan said the powers were needed to ensure future investigations were not stifled by legal loopholes. "Since the shooting attack at Lakemba police station, two limitations in police powers have been identified," he told Parliament. "Gaps or deficiencies which have been allowed to remain could limit the effectiveness of police response." The legislation delivers precisely the powers Mr Ryan requested after a gang showered his officers with bullets in a drive-by attack on Lakemba police station earlier this month. Mr Ryan said the reforms could help police catch gangs engaging in drive-by shootings. Until now, police powers to stop and search vehicles have been limited to a particular vehicle. If police suspected a bomb was in a car at a specific location, existing provisions would not allow for a search of all vehicles at that location. If an escaped prisoner was suspected to be travelling along a particular route, police would not have the power to set up a road block. And until now, police powers to demand driver identification have been limited to traffic breaches. The decision to grant new powers appears to be at odds with comments by Attorney-General Jeff Shaw who argued against further expanding police powers immediately after the Lakemba attack. Mr Shaw warned that the shooting, "however terrible, should not usher in draconian and anti-democratic laws". "I don't think it should precipitate calls for massive expansion of police powers, for example," Mr Shaw told a crime conference. The next day Mr Ryan put Premier Bob Carr on the spot at a joint press conference by outlining the extra police powers he desired. Asked if he would back the reforms, Mr Carr said police would be "given anything they needed" to help solve crimes. Police will be allowed to set up a road block for up to six hours, after which they must seek authorisation for an extension from an officer. Failure to comply with the new legislation will carry a $5000 fine or 12 months' jail.
------------------------------------------------------------------- Drug Boffins Put A Sock In It (The Australian says heavies from the New South Wales Health Department and the office of its minister have issued a decree censoring workers in the drug field, particularly those in the sensitive area of illicit drugs. With an election in the offing, the government is keen to keep the focus on law and order and away from anything that might portray it as soft on drugs.) Date: Sun, 15 Nov 1998 08:18:36 -0800 From: firstname.lastname@example.org (MAPNews) To: email@example.com Subject: MN: Australia: Drug Boffins Put A Sock In It Sender: firstname.lastname@example.org Reply-To: email@example.com Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: firstname.lastname@example.org (Ken Russell) Source: Australian, The (Australia) Contact: email@example.com Website: http://www.theaustralian.com.au/ Pubdate: 11 Nov 1998 Page: 17 DRUG BOFFINS PUT A SOCK IN IT HEAVIES from the NSW Health Department and the office of its minister have issued a decree censoring workers in the drug field, particularly the sensitive area of illicit drugs. With an election in the offing, the Government is keen to keep the focus on law and order and away from anything that might portray it as soft on drugs. So great is the concern that one prominent researcher has been told not to speak to the press. Even the usual "no comment" - we're told - would be going a bit far. Researchers discussing their work with naltrexone and heroin addicts at the conference of the Australian Professional Society of Alcohol and Other Drugs in Sydney yesterday were babysat by a department PR officer. As one speaker took the podium, some observers attested to a narrowing of eyes - a glare even - in warning against commenting in too much detail.
------------------------------------------------------------------- IOC Drug Policy Overhaul Predicted (According to The Chicago Tribune, Dr. Ken Fitch, a member of the International Olympic Committee's medical commission, said in Sydney, Australia, that a "radical" overhaul of the IOC's drug policy would take place at a meeting next month, including the removal of some narcotics from the banned list.) Date: Wed, 11 Nov 1998 19:25:39 -0800 From: firstname.lastname@example.org (MAPNews) To: email@example.com Subject: MN: Ioc Drug Policy Overhaul Predicted Sender: firstname.lastname@example.org Reply-To: email@example.com Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Steve Young Source: Chicago Tribune (IL) Contact: firstname.lastname@example.org Website: http://www.chicagotribune.com/ Copyright: 1998 Chicago Tribune Company Pubdate: 11 Nov 1998 Author: Mark Shapiro Section: Sports IOC DRUG POLICY OVERHAUL PREDICTED SYDNEY, Australia -- Medical commission member Dr. Ken Fitch says a "radical" overhaul of the International Olympic Committee's drug policy will take place at a meeting next month, including the removal of some narcotics from the banned list. Fitch, who is on the medical commissions for both the IOC and Sydney Olympic organizers, said he would also urge a return to pre-competition testing by the IOC in the days leading up to the 2000 Games. Fitch said he supported comments by IOC president Juan Antonio Samaranch earlier this year that the banned list needed simplification. "Mainly drugs like morphine, pethidine," need to be dropped from the banned list, Fitch said. He said heroin would remain on the list.
------------------------------------------------------------------- Lords Back Cannabis Use For Patients Suffering Pain (The Guardian, in Britain, discusses the report published today by the House of Lords Select Committee on Science and Technology saying doctors should be legally allowed to prescribe cannabis to multiple sclerosis sufferers and other patients who find it helps relieve pain.) Date: Wed, 11 Nov 1998 18:40:36 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: Lords Back Cannabis Use For Patients Suffering Pain Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Martin Cooke (email@example.com) Pubdate: Wed, 11 Nov 1998 Source: Guardian, The (UK) Contact: firstname.lastname@example.org Website: http://www.guardian.co.uk/ Copyright: Guardian Media Group 1998 Author: Sarah Boseley LORDS BACK CANNABIS USE FOR PATIENTS SUFFERING PAIN Doctors should be legally allowed to prescribe cannabis for multiple sclerosis sufferers and other patients who find it helps relieve pain, says a report from a scientific committee of the House of Lords, published today. The report was hailed as courageous by patients who buy the drug on the streets and smoke it in fear of the law. Its findings were backed by pharmacists, but rejected by the British Medical Association, representing doctors. Government departments promptly let it be known that they would not lift the ban on a drug that has not undergone clinical trials. The House of Lords select committee on Science and Technology accepted the lack of "rigorous scientific evidence" for the pain-relieving properties of cannabis. But, said the chairman, Lord Perry of Walton, they were making their recommendation "primarily for compassionate reasons". As a Schedule 1 drug, cannabis is deemed to have no therapeutic value, and is not available to medicine. The Lords want it moved to Schedule 2, which would mean pharmacists could supply it and doctors could prescribe it, although it would not be licensed. Lord Perry, one of the majority of well-respected scientists and academics on the committee, said that "the evidence that I relieves pain, especially neorological pain, is quite convincing", even though most of it is anecdotal. Although serious clinical trials will begin in January, Lord Perry said it would take five years before cannabis or its derivatives would be licensed as a medicine. "We consider there is sufficient evidence of medicinal benefit to many patients to make it unjustifiable and inhumane to make them wait so long," he said. Since the only effective way to deliver cannabis to the brain swiftly is through smoking it at the moment, the Lords are even prepared to countenance its prescription for use in a joint, although they urged research into inhalation and other methods. They urged the Government to take a lead in Europe and reschedule cannabis now, but the Department of Health and the Home Office poured cold water on the idea. "The Government would not be prepared to countenance any movement to allow prescription before clinical trials and safety tests have been concluded," said a Home Office spokeswoman. The Department of Health said that any drug to be used in patient treatment must be licensed by the Medicines Control Agency "and you can't do that with a Schedule 1 drug". But the Royal Pharmaceutical Society, which will be running the trials in January, agrees with the Lords, as long as a standardised cannabis product can be produced - not a weed which can vary in strength. Clare Hodges, from the Alliance for Cannabis Therapeutics, who suffers from multiple sclerosis herself, said she was delighted with the report. "I think they have shown great compassion and great bravery," she said. Sir William Asscher, chairman of the BMA's Board of Science and Education, said he understood the Lords' humanitarian motives but could not support them. "Crude cannabis is a toxic mixture of more than 60 cannabinoids and other ingredients," he said.
------------------------------------------------------------------- Peers Support Cannabis Use (The Independent version) Date: Thu, 12 Nov 1998 17:38:53 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: Peers Support Cannabis Use Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Martin Cooke (email@example.com) Pubdate: Wed, 11 Nov 1998 Source: Independent, The (UK) Copyright: Published by Independent Newspapers (UK) Ltd. Contact: firstname.lastname@example.org Mail: The Independent, 1 Canada Square, Canary Wharf, London E14 5DL England Website: http://www.independent.co.uk/ Author: Sarah Schaefer, Political Reporter PEERS SUPPORT CANNABIS USE The likelihood of cannabis being legalised for medical use increased yesterday after a powerful Lords committee said it would be "unjustified" and "inhumane" to delay clinical trials of the drug further. Peers recommended an urgent change in the law to allow derivatives of the drug to be used for the treatment of multiple sclerosis and chronic pain. The 53-page report from the Lords' Science and Technology Committee concluded an eight-month inquiry. It will put pressure on the Government to relax the blanket ban on cannabis, which has lasted for the past 25 years. The Department of Health has always insisted evidence of the medical benefits of cannabis was too weak to justify a relaxation of the law. But the committee said that it has been persuaded that cannabis should be moved from its listing as a Schedule 1 drug, where it cannot be used except in research, to Schedule 2, allowing doctors and pharmacists to supply it on prescription. Lord Perry of Walton, the committee's chairman, said clinical trials of cannabis should be mounted "as a matter of urgency for compassionate reasons" as thousands of patients could be helped. "It would be unjustified and inhumane to make them wait much longer," he said. The committee was less convinced about the drug's effectiveness in tackling other conditions, including epilepsy, glaucoma and asthma, but Lord Perry made clear it would be at doctors' discretion when to prescribe the drug. He denied the legalisation of cannabis for medical use would be the first step towards the decriminalisation of the drug for recreational use, saying they were "completely separate matters". Lord Perry, who is 77, said: "Before any of you ask us if we have ever smoked pot, the answer is that we're not going to tell you. It's not relevant to the inquiry. But cannabis can be used to reduce the amount of morphine or heroin that is used for terminal conditions like cancer." Pulp Fiction glamorised drug-taking so much it may have increased heroin abuse, the outgoing British Board of Film Classification director, James Ferman, said yesterday. Some scenes in Quentin Tarantino's cult film were "practically an advertisement" for heroin, Mr Ferman told the Institute for the Study of Drug Dependence. "We didn't cut the film, and I don't know, looking back, whether that was a good idea," he said.
------------------------------------------------------------------- Legalise Cannabis For Sick, Say Peers (The Telegraph version) Date: Thu, 12 Nov 1998 19:24:41 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: Legalise Cannabis For Sick, Say Peers Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Martin Cooke (email@example.com) Pubdate: 11 Nov 1998 Source: Telegraph, The (UK) Contact: firstname.lastname@example.org Author: Polly Newton, Political Staff LEGALISE CANNABIS FOR SICK, SAY PEERS A CALL today by peers for cannabis to be legalised for medicinal use will be rejected by the Government despite pleas from multiple sclerosis sufferers who say the drug helps them to cope with the disease. In a report published this morning, the House of Lords science and technology committee urges the Government to allow doctors to prescribe cannabis for pain relief. The committee says ministers should not wait for the results of clinical trials, which are only just beginning and will last for several years. But George Howarth, the Home Office minister, said the Government would not be prepared to allow the prescription of cannabis before research had proved it safe. "The safety of patients is our priority, and the Government would not allow prescription of any drug which had not been tested for safety, efficacy and quality through that clinical process." He said they supported further trials into the benefits of cannabis for MS and chronic pain. The committee said there should be no lifting of the ban on the recreational use of cannabis, a recommendation that was welcomed by Mr Howarth. Lord Perry of Walton, the committee chairman, acknowledged that the recommendations might attract controversy. He said: "It would be out of step with quite a lot of countries, but we think it would be a good thing if the Government showed a lead." The Multiple Sclerosis Society estimates that at least 1,000 of the 85,000 sufferers in Britain use cannabis to alleviate their symptoms. Campaigners for the legalisation of cannabis for medicinal purposes welcomed the committee's conclusions. Clare Hodges, of the Alliance for Cannabis Therapeutics, who has MS, said the committee had shown compassion and bravery in its recommendations.
------------------------------------------------------------------- Lords Call To Make Cannabis Legal For Pain Relief (The Times version) Date: Thu, 12 Nov 1998 19:26:12 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: Lords Call To Make Cannabis Legal For Pain Relief Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Martin Cooke (email@example.com) Pubdate: 11 Nov 1998 Source: Times, The (UK) Contact: firstname.lastname@example.org Website: http://www.the-times.co.uk/ Author: James Landale, Political correspondent LORDS CALL TO MAKE CANNABIS LEGAL FOR PAIN RELIEF DOCTORS should be permitted to prescribe cannabis for medical use, a House of Lords committee is to propose today. The peers will urge the Government to act swiftly to lift the ban, so that thousands of people can take the drug to alleviate pain. Although the proposals from the Lords Science and Technology Committee will undoubtedly be supported by many sufferers, they are unlikely to secure the backing of Jack Straw, the Home Secretary. The Government is acutely sensitive to the whole issue and any relaxation of the law is unlikely in the short term. Under the Misuse of Drugs Regulations 1985, cannabis is a Schedule One drug and all use is banned, except for licensed research. The Lords Science and Technology Committee recommends that it be reclassified as a Schedule Two drug. The committee admits that there is no conclusive proof that cannabis has medical value but says there is enough anecdotal evidence that it can be used to treat multiple sclerosis and particular types of pain. It says that trials should begin at once on cannabis as a treatment for MS and chronic pain and calls for research into ways of administering it other than smoking. George Howarth, a Home Office Minister, rejected the recommendation and insisted that further clinical trials were needed. "The Government would not be prepared to countenance any move to allow prescription before clinical trials and safety tests have been completed," he said. The committee argues that the regulations should be relaxed immediately on compassionate grounds. The tests could last for some time and it could be years before any cannabis was available for use. Without it, 85,000 MS suffers would continue to face the symptoms of their disease without relief. The committee rejects claims that allowing cannabis for medical purposes will lead to further legalisation. The peers say their changes would prevent sufferers risking prosecution and help police to concentrate on people using the drug for illegal recreational uses. Lord Perry of Walton, the committee chairman and a former professor of pharmacology, said: "We have seen enough evidence to convince us that a doctor might legitimately want to prescribe cannabis to relieve pain, or the symptoms of MS, and that the criminal law ought not to stand in the way. Our recommendation would make the ban on recreational use easier to enforce. Above all, it would show compassion to patients who currently risk prosecution to get help." The British Medical Association backed the committee's call for clinical trials but opposed rescheduling the drug.
------------------------------------------------------------------- Out On A Limb Over Beneficial Joints (Guardian columnist Sarah Boseley says the report on medical marijuana published this morning by the House of Lords Select Committee on Science and Technology "admits" there is no scientific evidence that cannabis relieves the pain of multiple sclerosis sufferers and others. But the committee believed the evidence from patients themselves, and felt it was wrong that those in pain should have to break the law and that their doctors should be under pressure to connive with them. The committee said that its recommendation was not scientific, but compassionate.) Date: Wed, 11 Nov 1998 19:57:51 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: OPED: Out On A Limb Over Beneficial Joints Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Martin Cooke (email@example.com) Pubdate: 11 Nov 1998 Source: Guardian, The (UK) Contact: firstname.lastname@example.org Website: http://www.guardian.co.uk/ Copyright: Guardian Media Group 1998 Author: Sarah Boseley OUT ON A LIMB OVER BENEFICIAL JOINTS Sarah Boseley on the radical nature of the Lords committee's recommendation that doctors should be able to prescribe cannabis Scientific evidence that cannabis relieves the pain of multiple sclerosis sufferers and others does not exist. The House of Lords select committee on science and technology admits this in its report, published this morning. That is why it is extraordinary that the committee, as an independent group made up mostly of scientists, wants doctors to be allowed to prescribe cannabis to patients. The report is radical and represents a big departure from the position of the British Medical Association, which backed trials of cannabinoids - derivatives of the cannabis plant - last year but is firmly opposed to the use of cannabis itself, which it says is full of toxins. But multiple sclerosis and cancer patients who smoke dope because it relieves the pain, and - in MS - reduces spasms, say that the cannabinoids in tablet form so far developed do not have anything like the swift and effective impact of the real thing, smoked in a joint. The committee believes them, and feels it is wrong that those in pain should have to break the law and that their doctors should be under pressure to connive with them. The committee says that its recommendation is not scientific, but compassionate. Medical use of cannabis was only made illegal in this country in 1973. Before that, as the peers point out, "it has been used medically for thousands of years in oriental and Middle Eastern countries". Nobody has been killed by cannabis, which is generally accepted to be less toxic than alcohol. The committee states that "in all the evidence we have received, there is not enough rigorous scientific evidence to prove conclusively that cannabis itself has, or indeed has not, medical value of any kind." Members had been convinced not by scientific proof, but by "anecdotal evidence". They want cannabis to be made available legally to patients and quickly. That desire has put them in a difficult position. No standardised plant extract has yet been produced - as users know, batch strengths on the street vary enormously - and no effective way of taking it other than smoking, which the peers do not want to endorse, has been developed. They have taken the only logical route towards their goal. They have suggested, in effect, that doctors should write out a prescription for the patient to pick up his resin and his Rizlas at the local pharmacy. The Royal Pharmaceutical Society, which is about to start clinical trials, agrees with the committee - in fact, they say, they said it first. The RPS would like to see doctors allowed to prescribe cannabis, but they point out that pharmacies would not be supplying the sort of cannabis that is smuggled in the soles of people's shoes from Morocco or traded in cafes in Amsterdam. If cannabis were moved from schedule 1, where it ranks as an illegal drug of abuse with no therapeutic use, to schedule 2, to become a controlled drug which can be prescribed under some circumstances, manufacturers would be able to produce and supply to chemists a standardised product. Tony Moffat, the RPS's chief scientist, says the society believes the way ahead lies in cannabinoids - the active ingredients - rather than the whole plant, which he describes as "a pharmacologically dirty substance. When you ingest cannabis you take in hundreds of compounds, some of which may do harm and some of which may be helpful. What we need to do is isolate the useful cannabinoids and that is why we need more research." But the two-year clinical trials, to be launched in January, will examine both. Groups of volunteers, probably with MS, will take either the cannabinoid THC, which scientists think is responsible for the drug's pain-relieving effects, or an extract of the whole plant, or a placebo. The results could be crucial. At the moment, most European countries take the line of the World Health Organisation that cannabis has no therapeutic value and is only a drug of abuse. Under a WHO convention, Europe agrees to ban its use by doctors. But if the RPS trials prove there is therapeutic use, then the WHO line will probably change and the way will be open for medicinal use everywhere. The peers think Britain should not wait. "We consider that the Government should not be afraid to give a lead in this matter in a responsible way," says the report. But they also urge that the clinical trials should get going as fast as possible. While they suggest that smoking cannabis would be acceptable for the time being in patients who need immediate pain relief, they say that this is not satisfactory in the long run. They recommend research into other ways of taking it, such as inhalation, "which would retain the benefit of rapid absorption offered by smoking, without the adverse effects". Unfortunately, cannabis taken orally is degraded by the liver before much of it can reach the brain, where it has its effects. According to the UK Alliance for Cannabis Therapeutics, the drug is probably used by several hundred people suffering from MS, although they may amount to no more than 1 per cent of those with the disease. Others who use it have spinal injuries, back pain, chronic arthritis, epilepsy and ME. The cannabinoids Nabilone and Dronabil are prescribed by some doctors for the nausea that follows chemotherapy for cancer. But ACT believes more people in this category smoke cannabis itself.
------------------------------------------------------------------- Cannabis Therapy (A letter to the editor of The Independent, in Britain, from a multiple sclerosis patient who uses marijuana as medicine, implores the government to heed today's report from the House of Lords Select Committee on Science and Technology.) Date: Wed, 11 Nov 1998 19:59:41 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: PUB LTE: Cannabis Therapy Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Martin Cooke (email@example.com) Pubdate: 11 Nov 1998 Source: Independent, The (UK) Contact: firstname.lastname@example.org Website: http://www.independent.co.uk/ Copyright: 1998. Published by Independent Newspapers (UK) Ltd. Author: Andrew Coldwell Section: Letters CANNABIS THERAPY Sir: With the publication of the Lords report on medicinal cannabis, I thought it prudent as a cannabis-using multiple sclerosis sufferer and a representative of the Alliance for Cannabis Therapeutics, to present the views of the people most affected by the blanket prohibition of cannabis. There are thousands of sick people throughout the UK using cannabis and finding it of benefit for many illnesses. If we carry on using cannabis we are leaving ourselves open to criminal prosecution, but if we obey the law and desist from the practice we are faced with the very real possibility of our condition worsening. It must be understood that we are not hedonistic, irresponsible teenagers, but ill people who find themselves in the absurd position of being denied the one effective means of palliative treatment available to them by, in many cases, the party they had supported at the general election. It is disturbing that instead of endeavouring to institute objective research into the medicinal properties of pure cannabis, the Government, without scientific justification, seems to take some satisfaction in denying us this vital medication. I did not expect, or intend, to be in conflict with my own government at this point in my life - MS itself is a daunting foe - but this government must surely have the wisdom to understand that we are no threat to society's stability, but just incurably ill people wishing to treat themselves as they, and in most cases their doctors, see fit. It is an absurdity, if not an obscenity, to be forced to seek our medication from criminal sources. ANDREW COLDWELL, Huddersfield, West Yorkshire
------------------------------------------------------------------- Let GPs Prescribe The Weed (A staff editorial in The Guardian, in Britain, rejects the British Medical Association's criticism of today's report from the House of Lords Select Committee on Science and Technology, which recommends that General Practitioners be allowed to prescribe herbal cannabis for medical use. "The Lords should be congratulated for listening to patients rather than researchers. Knowing why it works would be helpful but making it illegal until we know why is wrong.") Date: Wed, 11 Nov 1998 18:48:56 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: Oped: Let GPS Prescribe The Weed Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Martin Cooke (email@example.com) Pubdate: Wed, 11 Nov 1998 Source: Guardian, The (UK) Contact: firstname.lastname@example.org Website: http://www.guardian.co.uk/ Copyright: Guardian Media Group 1998 LET GPS PRESCRIBE THE WEED Who says scientists should not use common sense? The House of Lords Select Committee on Science and Technology caused a considerable kerfuffle in scientific circles yesterday. They concluded in their latest report that there is insufficient scientific evidence to prove the medical value of cannabis but even so recommended that the Government should reclassify the drug to allow doctors to prescribe it as an unlicensed medicine on a named-patient basis. This was not a collection of hereditary nobodies but a notable panel heavily weighted with distinguished medical scientists (a biologist, chemist, physicist, medical researcher, neurologist, pathologist and practising fertility specialist) advised by Oxford University's visiting professor of pharmacology. In an unequivocal conclusion they declare: "We have received enough anecdotal evidence to convince us that cannabis almost certainly does have genuine medical applications, especially in treating the painful muscular spasms and other symptoms of MS and in the control of other forms of pain." The British Medical Association was not amused. It criticised the Lords for failing to distinguish between the active constituents of cannabis and cannabis itself. It noted cannabis had many toxic ingredients and 60-plus cannabinoids. It believed there should be no change to its legal position until further research had established which cannabinoids had therapeutic value so that new cannabis-based drugs could be developed. It opposed the use of crude cannabis because of the "unpredictable nature of its effects". But "unpredictable" is the wrong word. Although there is only one small clinical trial on the medical benefits of cannabis there is a mountain of evidence from MS sufferers that cannabis does ease their pain. The reason why cannabis has these effects may be "unknown" but the effects are not "unpredictable". This was one of the reasons why the Lords came out in support of using the drug. Even the medic about to conduct the clinical trials into cannabis, who spoke out against the report yesterday, conceded the anecdotal evidence was impressive. The Lords should be congratulated for listening to patients rather than researchers. Cannabis was used medically for centuries before being overtaken by more powerful drugs but it still provides relief for a small category of ailments where modern drugs have little effect. Knowing why it works would be helpful but making it illegal until we know why is wrong.
------------------------------------------------------------------- Select Committee on Science and Technology Report (The text of the report on medical marijuana commissioned by the House of Lords says the Government should allow doctors to prescribe cannabis for medical use. "Far from being a step towards general legalisation, our recommendation would make the ban on recreational use easier to enforce.") Date: Wed, 11 Nov 1998 14:50:02 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: Press Release: House of Lords Cannabis Report Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: DrugSense Pubdate: Wed, 11 Nov 1998 Source: The House of Lords, Science and Technology Committee (UK) Contact: Fax: +0171-219 6715 or 0171-219 4931 Mail: Science and Technology Committee, House of Lords, London, SW1A 0PW Website: http://www.parliament.the-stationery-office.co.uk/pa/ld/ldhome.htm Note: Thanks to a tip from Stuart Kocher that led us to this important document. It is being posted by chapters, but first, the press release: Select Committee on Science and Technology Report *** H O U S E of L O R D S P R E S S I N F O R M A T I O N EMBARGO 0001 HOURS WEDNESDAY 11th NOVEMBER 1998 *** LORDS SAY, LEGALISE CANNABIS FOR MEDICAL USE The Government should allow doctors to prescribe cannabis for medical use: this is the conclusion of a report by the House of Lords Science and Technology Committee, published today. Lord Perry of Walton, chairman of the inquiry said: "We have seen enough evidence to convince us that a doctor might legitimately want to prescribe cannabis to relieve pain, or the symptoms of multiple sclerosis (MS), and that the criminal law ought not to stand in the way. Far from being a step towards general legalisation, our recommendation would make the ban on recreational use easier to enforce. Above all, it would show compassion to patients who currently risk prosecution to get help." MEDICAL USE Cannabis is a "Schedule 1" drug, and cannot be used at all in medicine, except for research under special Home Office licence. The Lords recommend that it should be moved to "Schedule 2". This would allow doctors to prescribe it, subject to certain special regulations, and it would allow doctors and pharmacists to supply it in accordance with a prescription. The report sets out evidence that cannabis can be effective in some patients to relieve the symptoms of MS, and against certain forms of pain. The Lords say, this evidence is enough to justify a change in the law. They are less convinced about its effectiveness in other conditions, including epilepsy, glaucoma and asthma. The Lords welcome the fact that clinical trials of cannabis are currently being launched, by the Royal Pharmaceutical Society, and by Dr Geoffrey Guy of GW Pharmaceuticals, with a view to the eventual licensing of cannabis as a medicine. The Lords say, however, that cannabis should be rescheduled now, rather than waiting several years for the results of these trials. If cannabis ever becomes a licensed medicine, the Lords do not envisage it being licensed for smoking; they call for research into alternative delivery systems. At present, people who use cannabis for medical reasons risk prosecution; and juries sometimes refuse to convict such people, which brings the law into disrepute. If prescription were legalised, then someone using cannabis for medical reasons who was accused of recreational use could clear himself at once by producing the prescription. [More] RECREATIONAL USE The Lords find enough evidence of toxic effects of cannabis to justify maintaining the present ban on recreational use. Besides being intoxicating, they report that: - regular heavy use can lead to psychological dependence, and even in some cases to physical dependence, involving withdrawal symptoms; - cannabis can pose a risk to people with a heart condition; - cannabis can exacerbate pre-existing mental illness; - smoking cannabis is as bad for the lungs as smoking tobacco, and may cause cancer. NOTES FOR EDITORS 1. The report follows an inquiry which began in April, and included 12 public hearings. A list of the Lords who took part in the study is attached : 2. The report is published by The Stationery Office: Cannabis, HL Paper 151, ISBN 0 10 4151986, £9.50. 3. The evidence taken by the Committee is published separately as HL Paper 151-I, ISBN 0 10 4792981, £22.60. 4. The full text will be on the Internet on publication, accessible via the UK Parliament home page at www.parliament.uk 4. The Government are required to respond in writing to the report; and the report will be debated in the House of Lords. Further information from Elaine Morgan/Tessa Perfect House of Lords Committee Office 'Phone 0171-219 6075; Fax 0171-219 4931 [Ends] CHAIRMAN Lord Perry of Walton FRS (Lib Dem): former Professor of Pharmacology; founding Vice-Chancellor of the Open University 1969-81. MEMBERS Lord Butterfield (Cons): Vice-Chancellor of Nottingham University 1970-75; Regius Professor of Physic (ie medicine), Cambridge, 1975-87; Vice-Chancellor of Cambridge University 1983-85. Lord Butterworth (Cons): Vice-Chancellor of the University of Warwick 1963-85. Lord Carmichael of Kelvingrove (Lab): MP 1962-83; former junior Minister in various departments. Lord Dixon-Smith (Cons): former Chairman, Association of County Councils. Lord Kirkwood (Lib Dem): metallurgist; former lecturer, Sheffield University. Lord Nathan (cross-bench): solicitor; former member of Royal Commission on Environmental Pollution. Lord Porter of Luddenham (cross-bench): Nobel Prize for Chemistry 1967; President of the Royal Society 1985-90. Lord Rea (Lab): former GP. Lord Soulsby of Swaffham Prior (Cons): Emeritus Professor of Animal Pathology, Cambridge; President of the Royal Society of Medicine. Lord Walton of Detchant (cross-bench): former professor of Neurology and Dean of Medicine, Newcastle University; former President of the General Medical Council, the British Medical Association, and the World Federation of Neurology. Lord Winston (Lab): Dean of the Institute of Obstetrics and Gynaecology. *** Select Committee on Science and Technology Ninth Report *** CANNABIS: THE SCIENTIFIC AND MEDICAL EVIDENCE CHAPTER 1 INTRODUCTION 1.1 Cannabis has been used medically for thousands of years in oriental and Middle Eastern countries and as an intoxicant for many hundreds of years in India and in the Middle East; and it was employed in Western medicine for at least two millennia. The medical use of cannabis in Europe and North America, however, declined in this century because of the lack of any standardised preparations of the plant product and its unreliable absorption when given by mouth, and because of the development of more potent and reliable drugs for the conditions for which cannabis was then being used. 1.2 During the 1960s and 1970s there was a large increase in the use of smoked cannabis as an intoxicant in the USA and in Europe, where it had been largely unknown previously as a drug of abuse. The recreational use of cannabis has continued to increase in recent years, particularly among the young. Medical use in the United Kingdom was prohibited in 1973; but cannabis is now the most widely used of all illegal intoxicants. 1.3 During the 1980s and 1990s there has been renewed interest in the potential medical uses of cannabis and its derivatives. Substantial numbers of patients with various conditions are illegally selfmedicating with cannabis and are convinced that they derive medical benefit-although scientific evidence for or against such a conclusion is largely lacking. This has led to calls for cannabis again to be made available for medical applications. 1.4 In Britain this debate has led a number of expert bodies to review the medical and scientific evidence for and against such proposals. The British Medical Association published a report on the topic in 1997. The Department of Health recently commissioned three literature reviews on cannabis, at the request of the Advisory Council on the Misuse of Drugs (ACMD); we have seen these (they were placed in the Library of the House on 9 June), and the authors have all given evidence to this inquiry. Reports were also published last year by the US National Institutes of Health and the American Medical Association. 1.5 In the light of this heightened interest in cannabis, and particularly the report by the BMA, we decided to examine the scientific and medical evidence to determine whether there was a case for relaxing some of the current restrictions on the medical uses of cannabis. We have also considered whether the continued prohibition of recreational use is justified on the basis of the scientific evidence of adverse effects. Recreational use raises other issues besides the adverse effects of the drug; these are outside our remit "to consider science and technology", belonging instead to the realms of law, sociology and even philosophy, and we have not considered them. Neither have we considered whether cannabis is a stepping stone or gateway to other more dangerous drugs; we have confined our considerations solely to cannabis. 1.6 Chapters 2 and 3 of this Report are introductory, giving brief accounts of the history of cannabis and its pharmacology. In Chapters 4-7 we review the evidence which we have received on the four key issues: the adverse effects of taking cannabis; current and proposed medical uses; recreational use; and the implications of possible changes to the law. Our conclusions and recommendations are set out in Chapter 8. 1.7 This report was prepared by Sub-Committee I, whose members are listed in Appendix 1. They received evidence from the persons and organisations listed in Appendix 2, to all of whom we are grateful for their help. We are particularly grateful to the Sub-Committee's Specialist Adviser, Professor Leslie Iversen FRS, Visiting Professor of Pharmacology at the University of Oxford. Professor Iversen attended two international conferences on the Sub-Committee's behalf; his accounts of these appear in Appendices 3 and 4. Abbreviations are listed in Appendix 5. 1.8 We also acknowledge the assistance of the Parliamentary Office of Science and Technology (POST). POST's report Common Illegal Drugs and their Effects (May 1996), and POST note 113 Cannabis Update (March 1998), have been particularly helpful. *** 1 Therapeutic uses of cannabis, BMA/Harwood Academic Publishers, 1997, ISBN 90-5702-318-0. Back 2 Cannabis: clinical and pharmacological aspects, by Prof C H Ashton; Psychiatric aspects of cannabis use, by Dr A Johns; Therapeutic aspects of cannabis and cannabinoids, by Dr P Robson. Back 3 NIH Report on the medical uses of marijuana, August 1997; AMA Medical Marijuana, December 1997. Back *** Select Committee on Science and Technology Ninth Report *** CHAPTER 2 HISTORY OF THE USE OF CANNABIS 2.1 The earliest known reference to cannabis is in Assyrian tablets of the seventh century BC. It has thus been in use for at least 2600 years. Like very many other herbs, it has been used medically for a wide variety of ailments, especially throughout Asia and the Middle East. The mild euphoria that it induces led to its use as an intoxicant, perhaps most notably in countries where Islam prohibited the use of alcohol. 2.2 In Western medicine, it appeared in the Herbal (i.e. pharmacopoeia) of Dioscorides of about 60 AD, and in all subsequent herbals. The 16th century saw a detailed interest in cannabis, with reports of it and its usages being sent back by many travellers to the East, and the number of possible uses given in the herbals doubled. In England, the Herbal of John Gerard (1597) recommended it as it "consumeth wind and drieth up seed [i.e. semen]", and quoted Dioscorides as recommending it for easing the pain of earache and for the treatment of jaundice. Nicholas Culpeper, in his Herbal (1653), gave the same indications for the use of cannabis seeds, and also recommended the decoction of the roots, as this "allayeth inflammations, easeth the pain of gout, tumours or knots of joints, pain of hips...". 2.3 In these and other early Herbals, each medicine was said to have multiple uses, often without justification. More critical views ultimately prevailed, but only slowly. Thus by 1788 the New Edinburgh Dispensatory still included three quarters of the entries of Dioscorides, but excluded most animal products. Such exotic remedies as "scrapings of an elephant's tooth", "dust from the walls of a wrestling school" and, remarkably, as a cure for quartan malaria, "seven bed bugs in meat and beans", had been eliminated. The loss of the animal products and most of the minerals left the 1788 New Dispensatory consisting mainly of herbal remedies. There was little change for 150 years, and the British Pharmacopoeia of 1914 included most of the contents of the volume of 1788. But the situation was about to change radically, with the rise of synthetic pharmaceutical chemistry. 2.4 Meanwhile, in 1833 Samuel Carey in his Supplement to the Pharmacopoeia and Treatise on Pharmacology advised that cannabis could be used to make "an agreeable intoxicating drink". This is the only British reference to cannabis as an intoxicant known to us from this period. 2.5 Cannabis was reintroduced into British medicine in 1842 by Dr W O'Shaughnessy, an army surgeon who had served in India. In Victorian times it was widely used for a variety of ailments, including muscle spasms, menstrual cramps, rheumatism, and the convulsions of tetanus, rabies and epilepsy; it was also used to promote uterine contractions in childbirth, and as a sedative to induce sleep. It is said to have been used by Queen Victoria against period pains: there is no actual proof of this at all, but Sir Robert Russell, for many years her personal physician, wrote extensively on cannabis, recommending it for use in dysmenorrhoea. It was administered by mouth, not by smoking, but usually in the form of a tincture (an extract in alcohol). Cannabis extracts were also incorporated in many different proprietary medicines. 2.6 "People were well aware at that stage that [cannabis] was an unpredictable drug" (Edwards Q 26). The advent of a host of new and better synthetic drugs led to the abandonment of many ancient herbal remedies, including cannabis. Thus in the British Pharmacopoeia of 1932 no fewer than 400 herbal remedies were omitted, among them cannabis, extract of cannabis and tincture of cannabis-though all three remained in the British Pharmaceutical Codex of 1949. 2.7 Until 1968, the only control of medicines in the United Kingdom (other than those regarded as dangerous) was provided by the pharmacopoeias, which set quality standards for the preparation of drugs. The Medicines Act 1968 was enacted following the thalidomide tragedy: it gave the Government power to license pharmaceutical companies, and individual products and clinical trials. It also established the Medicines Commission and the Committee on the Safety of Medicines, to advise the Government on the exercise of their new powers. Existing drugs received "licences of right". The licensing powers are now exercised through the Medicines Control Agency (MCA). Doctors may prescribe an unlicensed drug, or a licensed drug for an unlicensed indication ("off-label"); but they do so at their own risk, and without the benefit of the surveillance for adverse effects which is conducted in respect of licensed medicines through the "yellow card" system. 2.8 Drug abuse has been the subject of international conventions since 1912. In 1961 these were consolidated and brought up to date by the UN Single Convention on Narcotic Drugs. Cannabis and cannabis resin were listed in Schedule IV, which entitled (but did not oblige) parties to adopt "special measures of control", and to ban them altogether "except for amounts which may be necessary for medical and scientific research only, including clinical trials..." (Article 2.5). According to the Home Office (p 150), this reflected "WHO's view that the drug was widely abused, had no therapeutic value and was obsolete in medical practice". Under the Dangerous Drugs Act 1964 (shortly consolidated by the Dangerous Drugs Act 1965), which implemented the Convention in the United Kingdom, cannabis was still able to be prescribed, though subject to certain controls. The tincture received a "licence of right" under the Medicines Act 1968; doctors were therefore still able to prescribe it. 2.9 The scale of drug abuse increased dramatically during the 1960s. In 1971 the UN adopted a further Convention on Psychotropic Substances; and the United Kingdom enacted the Misuse of Drugs Act 1971, which repealed the Act of 1965 and other enactments, replacing them with a more comprehensive and flexible regime. Cannabinol and its derivatives including THC (the chemical which gives cannabis its psychoactive properties-see Chapter 3) appeared in Schedule I to the Convention, and parties were therefore obliged to ban them "except for scientific and very limited medical purposes by duly authorized persons" (Article 7(a)). In 1973 the licences of right granted in 1968 were reviewed, and the original Misuse of Drugs Regulations (SI 1973 No. 797) were made under the 1971 Act. Cannabis's licence of right was not renewed, and the Regulations listed cannabis, cannabis resin and cannabinol and its derivatives in Schedule 4-which is now Schedule 1 to the Misuse of Drugs Regulations 1985 (No. 2066)-thereby prohibiting medical use altogether. 2.10 According to the MCA, by 1973 there was "insufficient evidence" to support medical use of the tincture (Q 174), and it was rarely prescribed except to patients who were already drug misusers. The Parliamentary Under-Secretary of State for Health told the Commons on 14 January 1998 (col. 320), "It was rarely used and, when it was, it was used mainly for its sedative qualities. Advice at the time from the World Health Organization was that cannabis was no more effective than any other available drug in treating the conditions for which it was used, so its use was stopped." According to the Department of Health, there was also a problem of diversion to recreational use through bogus prescriptions (Q 174). *** 4 The British Pharmaceutical Codex, produced by the Royal Pharmaceutical Society of Great Britain, was a source of officially recognised standards for pharmaceutical preparations until 1979. Since then it has been in the process of being superseded by the British and European Pharmacopoeias. Back *** CHAPTER 3 PHARMACOLOGY OF CANNABIS AND THE CANNABINOIDS 3.1 The plant Cannabis sativa is also known as hemp; it is related to the nettle and the hop. It grows readily in a warm climate, and may be grown in more temperate regions. As a drug of abuse, it usually takes the form of herbal cannabis (marijuana), consisting of the dried leaves and female flower heads, or cannabis resin (hashish), the resin secreted by the leaves and flower heads, which may be compressed into blocks. 3.2 The family of chemically related 21carbon alkaloids found uniquely in the cannabis plant are known as cannabinoids. There are more than 60 different cannabinoids; one of these, D9tetrahydrocannabinol (THC), is the most abundant and accounts for the intoxicating properties of cannabis. Other cannabinoids which occur in some abundance (e.g. cannabidiol and cannabinol) are not psychoactive, but it is thought that they may modify the effects of THC. The amounts and proportions of the various cannabinoids in each plant vary from strain to strain, and can be adjusted by breeding. By coincidence, the chemistry and pharmacology of cannabis were among the principal interests of the late Lord Todd, when he worked at Manchester University in the 1930s; he went on to become, among other things, the first Chairman of the House of Lords Select Committee on Science and Technology on its establishment in 1979. 3.3 THC and other cannabinoids dissolve readily in fat but not in water. This limits the possible formulations of cannabis and cannabinoid preparations, and slows down their absorption from the gut. On the other hand, when cannabis is smoked (in a "joint" or "reefer", or in a pipe), THC is absorbed very quickly into the bloodstream, through the large surface area of the pharynx and the lungs. After smoking, the psychoactive effects of THC are perceptible within seconds, and peak effects are achieved within minutes. When cannabis or cannabinoids are taken by mouth, peak effects may not occur for several hours, but they last longer. After smoking or oral ingestion, the drug persists in the brain longer than in the blood; so the psychological effects persist for some time after the level of THC in the blood has begun to decline. 3.4 Smoking delivers 30 per cent or more of the total THC in a cannabis cigarette to the blood stream. The proportion of THC absorbed after taking cannabis by mouth is 2-3 times less, because after absorption in the gut the drug is largely degraded by metabolism in the liver before it reaches the general circulation. Preliminary reports indicate that absorption into the circulation can be increased if THC is administered by rectal suppository, as this route delivers the drug directly into the circulation, avoiding the liver. 3.5 Once THC has entered the bloodstream, it is widely distributed in the body, especially in fatty tissues. The slow release of THC from these tissues produces low levels of drug in the blood for several days after a single dose, but there is little evidence that any significant pharmacological effects persist for more than 4-6 hours after smoking or 6-8 after oral ingestion. The persistence of the drug in the body, and the continuous excretion of degradation products in the urine, can however give rise to cannabispositive forensic tests days or even weeks after the most recent dose. (The implications of this for roadside testing of drivers are considered below, at paragraph 4.9.) 3.6 According to Professor Trevor Robbins, speaking for the Medical Research Council (MRC), "Cannabinoid pharmacology has exploded in the last decade1/4, opening up1/4all sorts of exciting possibilities" (Q 628). These advances are reviewed in evidence to this Committee by the Royal Society and by Dr Roger Pertwee of the University of Aberdeen. It is now recognised that THC interacts with a naturally occurring system in the body, known as the cannabinoid system. THC takes effect by acting upon cannabinoid receptors (see Box 1). Two types of cannabinoid receptor have been identified: the CB1 receptor and the CB2 receptor. CB1 receptors are present on nerve cells in the brain and spinal cord as well as in some peripheral tissues (i.e. tissues outside the brain); CB2 receptors are found mainly on cells of the immune system and are not present in the brain. 3.7 The roles played by CB1 and CB2 receptors in determining the various effects of cannabis in the whole organism remain to be established. Among the effects of cannabinoids known from animal experiments to be mediated by CB1 receptors are pain relief, impairments in memory and in the control of movements, lowering of body temperature and reductions in the activity of the gut. As CB1 receptors are the only ones known to exist in the brain, it is assumed that they mediate the intoxicant effects of THC. Little is known about the physiological role of the more recently discovered CB2 receptor, but it seems to be involved in the modulation of the function of the immune system. BOX 1: CANNABIS PHARMACOLOGY-TERMINOLOGY In common with many other drugs, the effects of THC result from its ability to activate special proteins known as receptors found on the surface of certain cells. The drug binds specifically to these proteins and activates a series of processes within the cells, leading to alterations in the cell's activity. Drugs, such as THC, that are able to "switch on" a receptor are known as agonists at that receptor. Other substances, however, bind to the receptor and, rather than activating it, prevent its activation by agonists; such substances are known as receptor antagonists. The term cannabinoid was originally used to describe the family of naturally occurring chemicals found in cannabis, of which THC is the principal member. It is now also taken to encompass all those substances capable of activating cannabinoid receptors. These include the naturally occurring plant cannabinoids, certain synthetic substances (e.g. nabilone-see Box 4 below), and the recently discovered endogenous cannabinoids (see paragraph 3.8 below). 3.8 Another important recent discovery has been that the body contains naturally occurring ("endogenous") compounds that can activate cannabinoid receptors. The most important of these "endogenous cannabinoids" are the fatlike materials arichidonylethanolamide ("anandamide") and 2arichidonylglycerol (2AG). 3.9 These discoveries have transformed the character of scientific research on cannabis, from an attempt to understand the mode of action of a psychoactive drug to the investigation of a hitherto unrecognised physiological control system in the brain and other organs. Although the physiological significance of this system is still largely unknown, one of the principal actions of THC and the endogenous cannabinoids seems to be to regulate the amounts of chemical messenger substances released from nerves in the brain, thus modulating neural activity. 3.10 The discovery of the endogenous cannabinoid system has significant implications for future pharmaceutical research in this area. Drugs that selectively activate CB1 or CB2 receptors (agonists), or selectively block one or other of these receptor types (antagonists), have already been developed by some pharmaceutical companies (Lambert p 109 and Q 438; Pertwee Q 285). Agonists to the CB2 receptor may have beneficial effects in modulating immune responses, and would not be expected to possess any psychoactive properties as the CB2 receptor is not found in the brain. Antagonists to the CB1 receptor are also being investigated, as novel therapeutic agents with the potential of reducing memory deficits associated with ageing or neurological disease, as novel treatments for schizophrenia or other psychoses, and as appetite suppressants. 3.11 It seems likely that most of the putative medical indications proposed for cannabis involve actions of the drug on CB1 receptors in the central nervous system. Extensive attempts were made by academic and pharmaceutical industry researchers during the 1970s to develop new chemically modified cannabinoid molecules that separated the desired therapeutic effects from the psychoactive properties of these substances; but so far no such compound has been discovered. 3.12 Research continues apace. Professor Patrick Wall of St Thomas' Hospital reports "intense activity in universities and pharmaceutical companies" in this field; "Large numbers of cannabinoids are being synthesised and investigated particularly by US companies" (p 31); "It is an exciting period" (Q 101, cp Q 125, Pertwee QQ 281-298 and Notcutt Q 411). According to Dr Lambert, "The pharmaceutical industry has now provided the researcher with a wide range of tools to probe the cannabinoid system". 3.13 Recent data from animal studies reveal that, in common with various drugs of addiction (heroin, cocaine, nicotine and amphetamines), THC activates the release of the chemical messenger dopamine in some regions of the brain of rats (Pertwee Q 311, Wall Q 126). This is considered important as this pattern of dopamine release is thought to be associated with the rewarding properties of these drugs and hence may be related to their ability to cause dependence. 3.14 Other recent scientific findings indicate a relationship between the cannabinoid system in the brain and the naturally occurring opioid system. The ability of THC to trigger dopamine release in the rat brain is blocked by prior administration of naloxone, a drug that selectively blocks the actions of opiates in the brain. This suggests that some of the psychoactive effects of THC and other cannabinoids may be mediated indirectly through an ability to activate the opioid system (Pertwee Q 311). Recent studies have also shown that the administration of THC to animals enhances the pain-relieving effects of morphine and related opiates. Furthermore, administration of naloxone (the opiate-blocker) to animals previously treated repeatedly with a cannabinoid produced some physical withdrawal signs; conversely, administration of a cannabinoid antagonist to animals previously dependent on heroin elicited some (but not all) of the signs of opiate withdrawal (see Appendix 4, paragraph 8). On the other hand, although some of the actions of THC may involve activation of the opioid system, THC does not mimic morphine or heroin either in its effects on animals or in the subjective experience of human users. 3.15 This new information may or may not be relevant to the debate as to whether cannabis induces physical dependence. We discuss the degree to which cannabis may induce dependence in man below, in Chapter 4. *** 5 Dr Pertwee is a world expert on the cannabinoids, and current President of the International Cannabinoid Research Society. At the University of Aberdeen, he heads a research team of eight scientists engaged in research in this area. He was a contributing author to the BMA report. Back 6 Professor Wall is editor-in-chief of the medical journal Pain; he was a contributing author to the BMA report, and appeared before us on behalf of the ACT. Back 7 Hirst R A, Lambert D G and Notcutt W G, Pharmacology and potential therapeutic uses of cannabis. Br. J. Anaesthesia, July 1998. Back 8 The opioid system consists of receptors normally activated by the enkephalins and endorphins, normally released in response to pain and stress. They are also activated by morphine, heroin and other opiates. Back *** Select Committee on Science and Technology Ninth Report *** CHAPTER 4 TOXIC EFFECTS OF CANNABIS AND CANNABINOIDS: REVIEW OF THE EVIDENCE 4.1 The prohibition of the recreational use of cannabis, and some of the doubts about medical use, are based on the presumption that cannabis is harmful to individual and public health. We have tested the strength of that presumption, and this Chapter records what we have found. New research on this subject is constantly coming forward, so this cannot be said to be the last word on it. Although cannabis is not in the premier league of dangerous substances, new research tends to suggest that it may be more hazardous to health than might have been thought only a few years ago (Edwards QQ 21, 27). 4.2 In assessing the adverse effects associated with cannabis use, we have been assisted by a number of detailed recent reviews, including the recent WHO report Cannabis: a health perspective and research agenda (WHO/MSA/PSA/97.4); the Australian National Drug Strategy report The health and psychological consequences of cannabis use (1994) and other documents submitted by Professor Wayne Hall, Executive Director of the Australian National Drug and Alcohol Research Centre in Sydney, and his colleagues; and the recent reviews noted above commissioned by the Department of Health. The evidence submitted to us by the Royal Society and the Royal College of Psychiatrists is also particularly relevant. Acute (short-term) effects of cannabis 4.3 The acute toxicity of cannabis and the cannabinoids is very low; no-one has ever died as a direct and immediate consequence of recreational or medical use (DH QQ 219223). Official statistics record two deaths involving cannabis (and no other drug) in 1993, two in 1994 and one in 1995 (HC WA 533, 21 January 1998); but these were due to inhalation of vomit. Animal studies have shown a very large separation (by a factor of more than 10,000) between pharmacologically effective and lethal doses. 4.4 One minor toxic side-effect of taking cannabis which merits attention is the short-term effect on the heart and vascular system. This can lead to significant increases in heart rate and a lowering of the blood pressure (Pertwee Q 299). For this reason patients with a history of angina or other cardiovascular disease could be at risk and should probably be excluded from any clinical trials of cannabis-based medicines. 4.5 The most familiar short-term effect of cannabis is to give a "high" - a state of euphoric intoxication. This is, of course, precisely the effect sought by the recreational user, analogous to the effect of alcohol and sought for similar reasons. We have been told, however, that people who use cannabis for medical purposes regard it as an unwelcome side-effect (Hodges Q 97). 4.6 Intoxication with cannabis leads to a slight impairment of psychomotor and cognitive function, which is important for those driving a vehicle, flying an aircraft or operating machinery (DH Q 197). The Department of Health rate this as "the major concern from a public health perspective" raised by recreational use (p 46), and Professor Hall considers it the most serious possible short-term consequence of cannabis use, both for the user and for the public (p 222). 4.7 There is some disagreement about how long such impairments persist after taking cannabis: most assume that they last for only a few hours (e.g. Kendall p 266); but Professor Heather Ashton of the University of Newcastle-upon-Tyne, principal author of the BMA report, suggested that subtle cognitive impairments could persist for 24 or even 48 hours or more (Q 72), whereas the DETR say "probably .... 24 hours at most" (Press Notice 94/Transport, 11 February 1998). On the other hand the impairment in driving skills does not appear to be severe, even immediately after taking cannabis, when subjects are tested in a driving simulator. This may be because people intoxicated by cannabis appear to compensate for their impairment by taking fewer risks and driving more slowly, whereas alcohol tends to encourage people to take greater risks and drive more aggressively (POST note 113; cp DH p 240). 4.8 Analysis of blood samples from road traffic fatalities in 1996-97 (the results of the first 15 months of a three year DETR study-Press Notice 94/Transport, 11 February 1998) showed that 8 per cent of the victims were positive for cannabis, including 10 per cent of the victims who were driving. However, it is not clear what figures would have been obtained from a random sample of road users not involved in accidents (DH Q 211); and some of those who tested positive may have taken the cannabis as much as 30 days before, so that the effects would have worn off long since (DH p 240). The interpretation of traffic accident data is further confounded by the fact that 22 per cent of the drivers found to be cannabispositive also had evidence of alcohol intake; proportions of alcoholpositives among cannabispositive drivers as high as 75 per cent have been reported in other countries in similar studies. Professor Hall considers cannabis's contribution to danger on the roads to be very small; in his view the major effect of cannabis use on driving may be in amplifying the impairments caused by alcohol (cp Keen Q 42). According to a survey of 1,333 regular cannabis users by the Independent Drug Monitoring Unit (IDMU) in 1994, users who drove reported a level of accidents no higher than the general population; those with the highest accident rates were more likely to be heavier poly-drug users. 4.9 It is difficult to see how cannabis intoxication could be monitored, if its use were permitted. There could be no equivalent of the breathalyser for alcohol, since small amounts of cannabis continue to be released from fat into the blood long after any short-term impairment has worn off (see paragraph 3.5 above). 4.10 A single dose of cannabis for an inexperienced user, or an overdose for an habitual user, can sometimes induce a variety of intensely unpleasant psychic effects including anxiety, panic, paranoia and feelings of impending doom (BMA p 9, RCPsych p 282). These adverse reactions are sometimes referred to as a "whitey" as the subject may become unusually pallid (Montgomery Q 577). These effects usually persist for only a few hours. 4.11 In some instances cannabis use may lead to a longer-lasting toxic psychosis involving delusions and hallucinations that can be misdiagnosed as schizophrenic illness (Strang Q 239, van der Laan Q 512). This is transient and clears up within a few days on termination of drug use; but the habitual user risks developing a more persistent psychosis, and potentially serious consequences (such as action under the Mental Health Acts and complications resulting from the administration of powerful neuroleptic drugs) may follow if an erroneous diagnosis of schizophrenia is made. It is also well established that cannabis can exacerbate the symptoms of those already suffering from schizophrenic illness (Q 239) and may worsen the course of the illness; but there is little evidence that cannabis use can precipitate schizophrenia or other mental illness in those not already predisposed to it (RCPsych p 283). 4.12 These relatively rare adverse psychological effects of cannabis are not considered to represent a serious limitation on the potential medical use of the drug (Strang Q 244), save that patients suffering from schizophrenic illness or other psychoses should be excluded. However they do constitute an issue for public health. According to the Department of Health, cannabis contributes to the extra cost of acute psychiatric services imposed by drug misuse, though this cannot be separately costed (p 46; cp RCPsych p 282). The Royal College of Psychiatrists (p 284) believe that the proportion of users who experience acute adverse mental effects is "significant". Chronic (long-term) toxicity 4.13 Cannabis can have untoward long-term effects on cognitive performance, i.e. the performance of the brain, particularly in heavy users. These have been reviewed for us by the Royal College of Psychiatrists and the Royal Society. While users may show little or no impairment in simple tests of short-term memory, they show significant impairments in tasks that require more complex manipulation of learned material (so-called "executive" brain functions) (Edwards Q 21). There is some evidence that some impairment in complex cognitive function may persist even after cannabis use is discontinued; but such residual deficits if present are small, and their presence controversial (van Amsterdam Q 494, Hall Q 741). Dr Jan van Amsterdam of the Netherlands National Institute of Public Health and the Environment, who has reviewed the literature on long-term cognitive effects of prolonged heavy use and kindly came to Westminster to tell us his findings, pointed out the practical difficulties of assessing possible residual effects (Q 487). These include the impossibility of obtaining predrug baseline values (i.e. measures of the cognitive functioning of the subject before their first use of cannabis), the difficulty of estimating the drug dose taken, the need for a lengthy "washout" period after termination of use to allow for the slow elimination of residual cannabis from the body, and the possibility of confusing long-term deficits with withdrawal effects. He felt that many of the published reports on this subject had not taken adequate account of these problems. 4.14 The occurrence of an "amotivational syndrome" in long-term heavy cannabis users, with loss of energy and the will to work, has been postulated. However it is now generally discounted (van Amsterdam Q 503); it is thought to represent nothing more than ongoing intoxication in frequent users of the drug (RCPsych p 283). 4.15 Animal experiments have shown that cannabinoids cause alterations in both male and female sexual hormones; but there is no evidence that cannabis adversely affects human fertility, or that it causes chromosomal or genetic damage (WHO report ch.7). The consumption of cannabis by pregnant women may, however, lead to significantly shorter gestation and lower birth-weight babies in mothers smoking cannabis six or more times a week (WHO report ch.8; DH p 47). These effects may be due to the inhalation of carbon monoxide in cannabis smoke, which lowers the ability of the blood to carry oxygen to the foetus, rather to any direct effect of cannabinoids. If so, they are comparable with the effects of smoking tobacco. 4.16 The NHS National Teratology [i.e. foetal abnormality] Information Service advise, "There are a few case reports of malformations following marijuana use in pregnancy. However, there is no conclusive evidence to suggest either an increase in the overall malformation rate or any specific pattern of malformations". Nevertheless, they warn: "We would not recommend the legalisation of cannabis because of the potential fetotoxicity that may occur if it is used in pregnancy" (p 280). 4.17 Most of our witnesses regard the consequences of smoking cannabis as the most important long-term risk associated with cannabis use. Cannabis smoke contains all of the toxic chemicals present in tobacco smoke (apart from nicotine), with greater concentrations of carcinogenic benzanthracenes and benzpyrenes It has been estimated (BMA p 11) that smoking a cannabis cigarette (containing only herbal cannabis) results in approximately a fivefold greater increase in carboxyhaemoglobin concentration, a threefold greater increase in the amount of tar inhaled, and a retention in the respiratory tract of one third more tar, than smoking a tobacco cigarette. Cannabis resin, the most commonly used form of cannabis in the United Kingdom, is often smoked mixed with tobacco, thus adding the well-documented risks of exposure to tobacco smoke, while complicating the picture for the researcher. 4.18 Regular cannabis smokers suffer from an increased incidence of respiratory disorders, including cough, bronchitis and asthma. Microscopic examination of the cells lining the airways of cannabis smokers has revealed the presence of an inflammatory response and some evidence for what may be pre-cancerous changes. There is as yet no epidemiological evidence for an increased risk of lung cancer (DH p 46, Q 205); but, by analogy with tobacco smoking, such a link may take 25-30 years or more before it becomes evident, and the widespread use of smoked cannabis in Western societies dates only from the 1970s. There are some reports of an increased incidence of cancers of the mouth and throat in young cannabis users, but so far these involve only small numbers and no cause and effect relationship has been established. Nevertheless, Professor Hall considers it a "pretty reasonable bet" that heavy users incur a risk of cancer (Q 741); and the risk is considered by some of our witnesses to be sufficiently serious to rule out any approval of long-term medical use of smoked cannabis, and to justify the present prohibition on recreational use. Tolerance to cannabis 4.19 Tolerance is the phenomenon whereby a regular user of a drug requires more each time to achieve the same effect. It is not an adverse effect in itself; but it may make medical use more difficult, and recreational use more damaging as the user's demand for the drug increases. 4.20 Dr Pertwee told us that both animal and human data show that tolerance can develop on repeated administration of high doses of cannabinoids; tolerance may develop more readily to some effects in animals (e.g. lowering of body temperature) than to others (Q 304). However Clare Hodges, a sufferer from MS, said that she had not experienced tolerance to the palliative effects of low doses of cannabis, and had been taking the same dose (9g of herbal cannabis per week, costing about £30 per week, usually smoked) for six years; neither had other medical users reported tolerance in their experience (QQ 117-119; cp LMMSG p 269). 4.21 Whether tolerance develops may therefore depend on how much drug is consumed, and how often. Neil Montgomery, a research journalist currently studying cannabis users through the Department of Social Anthropology at the University of Edinburgh, said that his observations of heavy cannabis users (using more than 28g of cannabis resin per week) suggested that they needed as much as eight times higher doses to achieve the same psychoactive effects as regular users consuming smaller doses of the drug (Q 570). Clear evidence of tolerance has also been reported in volunteers given large doses of THC under laboratory conditions (Pertwee Q 304). 4.22 This conforms with the evidence of Professor Wall, who compared the experience with morphine and related opiate pain-relieving agents during the past 20-30 years, pioneered by Dame Cicely Saunders and the Hospice movement. This has shown that tolerance (and addiction-see below) are not major problems in the medical use of these drugs, although in recreational use they may pose severe problems (Q 120). Dependence on cannabis 4.23 The repeated use of cannabis or cannabinoids does not result in severe physical withdrawal symptoms when the drug is withdrawn; so many have argued that these drugs are not capable of inducing dependence. Dr Pertwee, and Dr David Kendall of the University of Nottingham (p 267), however, described new evidence from animal studies showing marked signs of withdrawal in animals treated repeatedly with large doses of cannabinoids and then challenged with a newly developed cannabinoid CB1 receptor antagonist (see Box 1) called SR141716A. This has provided the first real evidence for physical dependence and withdrawal symptoms in animals (QQ 308-310). 4.24 The BMA report says that withdrawal symptoms from cannabis in man are mild and shortlived; but in the light of the newer definitions of dependence noted in Box 2 this evidence is inconclusive. Professor Ashton indicated that she felt cannabis to be potentially addictive, and compared the withdrawal symptoms-tremor, restlessness and insomnia-to those experienced by users of alcohol, sleeping pills or tranquillisers. She had talked to students with quite severe cannabis withdrawal problems (Q 73). BOX 2: DEFINITIONS OF DEPENDENCE The consumption of any psychoactive drug, legal or illegal, can be thought of as comprising three stages: use, abuse, and addiction. Each stage is marked by higher levels of drug use and increasingly serious consequences. Abuse and addiction have been defined and redefined by various organisations over the years. The most influential current system of diagnosis is that published by the American Psychiatric Association (DSM-IV, 1994). This uses the term substance dependence instead of addiction, and defines this as a cluster of symptoms indicating that the individual continues to use the substance despite significant substance-related problems. The symptoms may include tolerance (the need to take larger and larger doses of the substance to achieve the desired effect), and physical dependence (an altered physical state induced by the substance which produces physical withdrawal symptoms, such as nausea, vomiting, seizures and headache, when substance use is terminated); but neither of these is necessary or sufficient for the diagnosis of substance dependence. Using DSM-IV, dependence can be defined in some instances entirely in terms of psychological dependence; this differs from earlier thinking on these concepts, which tended to equate addiction with physical dependence. The DSM-IV system also defines substance abuse as a less severe diagnosis, involving a pattern of repeated drug use with adverse consequences but falling short of the criteria for substance dependence. 4.25 Professor Griffith Edwards, a member of the Advisory Council on the Misuse of Drugs (Q 27), said that, using internationally agreed criteria (DSM-IV-see Box 2), there seemed no doubt that some regular cannabis users become dependent, and that they suffer withdrawal symptoms on terminating drug use. According to the WHO report, cannabis dependence is characterised by a loss of control over drug use, cognitive and motivational impairments that interfere with work performance, lowered self-esteem and often depression. Professor Hall wrote, "By popular repute, cannabis is not a drug of dependence because it does not have a clearly defined withdrawal syndrome. There is, however, little doubt that some users who want to stop or cut down their cannabis use find it very difficult to do so, and continue to use cannabis despite the adverse effects that it has on their lives." In oral evidence he added that users who sought treatment for cannabis dependence had typically taken large amounts of cannabis every day for perhaps 15 years or more (Q 745). 4.26 The Institute for the Study of Drug Dependence likewise conclude that, while physical dependence is rare, "Regular users can come to feel a psychological need for the drug or may rely on it as a "social lubricant": it is not unknown for people to use cannabis so frequently that they are almost constantly under the influence" (p 263). 4.27 One measure of the significance of cannabis dependence is the proportion of users who become dependent. Since cannabis dependence is poorly defined, and the total number of users is unknown, this figure is elusive. Data from a recent study of 200 regular users in Australia suggest that more than 50 per cent of such users may be classified as dependent, although many of these do not consider themselves as dependent. This corresponds with the finding of an American study of 1991, cited by the WHO report, that "about half of those who use cannabis daily will become dependent". According to Professor Hall, "Epidemiological studies suggest that cannabis dependence in the sense of impaired control over use is the most common form of drug dependence after tobacco and alcohol, affecting as many as one in ten of those who ever use the drug" (p 221). 4.28 Neil Montgomery estimates that approximately 5 per cent of regular cannabis users are heavy users, consuming as much as 28g of cannabis resin per week. "These are people who have become dependent on cannabis; they are psychologically addicted to the almost constant consumption of cannabis...Becoming stoned and remaining stoned throughout the day is their prime directive" (Q 554). 4.29 Another measure of the extent of cannabis dependence is the number of people who seek treatment for it. Department of Health figures (1996) show that in 6 per cent of all contacts with regional drug clinics cannabis was the main drug of misuse (Q 27). A similar figure, that cannabis users constitute 7 per cent of all new admissions to drug treatment centres in Australia, was reported recently. Dr Philip Robson, who runs a Regional Drug Dependence Unit in Oxford, said that 4.9 per cent of those admitted to his unit cited cannabis as their main drug (Q 462). However he did not regard cannabis as an important drug of addiction: "The drug falls well below the threshold of what would be expected for a dependencyproducing drug which has clinical significance...I do not meet people who are prepared to knock over old ladies in the street or burglarise houses or commit other crimes to obtain cannabis". Professor Robbins estimated that at least 2 per cent of regular cannabis users (whom he defined as those using cannabis more than once a week) in the USA are dependent, on the basis of an estimate of 5m users and an official figure of 100,000 on specific treatment for cannabis dependency syndrome (Q 623). 4.30 It has been suggested that US figures may be inflated by people on compulsory treatment, for instance after testing positive at work, who may not in fact be dependent. According to Professor Hall, however, "In Australia ... drug testing is uncommon and there is no cannabis treatment industry. Yet treatment services...have seen an increase in the number of persons seeking help for cannabis" (p 221). He even suggests that the figures may be kept down by the widespread belief that it is not possible to be dependent on cannabis (Q 748). 4.31 Giving up cannabis is widely believed to be relatively easy: according to the Department of Health, "studies report that of those who had ever been daily users only 15 per cent persisted with daily use in their late twenties" (p 45). Most epidemiological studies in Britain and the United States have shown that the illicit use of cannabis mainly involves people in their late teens and twenties, with relatively few users over the age of 30. 4.32 It has been assumed that young cannabis users give up the habit when they enter their thirties; IDMU (p 236), however, suggest that this pattern may be changing. The British Crime Survey (1996) shows that although the prevalence of cannabis use falls after the age of 30, the greatest proportional increases in the period 1991-1996 were in older age groups, with incidence of past use doubling in the 40-44 age group (from 15 per cent to 30 per cent) and trebling in the 45-59 age group (from 3 per cent to 10 per cent). IDMU conclude that the current relatively low levels of cannabis use in the over-30 age group may reflect a generational and cultural divide, rather than substantial numbers of users giving up. 4.33 It is therefore clear that cannabis causes psychological dependence in some users, and may cause physical dependence in a few. The Department of Health sum up the position thus (p 45, cp Edwards Q 28): "Cannabis is a weakly addictive drug but does induce dependence in a significant minority of regular cannabis users." *** 9 Including Hall W, Room R and Bondy S, A comparison of the health effects of alcohol, cannabis, tobacco and opiates, in Kallant H, Corrigal W, Hall W and Smart R eds The Health Effects of Cannabis, Addiction Research Foundation, Toronto, 1998; and articles awaiting publication in Addiction (Respiratory risks of cannabis smoking, 1998, 93, 1461), Drug and Alcohol Review, and the Lancet Seminar series (14 November 1998). Back 10 N Solowij, Cannabis and Cognitive Functioning, Cambridge University Press, 1998. Back 11 See in particular DH p 46; papers kindly supplied by Professor Donald Tashkin, University of California Los Angeles School of Medicine, and Professor Hall; and Appendix 3, paragraph 8. Back 12 Carboxy-haemoglobin is formed by the action of carbon monoxide on haemoglobin in the blood. It interferes with the transport of oxygen around the body. Back 13 E.g. Taylor FM III, Marijuana as a potential respiratory carcinogen: a retrospective analysis of a community hospital population, South. Med. J. 1988, 81, 1213. Back 14 Miss Hodges is the founder-Director of the UK Alliance for Cannabis Therapeutics (ACT). "Clare Hodges" is a nom de guerre. Back 15 Professor Edwards is Professor Emeritus of Addiction Behaviour at the Institute of Psychiatry, University of London; past Chairman of the National Addiction Centre; and editor-in-chief of the journal Addiction. The ACMD is established under the Misuse of Drugs Act 1971, to advise the Government. Back 16 By Dr Wendy Swift, Australian National Drug and Alcohol Research Centre. Back 17 Consultant psychiatrist, Warneford Hospital; senior clinical lecturer, University of Oxford; author of one of the reviews for the Department of Health referred to in paragraph 1.4. Back *** Select Committee on Science and Technology Ninth Report *** CHAPTER 5 MEDICAL USE OF CANNABIS AND CANNABINOIDS: REVIEW OF THE EVIDENCE 5.1 The main reason for our inquiry is that there are now calls for the law to be changed to permit wider medical use of cannabinoids, and to permit the medical use of cannabis itself. This Chapter reviews the evidence which we have received about current and proposed medical uses for cannabis and the cannabinoids. It is important to distinguish the different substances and preparations; for instance, cannabis leaf must be distinguished from cannabis extract, and whole cannabis from THC. It is also important, though not always easy, to distinguish the various possible routes of administration, e.g. by smoking and by mouth. Current medical use of cannabis 5.2 Today in the United Kingdom, medical use of cannabis itself is illegal (see Box 3) but quite widespread. According to the BMA report, "many normally law-abiding citizens-probably many thousands in the developed world" use cannabis illegally for therapy. Most such users smoke their cannabis, but some take it by mouth. The UK Alliance for Cannabis Therapeutics (ACT) know of 200 people in the United Kingdom who have used cannabis for MS (p 29); 53 took part in a recent study of perceived effects of smoked cannabis (Q 262). Clare Hodges writes, "It is impossible to know how many people with MS use cannabis...My impression is that most people with MS do not". A Multiple Sclerosis Society survey produced a figure of one per cent; but the Society believe the true figure to be higher (Q 341). BOX 3: CURRENT LEGAL CONTROLS The regulation of cannabis in the United Kingdom under the Misuse of Drugs Act 1971 is complicated. Schedule 2 to the Act classifies cannabis itself, and cannabis resin, as Class B controlled drugs, and the cannabinoid cannabinol and its derivatives (defined as THC and 3-alkyl homologues thereof) as Class A controlled drugs. Offences involving Class A drugs attract stiffer penalties. Under the Act it is an offence to import, export, produce, supply or possess controlled drugs (though it is not an offence to use them); it is also an offence to cultivate cannabis plants, or to permit premises to be used for smoking cannabis. Reference is often made in this context to "Schedule 1 and Schedule 2". These are Schedules not to the Act itself, but to the Misuse of Drugs Regulations 1985 (No. 2066) made under the Act. Schedules 2-5 list drugs to which various exemptions from the Act apply; in particular, drugs in Schedule 2 may be administered by, or on the instructions of, a doctor or dentist (Regulation 7), may be produced by a practitioner or pharmacist (Reg. 8), may be supplied (Reg. 8) and possessed (Reg. 10) by various classes of person, including practitioners, pharmacists and heads of laboratories, and may be possessed by patients (Reg. 10). Schedule 1 lists drugs to which the exemptions do not apply; cannabis, cannabis resin, and cannabinol and its derivatives (other than dronabinol-see Box 5) appear in Schedule 1. The 1985 Regulations also empower the Secretary of State to license anyone to produce, possess or supply any controlled drug, including a Schedule 1 drug (Reg. 5); to license cultivation of cannabis plants (Reg. 12); and to approve premises for smoking cannabis for research purposes (Reg. 13). The position in practice is therefore that cannabis and most of its derivatives may not be used in medicine, and may be possessed for research only under Home Office licence. There are two psychoactive cannabinoids, nabilone and dronabinol, which may be used for medicine: see Boxes 4 and 5. Two non-psychoactive cannabinoids, cannabidiol and cannabichromene, are not controlled drugs, and could in theory be prescribed as unlicensed medicines, but no-one is currently doing so. This UK regime is one of the most restrictive in the world. Places with a more liberal regime include the Netherlands, Italy, Spain, Canada, and some states of Germany, Australia and the USA. 5.3 The ACT also know of 50 users with spinal injury, and 20 with other conditions. A survey conducted by the newspaper Disability Now in 1997 among its disabled readers revealed, among 200 respondents, 40 people taking cannabis for MS, 40 for spinal injury, 35 for back pain, 27 for arthritis and 64 for other conditions. IDMU's surveys of 2,794 regular cannabis users have revealed 78 whose main reason for using it is medical (p 244). 5.4 We have received written evidence (not included in the volume of printed evidence) from four patients suffering from MS (besides Miss Hodges) who report that cannabis has a beneficial effect on their symptoms and call for a change in the law to permit the prescription of cannabis. Dr Fred Schon, a consultant neurologist, described the apparently dramatic improvement obtained by selfmedication with smoked cannabis resin by an MS patient who had developed a severe and disabling abnormality of eye movements (p 303). We have also heard from people who have used cannabis against epilepsy, ME and pain, and as an anti-emetic after chemotherapy. Further anecdotal evidence was provided by the Alliance for Cannabis Therapeutics and the London Medical Marijuana Support Group. 5.5 According to Neil Montgomery, some users of cannabis for medical purposes are also, or have been, recreational users, and their medical use is to some extent conditioned by their recreational experience (p 132). Three of the nine such users who have given us evidence are in this category. An increasing number are growing their own cannabis, "primarily to avoid problems of impurity", or buying in bulk to ensure consistency of dose; either course exposes them to stiffer sentences, if caught, than the frequent purchase of small quantities (cp IDMU p 261). Medical users typically take cannabis as frequently as, but in smaller quantities than, recreational users (Q 567). 5.6 Use of cannabis for medical purposes is sometimes connived at by the medical professions. Clare Hodges took medical advice before trying cannabis for her MS, and was not dissuaded (p 27). "Over 50 patients have told the ACT that their doctors have recommended that they try cannabis for symptomatic relief" (p 29); and 50 of the 200 respondents to the Disability Now survey said their doctor knew and approved. 100 doctors are associated with the ACT (Q 96). Most medical users tell the Multiple Sclerosis Society that their doctors are "mildly supportive" (Q 341). One user's doctor knows that she uses cannabis for pain relief and is unconcerned. Another took to cannabis for his epilepsy on a doctor's recommendation. On the other hand, a third user's consultant would not support his letter to us, "due to the advances in anti-emetic drugs". According to Dr William Notcutt, a consultant anaesthetist, self-medication with cannabis for pain is now common, and "Advising on its use can be part of the pharmacological management of pain nowadays" (p 101, Q 434). Finally, the BMA report on medical use was itself prompted by a resolution in favour of medical use of "certain additional cannabinoids", passed by the BMA's Annual Representative Meeting in 1997. 5.7 The Government consider that the burden of proof rests on the proponents of medical use of herbal cannabis. As recently as 1 March 1994, the then Home Office Minister referred in a Commons answer to "long-standing advice that cannabis has no recognised medical use" (HC WA 632). Since then, the Government line appears to have softened a little: on 2 July 1997, Tessa Jowell MP, the Minister of State for Health, said that officials were keeping available research under review. "At present the evidence is inconclusive. The key point is that a cannabis-based medicine has not been scientifically demonstrated to be safe, efficacious and of suitable quality" (HC WA 174). On 27 October 1997, Paul Flynn MP put it to George Howarth MP, Under-Secretary of State at the Home Office, that cannabis was already widely used, illegally, by sufferers from MS, cerebral palsy and glaucoma; the Minister replied, "All drugs used for medical purposes have to be scientifically tested. If cannabis succeeds in those tests...the Secretary of State for Health...would be willing to consider allowing medicinal use of it. Unfortunately, as of now, there is no such evidence" (col. 580; see also HL 20 April 1998, WA 192, and HC 5 May 1998, WA 351). 5.8 The Department of Health say the same in written evidence: "There is insufficient evidence to demonstrate the effectiveness of cannabis as a therapeutic agent at this stage" (p 48). In oral evidence they went a little further: "We very much recognise the importance of research in this area and its potential value, particularly when addressed to the needs of patients for whom we have relatively little else to offer" (Q 167). But MS is not the only condition where conventional treatments are relatively limited in their effects, and the Department warned against allowing the "added frisson" of cannabis to distort the perspective (Q 225). Advice to medical users 5.9 Given that use of cannabis for medical purposes is clearly going on in spite of the law, we asked some of our witnesses what advice they would give to people conducting or contemplating medical use, and to their doctors. The Department of Health suggest that doctors should advise users as to the legal position, and as to the "limited evidence" of efficacy. However, "one has also to recognise that people may choose to do things that their doctors advise against, and there would be a necessity for the doctor subsequently to continue to work to support that individual" (Q 172). One official went so far as to say, off the cuff but not off the record, "Other people's decisions have to be other people's decisions" (Q 224). 5.10 The BMA advise users of cannabis for medical purposes to be aware of the risks, to enrol for clinical trials, and to talk to their doctors about new alternative treatments; but they do not advise them to stop (Q 55). The Multiple Sclerosis Society "does not actually condone or encourage individuals in breaking the law" (Q 341). Current medical uses of cannabinoids 5.11 Although cannabis itself is illegal, certain cannabinoids are in current use in UK medicine, within the law. Cannabinoids have antinausea effects, and have been used clinically to suppress the nausea and vomiting associated with chemotherapy in cancer patients. This is the only medical indication for which adequate data from controlled clinical trials exist, mostly from studies in the 1970s with pure THC and the synthetic cannabinoid nabilone, an analogue of THC, which were found to be as effective as prochlorperazine and other antinausea agents available at the time. On the basis of this evidence nabilone was licensed and is available as a prescription medicine in the United Kingdom for this indication (see Box 4). However, according to Professor Malcolm Lader of the Institute of Psychiatry, University of London (Q 7), it has been little used. He believes that this is largely due to the fact that more powerful antinausea medicines were introduced in the 1980s-the serotonin antagonists ondansetron (Zofran), granisetron (Kytril) and tropisetron (Navoban), which are now widely used in conjunction with cancer chemotherapy (cp Hall p 221 and Appendix 3 paragraph 13). They have the advantage over the waterinsoluble cannabinoids that they can be delivered intravenously as well as by mouth, and they are effective in up to 90 per cent of patients. There have been no clinical trials to compare the effectiveness of cannabinoids with the serotonin antagonists (RPharmSoc p 287). Box 4: NABILONE Nabilone is an analogue of D9-THC. It was licensed in 1982 for prescription-only hospital-only use against nausea arising from chemotherapy and unresponsive to other treatment. It is manufactured synthetically by Eli Lilly & Co. Ltd and sold in the United Kingdom by Cambridge Selfcare Diagnostics Ltd; a pack of 20 1mg capsules (to be taken by mouth) costs £102. 5,400 packs were sold in 1997-98. It is not a controlled drug. According to Dr Kendall of the University of Nottingham, nabilone is not widely used to treat nausea (p 268). Nabilone is used "very infrequently" in MS-probably less than cannabis itself (MSSoc Q 353). However Dr Notcutt is using it for pain control at James Paget Hospital in Great Yarmouth-see paragraph 5.14. 5.12 This means that cannabis and cannabinoids are likely to be of benefit as anti-emetics only to the small proportion of patients who do not respond to existing treatments, or possibly in the treatment of the delayed stages of emesis which can occur for some days following cancer chemotherapy, and which do not respond well to the serotonin antagonists. Nevertheless, cannabinoids are undoubtedly effective as antiemetics and more research in this field might explore their use in combination with the serotonin antagonists, help to determine for which patients they are most appropriate, and examine the potential of the allegedly less psychoactive cannabinoid D8THC, for which there have been encouraging preliminary clinical results (Q 74). 5.13 THC itself (dronabinol-see Box 5) is licensed as an anti-emetic in the USA, but not in this country. The BMA report recommends that it should be licensed here. This would depend on the manufacturer applying for a licence; in the mean time, doctors may prescribe it on an unlicensed basis at their own risk. BOX 5: DRONABINOL Dronabinol is THC. It is marketed as Marinol, synthetic D9-THC in sesame oil, supplied in soft gelatine capsules (to be taken by mouth) containing 2.5, 5 or 10mg of THC. It is licensed in the USA as an anti-emetic, and also to stimulate the appetite of AIDS patients. Marinol is manufactured by Unimed Pharmaceuticals Inc. in the USA; it is significantly more expensive than nabilone (Notcutt Q 427). It is not licensed as an anti-emetic here; but in 1995, on WHO advice, it was moved from Schedule 1 to Schedule 2 of the 1985 Regulations (by the Misuse of Drugs (Amendment) Regulations 1995, No. 2048), and may therefore be prescribed on the named-patient basis defined in the 1985 Regulations (see Box 6). In a 1997 survey in the USA, only 6 per cent of 1,500 oncologists said they had prescribed dronabinol in the previous year (Brett p 204, cp Hall p 222). According to the BMA, take-up in the United Kingdom is low, because of the administrative obstacles and the availability of good alternatives (Q 83). According to Dr Notcutt of James Paget Hospital, Great Yarmouth (Q 422), it is not in practice available in the United Kingdom at present. 5.14 Dr Notcutt is currently treating patients suffering from intractable pain with nabilone, on an unlicensed basis. He has treated a total of 60 patients with a variety of chronic pain conditions, including MS, cancer, peripheral nerve damage and spinal lesions. As many as 50 per cent have derived some pain relief from nabilone, but a significant number of patients are unable to tolerate the side effects of the drug (unpleasant psychoactive effects and drowsiness) (Q 400) and the overall success rate is about 30 per cent (p 104). 5.15 Cannabis has been advocated to treat anorexia, but the scientific basis of this remains unclear. In normal subjects cannabis intake is followed about three hours later by an increased appetite ("the munchies"), particularly for sweet foods (Pertwee Q 256). Regular users of cannabis, however, become tolerant to this effect and appetite may even be depressed. According to the BMA report clinical trials have failed to establish any beneficial effect of THC on appetite in patients with anorexia nervosa. However, in controlled clinical trials in patients with advanced AIDSrelated illnesses, dronabinol significantly reduced nausea, prevented further weight loss and improved patients' mood. On the basis of such data the US Food and Drug Administration have licensed dronabinol for the treatment of anorexia associated with AIDS; Dr Robson sees this as "the most compelling indication" for cannabis-based medicines (Q 458). 5.16 There is a concern with regard to the use of cannabinoids in AIDS because of the possible immunosuppressive effects of these drugs (BMA QQ 79, 80, Hall Q 742). Such effects could be damaging in patients whose immune system is already compromised, although there is no evidence of any relationship between cannabis use and the rate of progression to AIDS in HIVpositive men (Robson Q 460). 5.17 The BMA report recommends that the licensed indications for nabilone be extended to preventing weight loss and treating anorexia in patients with cancer or AIDS, and that dronabinol should be licensed in this country for this indication. As noted already, this would depend on application by the manufacturers; in the mean time, doctors may prescribe "off-label" at their own risk. Dronabinol is a controlled drug, listed in Schedule 2 to the Misuse of Drugs Regulations (see Box 2); so prescription would have to be on the "named-patient" basis defined in the Regulations (see Box 6). BOX 6: PRESCRIPTION ON THE NAMED-PATIENT BASIS Under Regulation 15 of the Misuse of Drugs Regulations 1985, any prescription for a drug listed in Schedule 2 (or Schedule 3) to the Regulations shall: "(a) be in ink or otherwise so as to be indelible and be signed by the person issuing it with his usual signature and dated by him; (b) insofar as it specifies the information required by sub-paragraphs (e) and (f) below to be specified, be written by the person issuing it in his own handwriting; (c) except in the case of a health prescription, specify the address of the person issuing it; (d) have written thereon, if issued by a dentist, the words "for dental treatment only" and, if issued by a veterinary surgeon or a veterinary practitioner, a declaration that the controlled drug is prescribed for an animal or herd under his care; (e) specify the name and address of the person for whose treatment it is issued or, if it is issued by a veterinary surgeon or veterinary practitioner, of the person to whom the controlled drug prescribed is to be delivered; (f) specify the dose to be taken and- (i) in the case of a prescription containing a controlled drug which is a preparation, the form and, where appropriate, the strength of the preparation, and either the total quantity (in both words and figures) of the preparation or the number (in both words and figures) of dosage units, as appropriate, to be supplied; (ii) in any other case, the total quantity (in both words and figures) of the controlled drug to be supplied; (g) in the case of a prescription for a total quantity intended to be supplied by instalments, contain a direction specifying the amount of the instalments of the total amount which may be supplied and the intervals to be observed when supplying." Proposed new indications for cannabis-based medicines 5.18 Besides those conditions noted above for which cannabinoids are already used within the law, the conditions most often cited are MS and pain. Claims are also made in connection with epilepsy, glaucoma and asthma. We review the evidence on each of these conditions below. Multiple sclerosis 5.19 The Multiple Sclerosis Society has in its membership 35,000 of the total of 85,000 patients suffering from this disease in the United Kingdom. The Society estimate that more than 1 per cent of these patients, and possibly as many as 3-4 per cent, are illegally using cannabis for relief of symptoms (Q 341). Representatives of the Society described for us the commonest symptoms of the disease. Fatigue is the most frequent in 95 per cent of patients, followed by balance problems (84 per cent), muscle weakness (81 per cent), incontinence (76 per cent), muscle spasms (66 per cent), pain (61 per cent) and tremor (35 per cent) (Q 334). Although the interferons (alpha and beta) are proving to be of some value in relapsing-remitting and progressive cases of the disease, these symptoms are still poorly controlled by existing treatments, and no cure has been found. 5.20 Dr Lorna Layward of the Multiple Sclerosis Society, and Dr Pertwee, reviewed for us the six published clinical trials of cannabis or cannabinoids in MS. These have involved small numbers of patients (a total of 41 subjects worldwide), but some positive results have been reported, especially for spasticity, pain associated with spasticity, tremor and urinary bladder control (QQ 262, 372). Dr Pertwee took part in the study of perceived effects of cannabis on MS noted above: in a postal survey of 112 MS patients selfmedicating with cannabis in the United Kingdom and the USA, more than 90 per cent reported a beneficial effect on spasticity, and many also reported pain relief and improved urinary control (Q 262). 5.21 Dr Layward and Dr Pertwee referred to experimental results in animals which offer a scientific basis for the use of cannabis and cannabinoids in the treatment of MS. In an MSlike disease in mice (experimental autoimmune encephalomyelitis), low doses of cannabinoids alleviate the muscle tremor seen in such animals. Cannabinoids also suppress spinal cord reflexes in animals (QQ 262, 356). 5.22 It is natural to wonder whether the beneficial effects of cannabis reported by MS patients might simply be related to the feeling of well-being caused by the intoxicant properties of the drug. Clare Hodges said that cannabis greatly helped her physical symptoms, specifically the relief of discomfort in bladder and spine, and relief from nausea and tremors (Q 98). "Cannabis helps my body relax. I function and move much easier. The physical effects are very clear. It is not just a vague feeling of well-being". She positively prefers to avoid intoxication, and feels able to control the dose of cannabis to obtain physical relief without getting high (p 27, Q 98; cp LMMSG p 270). Professor Wall likened this to the experience of patients using selfadministered morphine or related narcotics for pain control, who control the dose to achieve a bearable level of pain without muddled thinking (Q 98). 5.23 The BMA report concluded, "It is somewhat paradoxical that cannabinoids are reported to be of therapeutic value in neurological disorders...since very similar symptoms can be caused by cannabis itself...it is not clear how much of the reputed effects of cannabis in motor disorders are due to psychoactive or analgesic effects". Nevertheless, it recommended that "A high priority should be given to carefully controlled trials of cannabinoids in patients with chronic spastic disorders which have not responded to other drugs". This view is shared by many of our witnesses. 5.24 The BMA report calls for the extension of the licensed indications for nabilone, and for the licensing of dronabinol, for use in MS and other chronic spastic disorders unresponsive to standard drugs. The wording of the report is ambiguous: on p 9 it says, "Depending on the results of...trials there may be a case for considering extension of the indications..."; on p 80 it says, "There is a case for the extension of the indications" for such use pending trials. The latter is repeated in the BMA's written evidence to us (p 10). According to Professor Ashton the ambiguity is inadvertent; and a letter from Professor Nathanson of the BMA (p 206) confirms that the BMA does indeed support licensing pending further research. 5.25 The National Drug Prevention Alliance suggest that this ambiguity reflects disagreement between Professor Ashton, the main author, and editors at the BMA. They would regard licensing in advance of trials as "an extraordinary aberration" (p 279). The Christian Institute say it would set "a very bad precedent" (p 208). In any case, the MCA are not prepared to allow anecdotal evidence as a substitute for clinical trials (QQ 168, 178, 189); and no application to extend the licence for nabilone has in fact been made (Q 191). *** 18 Consroe P, Musty R, Rein J, Tillery W and Pertwee R, The perceived effects of smoked cannabis on patients with MS, Eur. Neurol. 1997, 38, 44. Back 19 Dr Notcutt is a consultant in anaesthesia and pain management at James Paget Hospital, Great Yarmouth, and a senior lecturer at the University of East Anglia. He has extensive experience of the clinical use of nabilone (see Box 4) for the unlicensed indication of pain control. Back 20 Chairman of the Technical Sub-Committee of the ACMD. Back *** Select Committee on Science and Technology Ninth Report CHAPTER 6 RECREATIONAL USE OF CANNABIS Prevalence 6.1 Cannabis is by far the most widely used illicit drug in the United Kingdom, as in most other Western countries; and almost all of this use is for recreational rather than medical purposes. According to the Department of Health, "Cannabis is now the third most commonly consumed drug after alcohol and tobacco" (p 47). 6.2 Cannabis dominates the drug crime statistics, and the figures are rising. Figures for the whole United Kingdom for 1996 (Home Office Statistical Bulletin 10/98) show that 72,745 drug offenders (77 per cent of the total) committed offences involving cannabis (alone or with other drugs). There were 91,432 seizures of cannabis in 1996 (75 per cent of the total for all drugs) and this involved record quantities of cannabis resin (66,921 kg), herbal cannabis (34,373.6 kg) and cannabis plants (116,119 plants). These figures, which are the most recent available, represent more than a threefold increase over 1990, with a particularly sharp increase in the number of offences related to the cultivation of cannabis plants and the numbers of plants seized. 6.3 It is difficult to put a figure on the prevalence of cannabis use in the United Kingdom. The Parliamentary Office of Science and Technology, in their Cannabis Update of March 1998, gave figures from the British Crime Survey 1994 which indicate that in the adult population (16-59) 1 in 5 had "ever tried" cannabis (1 in 20 within the previous month) and in the 1629 age group just over 1 in 3 had "ever tried" cannabis (1 in 20 within the previous month). These figures are not dissimilar to those in the WHO report for other countries in Europe, with somewhat higher figures for the USA, Canada and Australia. They suggest that as many as 7.5m people aged 16-59 in the United Kingdom have used cannabis at least once, and that between 1.5m and 2m take the drug at least once a month (cp Montgomery Q 559). The Royal College of Physicians have established a Joint Working Party with the Royal College of Psychiatrists which among other matters will review the epidemiology of illicit drug use in the United Kingdom. Pattern of use 6.4 The pattern of cannabis consumption in the United Kingdom varies according to geography, socioeconomic conditions and the age of the user. Professor Edwards observed that cannabis is and has been used in very different ways in different times and places; for instance, there are people in south London who smoke 20 joints a day (Q 26). Dr Robson cautions that much of the use of cannabis in the community does not come to the attention of the health services or the police, and therefore little is known about it (Q 456). 6.5 The Independent Drug Monitoring Unit conducted a survey of 1,333 regular cannabis users who attended a major pop festival in Britain in the summer of 1994 (p 231). The majority were daily cannabis users with an average consumption of about 24.8g of cannabis resin per month. Respondents gave highly positive subjective ratings to cannabis (as opposed to negative subjective ratings to solvents, cocaine and heroin). More than 60 per cent believed that cannabis had been of benefit to their physical or mental health. They would prefer that the law was more liberal, but a majority (70 per cent) did not think that they would use more if it was. 6.6 Dr James Robertson, a GP working in Edinburgh, has reported the results of a survey (funded by the Royal College of General Practitioners) of 328 consecutive patients attending his surgery (average age 33.7 years). 200 patients (61 per cent) said that they had used cannabis at least once, and more detailed interviews of 101 of these revealed that 90 were regular users, with 67 using cannabis on a daily basis. Most spent £25 or less per week on cannabis, but a small number of individuals spent £100 or more per week. 6.7 Neil Montgomery described for us various ways to take cannabis recreationally (QQ 544-554). He divides recreational users into three groups: · Casual Irregular use, in amounts up to 1g of resin at a time, to an annual total of no more than 28g (Q 545); · Regular Regular use, typically of 0.5g of resin a day (equivalent to 3 or 4 smokes of a joint or pipe), adding up to about 3.5g per week (Q 548); · Heavy More or less permanently stoned, using more than 3.5g of resin per day and 28g or more per week (Q 554). The smallest group, around 5 per cent. "The extent to which a heavy user can consume cannabis is largely unappreciated." Herbal cannabis appears to be consumed at twice the rate of cannabis resin, presumably because of its lower content of THC. Comparable data are provided by IDMU (pp 231-3). 6.8 According to POST's Cannabis Update, 9 per cent of ever-users use cannabis daily, and 14 per cent several times a week, making it of all illegal drugs the one most likely to be used regularly. According to Professor John Strang, Director of the National Addiction Centre, few users end up in hospital with acute psychiatric problems, and most regular users are not nowadays advised by their doctor to change their habits (Q 244). For the risk of dependence, see Chapter 4. 6.9 Many cannabis users also consume a variety of other psychoactive agents. As the commonest method of using cannabis in the United Kingdom is to smoke cannabis resin mixed with tobacco, nicotine use is very high among cannabis users. Among other things, this makes it difficult to assess the respiratory risks of smoked cannabis as they are confused with the well-established risks of smoked tobacco. Alcohol use is also common, but regular cannabis users may consume less than non-cannabis users. Drug treatment clinics often see poly-drug users, who are consuming a variety of illicit substances, of which cannabis is commonly one (QQ 42, 216, 487, 515, 562; DH p 47). 6.10 According to the Department of Health, most cannabis users have discontinued by their mid to late 20s (p 46); and of those who have ever been daily users, only 15 per cent persist with daily use in their late 20s (p 45). Neil Montgomery has identified a group of regular users who stop in their 30s and start again in their 50s (Q 575). Content of cannabis consumed in the United Kingdom 6.11 Some of our witnesses expressed concern that the preparations of illicit cannabis used in the United Kingdom today are more potent than previously, exposing users to a greater risk of acute intoxication and long-term adverse effects. Professor Ashton (p 12) suggested that "a typical 1970s `reefer' contained about 10mg of THC..., while a typical `joint' today may contain 60-150mg or more of THC. This increase in potency results from sophisticated plant breeding and cultivation methods leading to highly potent varieties of cannabis, such as Skunkweed". Other witnesses made similar assertions (e.g. Q 33). 6.12 However, the Home Office Forensic Science Service, who have data on the THC content of seized cannabis samples, do not support the view that most users in the United Kingdom are exposed to material containing ten times as much THC as in the 1960s and 1970s. They say, "Cannabis resin...has a mean THC content of 4-5 per cent, although the range is from less than 1 per cent to around 10 per cent. This pattern has remained unchanged for many years" (p 218). Cannabis resin, imported most commonly from Morocco, Afghanistan or Pakistan (IDMU p 230), is the form of cannabis most widely used in the United Kingdom, and accounted for two thirds by weight of all seized material in 1996 (Home Office Statistical Bulletin 10/98). One of our witnesses, a user and convicted dealer, claimed that most modern cannabis is in fact weaker than material from the 1960s. 6.13 On the other hand, there appears to have been an increase in the THC content of herbal cannabis-probably because of the use of new strains of cannabis plant and improved growing conditions. In the United States, the University of Mississippi have analysed the THC content of seized cannabis on behalf of the US government since 1980 (see Appendix 4, paragraph 13). They report an increase in the THC content of herbal cannabis from around 2 per cent in 1980-81 to more than 4 per cent in 1997. The Forensic Science Service report that herbal cannabis in the United Kingdom currently also contains an average of 4-5 per cent THC. They also report that cannabis grown in the home, using improved growing techniques and improved plant varieties, now produces herbal cannabis with a considerably higher THC content, with an average close to 10 per cent THC and a range extending to over 20 per cent (p 218). Use of "hydroponic" cannabis (grown in a nutrient solution rather than in soil) appears to be increasing rapidly, with plant seizures in the United Kingdom up from 11,839 plants in 1992 to 116,119 in 1996. 6.14 Professor Hall suggested, "More potent forms of cannabis need not inevitably have more adverse effects on users' health than less potent forms. Indeed, it is conceivable that increased potency may have little or no adverse effect if users are able to titrate their dose to achieve the desired state of intoxication. If users do titrate their dose, the use of more potent cannabis products would reduce the amounts of cannabis material that was smoked, thereby marginally reducing the respiratory risks of cannabis smoking" (p 221; cp IDMU p 235). 6.15 The overall quality of imported cannabis resin appears to have fallen in recent years; many users perceive cannabis resin as adulterated and forensic analysis frequently confirms that this is the case, with the addition of caryophyllene, a constituent of cloves, being particularly common (IDMU p 230; Montgomery p 132 and QQ 577, 589). Yet Professor Hall considers that concern about herbicide contamination is unfounded, and that case history evidence of health problems from microbial contamination is limited. Neil Montgomery calls for research in this area. The state of the law 6.16 This Government show no sign of taking a softer line against recreational use of cannabis than their predecessors. According to the White Paper Tackling Drugs (Cm 3945) of April 1998, "The more evidence that becomes available about the risks of, for example, cannabis...the more discredited the notion that any of the substances currently controlled under the 1971 Act are harmless". This echoes the view of Professor Edwards of the ACMD: "We are in a rapidly changing field of knowledge"; and new knowledge is making cannabis look more dangerous, not less (QQ 21, 27). 6.17 Most of our professional witnesses agree that the adverse effects of cannabis fully justify prohibition (e.g. Henry/RCPath p 224). The only argument on the other side is that cannabis is arguably less dangerous than alcohol or tobacco (e.g. RCGP p 281, Kendall p 268). Professor Hall acknowledged this, but noted "the difficulty in predicting the effect that relaxation of cannabis prohibition would have on current patterns of cannabis use and the harms caused by that use" (p 222). 6.18 The Under-Secretary of State at the Home Office, George Howarth MP, told us confidently that legalising recreational use would cause such use to increase (Q 674). Professor Edwards, writing for the Royal Society, is less sure: "We would expect weakening of controls over cannabis to result in increased use levels, but this is an empirical question on which research at present is not conclusive...Removal of prohibition on cannabis would have to be described as a voyage into the unknown. Some added harm and some added costs would undoubtedly result" (p 303). There is international experience which might throw light on this question, but we have not explored it in detail. 6.19 We have not considered the wider range of social and criminological issues which would be raised by any proposal to change the law on recreational cannabis use. These include enforcement, the impact on use of other illegal drugs, and the international context and the danger of "drug tourism"; as well as ethical, philosophical and religious questions about the freedom of the individual, the nature of society and the morality of mind-altering drugs. As we said when we began this enquiry, these matters fall outside our remit as a Science and Technology Committee. An Independent Inquiry into the Misuse of Drugs Act, chaired by Lady Runciman of Doxford and supported by the Police Foundation, is currently considering the matter in its wider context; they expect to report next year. *** 23 See also the Annual Report on the State of the Drugs Problem in the EU 1997, by the European Monitoring Centre for Drugs and Drug Addiction. Back 24 Br. J. Gen. Pract. 1996, 46, 671. Back CHAPTER 7 CHANGING THE LAW ON MEDICAL USE AND RESEARCH: REVIEW OF THE EVIDENCE 7.1 In law, it would be possible to make cannabis and/or additional cannabinoids prescribable by moving them from Schedule 1 to Schedule 2 to the Misuse of Drugs Regulations, in advance of any cannabis-based medicine being licensed and reaching the market. However, the Government are not willing to reschedule cannabis in advance of licensing. Licensing depends on research and clinical trials: the Government are satisfied with the arrangements for allowing research and trials, but some of our witnesses are not. In the mean time, medical use remains illegal. Prosecution for use of cannabis for medical purposes 7.2 It is not known what proportion of prosecutions for possession of cannabis arise from medical use. The ACT drew our attention to 15 reported cases of people charged with cultivation, possession and/or supply in medical situations since 1996: of the 12 cases where the outcome was known, one resulted in a sentence of 50 hours' community service; in the other 11, either the prosecution was abandoned, the defendant was acquitted, or the sentence was no greater than a conditional discharge. IDMU offer further figures (p 258); they comment that, although outcomes in such cases are highly variable, juries seem more likely to acquit "where there is convincing medical evidence, given similar circumstances concerning paraphernalia". 7.3 People who use cannabis for medical purposes face prosecution if caught cultivating or possessing cannabis; but, according to Austin Mitchell MP, "It is bringing the law into a certain amount of difficulty and disrepute because either the police are cautioning or the courts are giving very lenient sentences" (Q 132). Dr Pertwee considers it unsatisfactory that such people are sometimes prosecuted, unsatisfactory that law-breaking is sometimes tolerated, and unsatisfactory that the position is inconsistent around the country (Q 313). 7.4 The BMA report recommends, "While research is under way, police, the courts and other prosecuting authorities should be aware of the medicinal reasons for the unlawful use of cannabis by those suffering from certain medical conditions for whom other drugs have proved ineffective" (cp Q 55). Similarly the Multiple Sclerosis Society want the law to treat people caught using cannabis for medical reasons in an "appropriately compassionate fashion" (p 90). They report that most people convicted in such circumstances receive a suspended sentence; but they are concerned about the way the system treats people as much as about the verdict (Q 341; cp IDMU p 261). 7.5 Mr Howarth, the Under-Secretary of State, declined to comment on how the Crown Prosecution Service and the courts treat such cases (QQ 668-673), beyond observing that in some cases the plea-in-mitigation of medical use might be trumped-up (Q 674). The Home Office added that official statistics do not distinguish between cases with a medical aspect and cases without; but that, on the anecdotal evidence, outcomes in medical cases were not obviously out of line with outcomes in purely recreational cases (Q 675). (The proportion of persons in the United Kingdom dealt with for possession of cannabis who are cautioned rather than prosecuted rose from 35 per cent in 1986 to 62 per cent in 1995-Home Office Statistical Bulletin 10/98.) Possible transfer from Schedule 1 to Schedule 2 7.6 According to the Home Office (p 150), cannabis could be transferred from Schedule 1 to Schedule 2 by statutory instrument, subject to negative resolution in Parliament. The ACMD would have to be consulted first. According to the Minister (Q 676), under the 1961 UN Convention, rescheduling cannabis itself and cannabis resin would not require international agreement; but, under the 1971 Convention, rescheduling cannabinol and its derivatives other than dronabinol would require prior amendment of the Schedules to the Convention through the WHO and the UN Commission on Narcotic Drugs, as happened in the case of dronabinol in 1995. 7.7 Rescheduling would allow doctors to prescribe; but the Home Office say, "Our understanding is that the ability of doctors to prescribe cannabis would be hampered in practice if a cannabis-based medicine had not been granted a marketing authorisation by the MCA". The Minister said that there were "compelling policy reasons" for requiring an MCA licence first (Q 676). When asked to explain the practical difficulties, he referred to the extra burden of responsibility which a doctor takes on by prescribing an unlicensed medicine (Q 679); he queried the wisdom of permitting prescription without proof of safety and quality (Q 680); and he noted that the ACMD had not called for change (Q 688). 7.8 Rescheduling would also allow doctors and pharmacists to manufacture and supply (Q 680); anyone else, including a pharmaceutical company, would require a Home Office licence. It would not in itself disapply section 8 of the Misuse of Drugs Act, which makes it an offence to allow cannabis to be smoked on premises; but this could be done by secondary legislation (Q 684). 7.9 So the Government could reschedule cannabis; the next question is, whether they should. Dr Lambert says, "Many patients are already illegally using cannabis...Their needs must be addressed whilst formal studies are undertaken". IDMU finds the present position "inhumane", and "unjustifiable both on moral and on public health grounds" (p 229). Dr Pertwee says (p 68), "A strong case can be made on the grounds of common sense and compassion for allowing doctors to prescribe...(oral) cannabis now for serious symptoms including muscle spasms"; but he admits that it will take better evidence to persuade the Department of Health (Q 263; see also paragraph 7.15 below). 7.10 Dr Robson described the present position as an "affront to humanity" (Q 460). He called for "compassionate reefers" for AIDS and cancer patients (p 118), and possibly for patients with non-terminal conditions who might feel that the increased risk of cancer was worth taking (Q 469). He suggested that patients might be made to confirm in writing that the doctor had explained the risks; and that, if it were felt necessary, the number of doctors entitled to prescribe cannabis could be limited, as in the case of diamorphine (heroin) or cocaine prescribed for addicts under the Misuse of Drugs (Supply to Addicts) Regulations 1997 (Q 471). He added that research into synthetic cannabinoids might soon make herbal cannabis obsolete; but, in the mean time, "it just is not a dangerous enough drug for me to want to ban it" (Q 472). 7.11 The ACT want "medical preparations of natural cannabis...to be made available on a doctor's prescription while research is going ahead" (p 28), by moving cannabis from Schedule 1 to Schedule 2 (Q 133). They argue that "we know now that cannabis can be effective and is safe enough to be prescribed by a doctor...and there are people who need treatment now". Similarly, six of our witnesses, all users of cannabis for medical purposes themselves, want cannabis to be prescribable or otherwise legalised for medical use. 195 out of 200 respondents to the Disability Now survey, of whom 192 were disabled and 134 had taken cannabis for medical purposes, wanted such use to be legalised. 7.12 The London Medical Marijuana Support Group (p 271) consider the issue to be one of patients' rights: "Please do not continue to make sick people criminals". They call for either rescheduling, or a new system involving registration of patients. They would solve the problem of supply by allowing patients to grow their own, or by setting up co-operatives, or by permitting commercial cultivation. They argue that different users get benefit from different preparations; so they do not want a standardised preparation-though this would be better than nothing. 7.13 If the law cannot be changed, it could in theory be applied with flexibility. IDMU suggest "directives to the CPS on criteria to use when deciding whether a prosecution of a medical cannabis user is in the public interest" (p 225). According to the Home Office, however, systematic non-enforcement would be "quite unacceptable" (Q 671). 7.14 Though some witnesses to this Committee favour immediate transfer from Schedule 1 to Schedule 2, others are against it. Professor Radda insisted that anecdotal evidence, however large in volume, was not sufficient reason for rescheduling (Q 657). Sir William Asscher considers that immediate rescheduling would actually threaten proper trials, such as those proposed by his working party (see Chapter 5), by encouraging patients to use cannabis in an uncontrolled way rather than enrolling for the trial and risking receiving a placebo (Q 808). 7.15 The Multiple Sclerosis Society want sufferers to be able to make "informed choice about therapeutic agents"; therefore they would not support prescription of cannabis for MS in advance of proper trials (p 90, Q 368). The Royal Society say that, pending proper trials, "There is no persuasive case for the non-experimental medical use of cannabis"; and they are against smoking (p 295). The Royal Pharmaceutical Society take the same line (p 289); so does Professor Strang, who would be worried if cannabis were given "some easy track" (Q 249); so does Edward Jurith, on sabbatical in Manchester from the post of General Counsel to the White House Office of National Drug Control Policy (p 265). The Christian Institute agree: "The rules must remain the same for all substances...Rescheduling cannabis would declare that cannabis is suitable for medical use. The studies have not been done to demonstrate this" (p 207). They add that permitting cannabis to be smoked "would profoundly damage current health promotion attempts to dissuade smoking". They suggest that other steps might be taken to help MS sufferers who are resorting to cannabis. Dr Pertwee considers that permitting prescription of cannabis could not be justified until both nabilone and dronabinol had been tried and failed (Q 314). 7.16 The BMA report recommends, "The WHO should advise the UN Commission on Narcotic Drugs to reschedule certain cannabinoids under the UN Convention on Psychotropic Substances, as in the case of dronabinol [which was rescheduled in 1995]. In response the Home Office should alter the Misuse of Drugs Act accordingly." Alternatively, "The Government should consider changing the Misuse of Drugs Act to allow the prescription of cannabinoids to patients with particular medical conditions that are not adequately controlled by existing treatments". On the other hand, David Nutt, Professor of Psychopharmacology at the University of Bristol, considers that the availability of nabilone, which may be prescribed on an unlicensed basis for any of the conditions identified by the BMA, makes it unnecessary to change the law (p 280). 7.17 The Royal Pharmaceutical Society caution that, if unlicensed use of cannabinoids becomes more common (as the BMA think it might, following their report-Q 83), there should be "full consultation between the medical and pharmacy professions" (p 290). They urge the Government to consider moving all cannabinoids from Schedule 1 to Schedule 2. Research 7.18 As noted in Chapter 3, cannabinoid pharmacology is currently a lively field of research. However, until Dr Guy's initiative, no new cannabis-based medicines were in commercial clinical development (Wall Q 134). As to why this should be so, most of our witnesses point to the "stigma" of working with a "disreputable" substance and a Schedule 1 controlled drug (e.g. Austin Mitchell MP Q 132, Pertwee Q 317, Robson Q 482). Others point to the likelihood that a non-synthetic cannabis-based medicine would be cheap and therefore unprofitable, and the markets for it small (RPharmSoc p 289; Lader QQ 7, 17)-though Professor Ashton and the BMA believe that the global market is potentially large (Q 57). Dr Pertwee believes that drug companies are very interested in the possibility of cannabinoids which avoid psychotropic effects by acting only on the CB2 receptor (Q 281); they are "dying to get in there, but they do not know what to do" (Q 295). 7.19 Dr Notcutt believes that what puts companies off research involving a Schedule 1 drug is not the stigma, but the "sheer difficulty" (Q 414). The principal additional difficulty is the requirement to obtain a licence from the Home Office (see Box 8). If cannabis were moved to Schedule 2 to the Regulations, research licences would no longer be required (Q 677). BOX 8: CANNABIS RESEARCH LICENCES Licences to possess any Schedule 1 drug for research may be granted by the Home Office under section 7 of the Misuse of Drugs Act and Regulation 5 of the Misuse of Drugs Regulations. The Under-Secretary of State at the Home Office, George Howarth MP, explained to us the conditions under which licences are granted (Q 662). There must be a legitimate reason for the research; details of method and timetable; ethical approval; and safeguards including safe custody and record-keeping. The research would normally be expected to be conducted at a university hospital or pharmaceutical company; and the method of administration must allow for control of dosage. According to the Home Office, there have been a total of 27 applications for cannabis research licences, of which 25 have been approved and two agreed in principle; no application for a licence has been refused (HC WA 255, 18 Dec. 1997). The Home Office supplied us with a list of 22 current licences. All are granted to named researchers, 20 at universities and two in hospitals. Most are for teaching or testing purposes; only three appear to be for research. Four of the licences were issued this year, compared with 22 over the previous 24 years; the Home Office attribute the increase to a Royal Pharmaceutical Society symposium on medical uses of cannabis in July 1997 (Q 666). There are 80 current research licences for Schedule 1 substances other than cannabis (Q 665). Among our witnesses, cannabis research licences are or have been held by Dr Pertwee, Dr Schon (see p 303 and Q 664), Dr Holdcroft (see paragraph 5.29), and Dr Guy (see paragraph 5.44); and Jo Barnes has a licence "in principle" for the Exeter pilot study (see paragraph 5.47). 7.20 In addition to the lack of commercial development work, there is little clinical research in this area. Professor Wall comments, "It is a paradox that a subject of such intense scientific interest should receive so little clinical attention. One reason...[is] the daunting and excessive bureaucratic control which artificially separates studies of cannabis from drugs such as narcotics. The other reason is the general social atmosphere which labels cannabis with every possible negative attitude" (p 31, cp Q 143). He compares the attitude to medical use of narcotics before the work of Dame Cicely Saunders (Q 127). Similarly Dr Lambert says, "The Schedule 1 status of cannabis has made modern clinical research almost impossible, primarily because of the legal, ethical and bureaucratic difficulties in conducting trials with patients. In addition, the general attitude towards cannabis...has not helped". This is regrettable, since there is "a wide range of possibilities and a massive opportunity for research". The Royal Pharmaceutical Society blame the "disappointing" lack of evidence on the "stigma" attached to cannabis, and the burden of licensing (p 288). 7.21 Professor Hall also believes that research has been chilled by the link with recreational use. He regards this link as "spurious". He observes, "The recent discovery of the cannabinoid receptor may help to overcome some of the resistance...by holding out the prospect that the psychoactive effects...can be disengaged from [the] other therapeutically desirable effects" (p 222). The Multiple Sclerosis Society believe that the stigma attached to cannabis as a medicine can be countered by "raising awareness" and taking the issue seriously, which to some extent has already happened (Q 372); and they know of numerous volunteers for trials (Q 389). 7.22 Dr Holdcroft notes two further difficulties: the lack of standardised preparations (she produced her own capsules), and the medicolegal problems of working with cannabis-naive subjects. Dr Notcutt blames the licensing system, and the problem of supply (Q 413); he is optimistic that Dr Guy's initiative may surmount both obstacles. Austin Mitchell MP believes that ethical committees "run a mile" from sanctioning clinical research using a Schedule 1 drug (Q 132). Professor Edwards likewise points to ethical problems (Q 19); he recommends, before blind trials, "a small series of open clinical investigations with repeat and careful observations on the individual patient". The National Drug Prevention Alliance, noting that the prospective markets may be too small to warrant the commercial cost of trials, suggest that trials might be grant-aided from public funds (p 279-they regard this as preferable to licensing without trials). 7.23 The Department of Health say, "Both the Home Office and MCA have always indicated that they are prepared to look sympathetically at well-founded research proposals in this area" (p 48, cp Q 167). However Dr Kendall calls for "relaxation of the level of control" over trials (p 268). Dr Robson, in his review for the Department, says, "Research will only be possible if the regulations imposed under the Misuse of Drugs Act are made more flexible". IDMU say (p 229), "The present licensing system and policy has severely limited research opportunities and should be reviewed"; given the rise in research activity noted above, the United Kingdom academic community and pharmaceutical industry may miss opportunities if the research licensing regime is not relaxed. 7.24 Yet the Multiple Sclerosis Society believe that the present system obstructs research more by its effect on attitudes than by practicalities (Q 388); and it is the impression of Austin Mitchell MP (Q 132) and Clare Hodges (Q 136) that the Home Office are already more flexible than they used to be. Professor Radda believes that a good research proposal will receive a licence without difficulty, and that scientists today are well used to regulation of this kind (Q 630). Dr Guy says that, although consultation was lengthy (from application to grant took 4 months-Q 663), the Home Office have been "most helpful" (p 162). 7.25 The BMA report said, "The regulation of cannabis and cannabinoids should be sufficiently flexible to allow such compounds to be researched without a Misuse of Drugs Act licence issued by the Home Office". In evidence, the BMA reported "very positive feedback" from the Department of Health and the Home Office on the pace of the licensing process (Q 82); but they said that at present there was serious delay (Q 92). The Home Office responded, saying, "Applications for research licences are dealt with as expeditiously as the circumstances allow" (p 149); the Minister gave the time from application to grant in the last six cases, which averaged seven weeks (Q 663). The BMA hope that guidelines for trials would help to accelerate the process (Q 92). 7.26 The Committee put to the BMA the idea of a meeting between the Home Office and researchers, and they welcomed it (Q 93). The Home Office say that they would be happy to hold such a meeting, jointly with the Department of Health: "It would provide a useful opportunity to highlight some of the complex issues involved such as the supply of standardised cannabis, and the adoption of sound methodologies". Work is now in hand to set up such a meeting (Q 686). Medical use and recreational use 7.27 "Without pressing the panic button", Professor Edwards points out that cannabis or preparations of cannabis supplied for medical use might be diverted to recreational use (Q 20). Professor Hall warns that, if doctors were allowed to prescribe cannabis, some might be tempted to profit from bogus prescriptions (Q 761). New Department of Health guidelines on clinical management of drug abuse are to cover "leakage" of prescribable controlled drugs (such as methadone) onto the black market; the Department comment that leakage of nabilone is "highly unlikely", since it is dispensed only by hospital pharmacies in small amounts (p 217). The BMA report says, "It would be prudent to develop a labelling system that does not identify prescribed drugs as cannabinoids, and to warn patients that such drugs should be kept in a place inaccessible to others". Professor Nathanson added that, ideally, cannabis-based medicines would be developed which had minimal psychoactive effects (Q 76). 7.28 On 23 January 1997, the then Under-Secretary of State, Home Office, told the House of Commons, "Many of those calling for the medical use of cannabis are using it as a stalking horse to promote the campaign for its legalisation" (HC col. 1060). David Copestake, a Methodist Minister who has researched and written in this field, takes this view; he observes that medical uses were once touted for tobacco (p 213). The NDPA say the same, claiming that the BMA has been "hi-jacked" and that the ACT are "very familiar" with lobbyists for legalisation (p 278). The Christian Institute agree (p 208). 7.29 The ACT insist that they are not calling for general legalisation (p 28). They point out that heroin (diamorphine) may be prescribed (it is a Class A drug under the Misuse of Drugs Act, yet in Schedule 2 to the 1985 Regulations). Dr Notcutt observes that there is no evidence that heroin abuse is thereby encouraged, and lists several other drugs of potential abuse which are used unlicensed in chronic pain (p 105). The MRC make the same point, and say (as do several other witnesses), "The question of potential medical uses for cannabis and its derivatives must be considered quite separately from the question of prohibition of recreational use" (p 144). According to Professor Hall, there is a stalking-horse element to the debate on medical use; but this should not be allowed to influence the argument either way (p 222). 7.30 The Department of Health still detect an element of the stalking-horse. However they acknowledge and support "the genuine concern of some people to find medicinal products for intractable conditions" (Q 176). *** 25 Hirst R A, Lambert D G and Notcutt W G, op. cit. Back 26 A member of the Independent Inquiry into the Misuse of Drugs Act-see paragraph 6.19. Back 27 Hirst R A, Lambert D G and Notcutt W G, op. cit. Back 28 Holdcroft A et al, op. cit. Back *** Select Committee on Science and Technology Ninth Report *** CHAPTER 8 OPINION OF THE COMMITTEE Medical use of cannabis: recommendations 8.1 We recognise that, in all the evidence we have received, there is not enough rigorous scientific evidence to prove conclusively that cannabis itself has, or indeed has not, medical value of any kind. 8.2 Nevertheless we have received enough anecdotal evidence (see above, paragraphs 5.4, 20-22, 27-30) to convince us that cannabis almost certainly does have genuine medical applications, especially in treating the painful muscular spasms and other symptoms of MS and in the control of other forms of pain. 8.3 We therefore recommend that clinical trials of cannabis for the treatment of MS and chronic pain should be mounted as a matter of urgency. We warmly welcome the fact that, in the course of our inquiry, both Dr Geoffrey Guy of GW Pharmaceuticals, and the Royal Pharmaceutical Society's working group under Sir William Asscher, have set off down this route (paragraphs 5.44-48). We welcome the Asscher group's intention to compare the effects of a standardised preparation of natural cannabis with those of the one synthetic cannabinoid already available, dronabinol, on the basis of the same dose level of THC. 8.4 Although neither Dr Guy nor the Asscher group contemplate trials of smoked cannabis, we agree with the Chief Executive of the MRC that such a trial should not be ruled out (paragraph 5.57). However we recognise the dangers of smoking, and we do not envisage smoking being used to administer any medicine eventually licensed. For this reason we recommend that research be promoted into alternative modes of administration (e.g. inhalation, sub-lingual, rectal) which would retain the benefit of rapid absorption offered by smoking, without the adverse effects. 8.5 The Government have said repeatedly that, if sufficient evidence in favour of cannabis as a medicine were produced for the MCA to be prepared to license it, they would amend the Misuse of Drugs Regulations so as to permit it to be prescribed. The problem with this policy is that it will take several years at least for this to happen. The Asscher group's trials are not expected to be complete before mid-2001, and will lead only to "proof of principle", leaving others to proceed with any pharmaceutical development. Dr Guy does not expect to receive a product licence in under five years. In the mean time, 85,000 people in this country will continue to suffer the very unpleasant symptoms of MS. Only a small proportion of these are known to have tried cannabis illegally; but of these, significant numbers report great relief of their symptoms. We do not believe that this position is satisfactory. 8.6 We therefore recommend that the Government should take steps to transfer cannabis and cannabis resin from Schedule 1 to the Misuse of Drugs Regulations to Schedule 2 (see Box 3), so as to allow doctors to prescribe an appropriate preparation of cannabis, albeit as an unlicensed medicine and on the named-patient basis (see Box 6), and to allow doctors and pharmacists to supply the drug prescribed. This would also, incidentally, allow research without a special licence from the Home Office (see Box 8). 8.7 It is argued in some quarters that some of those who campaign for medical use see it as a stalking-horse for the legalisation of recreational use (paragraphs 7.28-30). We do not see this as a reason to resist medical use if, as we believe, it is justified by the evidence. We prefer the argument recently advanced by Austin Mitchell MP in the House of Commons (14 January 1998, col. 317): at present, people who use cannabis for medical reasons are caught in the front line of the war against drug abuse. This makes criminals of people whose intentions are innocent, it adds to the burden on enforcement agencies, and it brings the law into disrepute. Legalising medical use on prescription, in the way that we recommend, would create a clear separation between medical and recreational use, under control of the health care professions. We believe it would in fact make the line against recreational use easier to hold. 8.8 Before moving cannabis out of Schedule 1, the Government are required by law to consult the Advisory Council on the Misuse of Drugs. We recommend that they do so at once, and respond to this report only after receiving and considering the advice of the Council. We recognise that this may take longer than the time normally allowed for such responses. Medical use of cannabinoids: recommendations 8.9 Unlike cannabis itself, the cannabinoid THC (dronabinol) and its analogue nabilone are already accepted by the Government as having medical value (paragraphs 5.11-17)-producing the anomaly that, while cannabis itself is banned as a psychoactive drug, THC, the principal substance which makes it psychoactive, is in legitimate medical use. Some of our witnesses are prepared (paragraph 5.50) to contemplate wider medical use of the cannabinoids, but not of cannabis itself. We disagree, since some users of both find cannabis itself more effective (paragraph 5.51). We do, however, welcome the inclusion of THC in the trials proposed by the Asscher group, in like-for-like comparison with cannabis itself. 8.10 Dronabinol (THC), though not licensed in this country, has already been moved to Schedule 2 to the Misuse of Drugs Regulations, and nabilone is a licensed medicine and not a controlled drug; so no Government action is required in either case to permit clinical trials or indeed prescription. All cannabinoids other than THC remain in Schedule 1, and transferring them would require agreement through the WHO under the 1971 Convention. We do not regard this as a priority, since we are not persuaded that any other cannabinoid has a convincing medical use; but we recommend that the Government should raise the matter of rescheduling the remaining cannabinoids with the WHO in due course, in order to facilitate research. Why change the law? 8.11 Our principal reason for recommending that the law be changed, to make legal the use of cannabis for medical purposes, is compassionate. Illegal medical use of cannabis is quite widespread (paragraphs 5.2-3); it is sometimes connived at and even in some cases encouraged by health professionals (paragraph 5.6); and yet at present it exposes patients and in some cases their carers to all the distress of criminal proceedings, with the possibility of serious penalties. We acknowledge that, if our recommendation were implemented, the United Kingdom would be moving out of step with many other countries; we consider that the Government should not be afraid to give a lead in this matter in a responsible way. 8.12 As a secondary reason, we would observe that the law in this area appears to be being enforced inconsistently, and in some cases with a very light hand (paragraphs 7.2-5). Some cases are not brought to court; where users of cannabis for medical purposes have been prosecuted, the sentence has sometimes been light; and there have even been cases where juries have refused to convict. The Minister told us that he was content to leave this as a matter for the discretion of the prosecuting authorities and the courts (QQ 668-673). That is a constitutionally proper position for a Minister; but it is not the right position for Parliament. If statute law is not enforced, Parliament is brought into disrepute; either enforcement must be tightened up, or the law must be changed. In this case, we recommend the latter. 8.13 A further subsidiary advantage of transfer from Schedule 1 to Schedule 2 would be the encouragement which this would give to research (paragraphs 7.18-26). There are exciting research opportunities in this field (see Chapter 3), which (on the basis of the number of grants by the MRC and the Wellcome Trust, and the number of Home Office research licences-paragraph 5.39 and Box 8) are not being fully taken up in this country, despite the excellence of British biomedical science. We are satisfied that the Home Office are not being deliberately obstructive; and we are glad that they have already taken up our proposal for a meeting between the research community and those responsible for the research licensing regime (paragraph 7.26). But, now that research in this field has taken off, and the existence of important medical applications is (in our view) well established, it is not appropriate for research to continue to be subject to this extra layer of administration. Transfer to Schedule 2 would also go some way to removing the stigma which many of our witnesses believe hangs over research in this field, deterring researchers, funding bodies, pharmaceutical companies and local ethics committees alike from involvement in research which might turn out to be of great importance. 8.14 As the Minister pointed out to us, a doctor who prescribed cannabis on these terms, in the absence of a product licensed by the MCA for the relevant indication, would take on himself full responsibility for the consequences (Q 679). This is true. However we have received evidence from doctors who are currently prescribing nabilone on an unlicensed basis (Notcutt Q 405). We believe that the overwhelming majority of members of the medical profession can be trusted not to be reckless in this matter, and that the professional regulatory bodies will deal effectively with any who are. 8.15 The Minister also observed that, in some cases, someone charged with a cannabis offence may claim medical use as a bogus defence or plea in mitigation (Q 674). We do not doubt that this happens at present; and, in the case of some people, it may be hard to tell where recreational use stops and medical use begins (paragraph 5.5). Rescheduling so as to permit prescription would in fact make this problem easier to deal with: rather than having to investigate individual medical histories, as at present, the authorities would simply ask to see the prescription. 8.16 As with any medicine, there are some groups of patients for whom cannabis-based medicines will not be appropriate. On the evidence before us, cannabis-based medicines should not be prescribed for persons with, or predisposed towards, schizophrenic illness (paragraph 4.12) or cardiovascular conditions (paragraph 4.4); nor, pending further research, should they be prescribed for pregnant women (paragraphs 4.15-16). As with many medicines, users should be warned of possible effects on driving ability (paragraphs 4.6-9) and cognitive function (paragraph 4.13). As with any potentially addictive medicine, the risk of addiction (paragraphs 4.23-33) should be weighed up when deciding whether to prescribe, and the user should be warned. Therefore, if doctors are permitted to prescribe cannabis on an unlicensed basis, the medical professional bodies should provide firm guidance on how to do so responsibly (paragraph 7.17). 8.17 As with any medicine which is open to abuse, safeguards must be put in place by the professional regulatory bodies to prevent diversion to improper purposes (paragraph 7.27). These might include a system of declarations to be signed by the doctor and the patient. Recreational use 8.18 It is believed in some quarters that the current absolute prohibition on the recreational use of cannabis and its derivatives is not justified by the adverse consequences for the user and the public. On the evidence before us, we disagree. On the contrary, we endorse the Government's statement in Tackling Drugs: "The more evidence becomes available about the risks of...cannabis,...the more discredited the notion that [it is] harmless" (paragraph 6.16). 8.19 The harms must not be overstated: cannabis is neither poisonous (paragraph 4.3), nor highly addictive, and we do not believe that it can cause schizophrenia in a previously well user with no predisposition to develop the disease. However, we are satisfied that: - It is intoxicating, enough to impair the ability to carry out safety-critical tasks (such as flying, driving or operating machinery) for several hours after taking (paragraphs 4.6-9); - It can have adverse psychic effects ranging from temporary distress, through transient psychosis, to the exacerbation of pre-existing mental illness (paragraphs 4.10-12); - Regular use can lead to psychological dependence (paragraphs 4.23-33); and, in some dependent individuals (perhaps 5-10 per cent of regular users), regular heavy use can produce a state of near continuous intoxication, making normal life impossible; - Withdrawal may occasionally involve unpleasant symptoms (paragraphs 4.23-25); - Cannabis impairs cognitive function during use (paragraph 4.6); - It increases the heart rate and lowers the blood pressure, carrying risks to people with cardiovascular conditions, especially first-time users who have not developed tolerance to this effect (paragraph 4.4). 8.20 Moreover, it is possible, though not proved, that the effects of cannabis on driving etc. may last longer than a few hours after taking (paragraph 4.7); that the damage to cognitive function may endure after withdrawal (paragraph 4.13); and that cannabis has adverse effects on the immune system (paragraph 5.16) and on fertility and reproduction (paragraphs 4.15-16). 8.21 In addition, smoking cannabis carries similar risks of respiratory disorders to smoking tobacco. It is also possible, though not proved, that exposure to cannabis smoke increases the risk of cancers of the mouth, throat and lung (paragraphs 4.17-18). 8.22 Therefore, on the basis of the scientific evidence which we have collected, we recommend that cannabis and its derivatives should continue to be controlled drugs. Summary of recommendations 8.23 (i) Clinical trials of cannabis for the treatment of MS and chronic pain should be mounted as a matter of urgency (paragraph 8.3). (ii) Research should be promoted into alternative modes of administration (e.g. inhalation, sub-lingual, rectal) which would retain the benefit of rapid absorption offered by smoking, without the adverse effects (paragraph 8.4). (iii) The Government should take steps to transfer cannabis and cannabis resin from Schedule 1 to the Misuse of Drugs Regulations to Schedule 2, so as to allow doctors to prescribe an appropriate preparation of cannabis, albeit as an unlicensed medicine and on the named-patient basis, and to allow doctors and pharmacists to supply the drug prescribed (paragraph 8.6). (iv) The Government should consult the Advisory Council on the Misuse of Drugs on this matter at once, and respond to this report only after receiving and considering their advice (paragraph 8.8). (v) The Government should raise the question of rescheduling the remaining cannabinoids with the WHO in due course (paragraph 8.10). (vi) If doctors are permitted to prescribe cannabis on an unlicensed basis, the medical professional bodies should provide firm guidance on how to do so responsibly (paragraph 8.16); and safeguards must be put in place by the professional regulatory bodies to prevent diversion to improper purposes (paragraph 8.17). (vii) Cannabis and its derivatives should continue to be controlled drugs (paragraph 8.22). *** Select Committee on Science and Technology Ninth Report *** APPENDIX 1 Members of the Sub-Committee which conducted the enquiry * Lord Butterfield * Lord Butterworth * Lord Carmichael of Kelvingrove * Lord Dixon-Smith * Lord Kirkwood * Lord Nathan * Lord Perry of Walton (Chairman) * Lord Porter of Luddenham * Lord Rea * Lord Soulsby of Swaffham Prior * Lord Walton of Detchant * Lord Winston * Co-opted members The Sub-Committee appointed as its Specialist Adviser: Professor Leslie Iversen FRS, Visiting Professor of Pharmacology, University of Oxford APPENDIX 2 Witnesses The following witnesses gave evidence. Those marked * gave oral evidence. Those marked ** gave written evidence which is not printed, but is available for inspection at the House of Lords Record Office (0171-219 5316): ** Academy of Medical Sciences (with Royal Society) ** Advisory Council on Misuse of Drugs ** Alliance for Cannabis Therapeutics ** Anonymous ** Professor Heather Ashton ** Association of Chief Police Officers ** Dr Anthony Blowers, Surrey's Drug Action Team ** Mary Brett, Dr Challoner's Grammar School (Boys), Amersham ** British Medical Association ** J Brown ** Christian Institute ** S Cooke ** David Copestake ** Dr Angela Coutts, University of Aberdeen ** Department of Complementary Medicine, University of Exeter ** R Creasey ** P Davidson ** M Davies ** S Day ** Department of Health ** Dutch National Institute of Public Health and the Environment ** Evangelical Coalition on Drugs Executive Committee ** C Fell ** Forensic Science Service ** L Gibson ** Professor Keith Green, Medical College of Georgia, USA ** Dr Geoffrey Guy ** Professor Wayne Hall, Executive Director, National Drug and Alcohol Research Centre, Australia ** Professor John Henry, Imperial College School of Medicine (on behalf of Royal College of Pathologists) ** Dr Anita Holdcroft, Imperial College School of Medicine ** Home Office ** M Humphreys ** Independent Drug Monitoring Unit ** Institute for the Study of Drug Dependence ** International Drug Strategy Institute ** Edward H Jurith ** Dr David Kendall, University of Nottingham Medical School ** Dr David Lambert ** D Lewis ** London Medical Marijuana Support Group ** Medical Research Council ** Medicines Control Agency ** Dr Tod H Mikuriya ** Austin Mitchell MP ** Mr Neil Montgomery ** Multiple Sclerosis Society ** National Addiction Centre ** National Drug Prevention Alliance ** NHS National Teratology Information Service ** Dr William Notcutt ** Professor David Nutt, University of Bristol ** Dr Roger Pertwee ** A Phillipson ** P Rigby ** Dr Philip Robson ** E Rorison ** Royal College of General Practitioners ** Royal College of Pathologists ** Royal College of Psychiatrists ** Royal Pharmaceutical Society of Great Britain ** Royal Society ** J Sayers ** Dr Fred Schon, Mayday Hospital Croydon and St George's Hospital ** Dr P Shaw ** Councillor C Simpson, Aberystwyth ** L Standen ** Dr Colin Stewart, Dundee Limb Fitting Centre ** G Vincent ** Young Christian Democrats *** APPENDIX 3 Notes on Conference "Marihuana and Medicine" at New York University Medical Center, New York, 20-21 March 1998 by Professor Leslie Iversen FRS, Specialist Adviser 1. The conference, organised by Professor G. Nahas and colleagues, gave an overview of the current position in the USA. A topical issue there is whether smoked marijuana should be permitted for medical use, since oral formulations of tetrahydrocannabinol (THC) and nabilone are already available medically. 2. M. Huestis (National Institute on Drug Abuse) reviewed new information on the disposition and metabolism of cannabis in human subjects, using sensitive analytical techniques to measure THC and some of the major metabolites. Because a substantial proportion of the absorbed THC is sequestered in fat tissues, the half life of the drug in blood is > 4 days and the half life of the major urinary metabolite 11carboxylic acid THC is > 30 hours. By measuring the ratio of unchanged THC to this metabolite in samples of blood or urine it may be possible to calculate when the last dose of THC was taken-information that could be of importance forensically. An unexpected finding was the large variability between subjects in the amount of THC absorbed by smoking a standard marijuana cigarette under laboratory conditions; even though the number and frequency of puffs was controlled there was a 3fold range. For the same subject tested on different occasions there was also a considerable variability in the amount of THC absorbed (17 per cent on average). 3. M. El Sohly (University of Mississippi) described the development of a rectal suppository formulation for delivery of THC in the form of a "prodrug" (the hemisuccinate ester) dissolved in a lipid base. Absorption of THC increased in a dosedependent manner and was prolonged (THC was measurable in blood for up to 8 hours). Because this route of absorption avoids first pass metabolism in the liver, the amount of THC absorbed into circulation was more than twice as great as after oral dosage. Unfortunately there was a high variability between subjects in the amount of THC absorbed (about 3fold). The advantages of this route of administration seem clear, but it was thought unlikely to be popular in the United States where suppository formulations have never been widely accepted. 4. B. Thomas (Research Triangle Institute) reviewed the operation of his laboratory which supplies standard marijuana cigarettes to the 8 individual glaucoma patients licensed in the US to receive this medication, and to research groups in the US and elsewhere. By using standard growing conditions (at the University of Mississippi) and different strains of cannabis plant they are able to generate marijuana cigarettes of consistent quality and standard THC content (standard = 1.8 per cent THC; strong = 4.0 per cent THC) free of microbial or insect contamination. Placebo cigarettes are prepared using leaf material extracted with alcohol to remove THC. 5. Roger Pertwee (University of Aberdeen) reviewed current knowledge of the two cannabinoid receptors CB1 (found in the brain and some peripheral organs) and CB2 (peripheral only). The presence of CB2 receptors on cells in the immune system has prompted some pharmaceutical companies to become interested in this as a possible target for the discovery of novel immunesuppressant or antiinflammatory drugs. The French company Sanofi and the Canadian company MerckFrosst have reported novel synthetic antagonists/agonists acting selectively at these sites. The availability of novel synthetic antagonists acting at the CB1 receptors (eg SR141716A (Sanofi), LY 320135 (Eli Lilly)) has provided valuable new research tools. New drugs are also being designed based on the structure of the endogenous cannabinoid anandamide. 6. R. Mechoulam (Hebrew University, Israel) described his identification of Ä9THC as the principal psychoactive compound in cannabis extracts, and his subsequent discovery of anandamide as the naturally occurring cannabislike compound in the brain. Other naturally occurring fatty acid derivatives also interact with cannabis receptors, and one of these, 2arachidonylglycerol, may act selectively at CB2 receptors. 7. E. Gardner (Albert Einstein College of Medicine, New York) described studies of the interaction of THC with reward pathways in rat brain. He confirmed earlier work from an Italian laboratory (Tanda et al, 1997, Science, 276:20482050) that administration of THC (0.5mg/kg) to rats caused an increase in dopamine release in the nucleus accumbens region of the brain and, furthermore, that this release could be blocked by coadministration of the drug naloxone, which blocks opiate receptors in the brain. He also found that THC sensitised rats to the rewarding effects of intracranial selfstimulation and that this effect was also blocked by naloxone. These results are potentially important as they indicate that THC stimulates dopamine pathways in the brain known to be activated by various addictive drugs-nicotine, amphetamine, heroin and cocaine. The blocking effects of naloxone suggest that THC may exert at least part of its rewarding effects indirectly by promoting a release of opiatelike chemicals in the brain. 8. D. Tashkin (University of California Los Angeles) surveyed the effects on the lung of long-term marijuana use. He conducted large scale studies in the 1980s in heavy marijuana smokers and compared them with subjects who smoked tobacco. Marijuana smokers showed some bronchial symptoms (cough, wheeze and bronchitis), but there was no evidence for any significant reduction in overall respiratory function. When data were collected annually for a further 8 years, the marijuana smokers did not show the agerelated decline in respiratory function seen in tobacco smokers. Nevertheless, there was concern about the longer-term effects of marijuana smoking. Examination of the lining of the airways revealed inflammatory changes in chronic marijuana smokers, with an increase in the number of mucussecreting cells and sometimes what appeared to be precancerous alterations in cells lining the lungs. Examination of lung biopsy specimens showed an increased expression of certain genes that are markers of lung tumours. In addition the immune defence system appears to be depressed in the lungs of marijuana smokers. The defending white cells (macrophages), although present in increased numbers, had a decreased ability to kill bacteria or fungi and produced reduced amounts of nitric oxide and cytokines, the normal defence chemicals. Suppression of immune system function may be related to a direct effect of cannabis on receptors on the macrophages and other immune system cells. Although there was no evidence for increases in lung cancers in marijuana smokers, there were some reports of increases in cancers of mouth and throat. The reduction in immune system function could make marijuana smokers especially vulnerable to lung infections. 9. K. Coe (formerly at Pfizer Research) and L. Lemberger (formerly at Eli Lilly Research) gave historical reviews of the development of novel drugs for the treatment of pain and prevention of nausea based on cannabinoid chemical structures. A project at Pfizer in the 1970s led to the discovery of the synthetic compound levonantradol and the related compound CP55,940. These compounds had a much greater water solubility than THC and proved to be up to 100 times more potent than morphine in some animal tests of pain. Levonantrodol entered pilot scale clinical trials and was effective in suppressing postoperative pain and in preventing nausea and vomiting associated with cancer chemotherapy. It was evident, however, that the drug did not separate the beneficial clinical effects from intoxicant effects, and the company abandoned the project in 1980. CP55,940 proved valuable, however, in radioactively labelled form as a probe which led to the identification of the cannabis CB1 receptor in the brain. 10. At Eli Lilly during the same period there was also a hope that the beneficial effects of cannabinoids could be separated from unwanted psychoactivity, and this led to the discovery and development of nabilone. Clinical trials established the effectiveness of this drug in the treatment of the nausea and vomiting associated with cancer chemotherapy. Although some patients complained of the druginduced "high", this appeared milder than that associated with THC. However, although nabilone was approved for medical use by the Food and Drug Administration, the US Drug Enforcement Agency insisted that it be given a "Schedule II" classification [i.e. a compound with some medical use but a high abuse potential, so doctors using it have to keep detailed records]. This led to the company withdrawing from the project and also failing to give any substantial marketing support to the compound. Postmarketing surveillance reports in the UK, where the compound has some limited use, have not shown any danger of abuse. 11. W. Notcutt (Great Yarmouth), a consultant in a pain clinic, reported on the positive effects of nabilone in the relief of pain in some of his patients who were suffering from chronic pain and not responding to other medications. In a total of 55 patients he observed beneficial effects of nabilone (improved sleep, reduced pain) in about one third. 12. K. Green (Medical College of Georgia) and M. Forbes (Columbia University College, NY) discussed the possible use of cannabis in the treatment of glaucoma. There are more than 2 million glaucoma patients in the USA alone, and glaucoma is a major cause of blindness. THC or smoked marijuana does cause a marked fall in intraocular pressure in both normal subjects and patients with glaucoma (up to 45 per cent reduction), but the effect is transient and returns to baseline within 34 hours. It is difficult to achieve longer-term control of intraocular pressure as this would require frequent repeat dosing. THC cannot be delivered topically to the eye (the preferred route for antiglaucoma medications) because of its low water solubility. It is possible that an improved topical delivery formulation, or topical use of a more water soluble synthetic cannabinoid, could be developed in the future. In the USA a small group of patients (8) have individual permission to use smoked marijuana to treat their glaucoma. 13. R. Graller (New Orleans) reviewed the use of cannabis in the treatment of nausea and vomiting. Although there have been several controlled clinical trials showing the effectiveness of orally administered THC and nabilone in patients receiving cancer chemotherapy, there are few data on smoked marijuana. In recent years a new class of antinausea drugs, the 5HT3 antagonists (e.g. ondansetron, granisetron) have radically improved the treatment of nausea and vomiting in cancer patients. He found that a combination of granisetron and the steroid dexamethasone controlled the symptoms in more than 90 per cent of patients. Unlike THC which cannot be given intravenously, granisetron can be given by this route as well as by mouth. 14. G. Francis (McGill University, Montreal) discussed the use of cannabis in the treatment of multiple sclerosis. There are few effective treatments for this disease, and more than 250,000 patients in the USA. Some symptoms are particularly poorly controlled by existing medicines, notably tremor, pain and spasticity. There are many anecdotal reports that these symptoms are eased by smoked marijuana, but so far there have been few controlled clinical trials. A currently ongoing study with 600 subjects aims to compare smoked marijuana with a placebo (cigarettes with THC removed). Results available so far suggest that the subjective reports of improvement by patients are not always accompanied by improvement in objective measures of performance. APPENDIX 4 Notes on the International Cannabinoid Research Society 1998 Symposium on Cannabinoids, La Grande Motte, France, 23-25 July 1998 by Professor Leslie Iversen FRS, Specialist Adviser 1. The annual meeting of this group of research scientists was held for the first time outside North America and was attended by about 150 scientists, largely from academia. Of the 135 papers presented 73 originated from the United States and 50 from Europe (including 12 from Britain, 5 of which were from Dr Pertwee's group in Aberdeen). Endogenous cannabinoids 2. A substantial number of papers focused on the naturally occurring cannabinoids in the brain and in peripheral tissues. At least two lipid derivatives are now recognised: anandamide (arichidonylethanolamide) and an arichidonic acid ester, 2arachidonylglycerol (2AG). The latter substance is as potent as anandamide and is present in much larger quantities than anandamide in the brain. Several papers focused on the biochemical mechanisms involved in the synthesis and degradation of these lipids in the brain, and progress has been made in defining the biochemical mechanisms involved. Attention has also focused on the development of metabolically more stable chemical analogues of anandamide and 2AG with improved activity in whole animal studies: the naturally occurring compounds are rapidly degraded and are thus not very active in vivo. Another lipid, palmitoylethanolamide, may represent the natural activator of CB2 receptors, although there was some disagreement about its pharmacological activity and selectivity. Cannabinoid receptors 3. Several groups are studying the detailed molecular architecture of the CB1 and CB2 receptors and beginning to identify the precise sites at which the cannabinoids bind to these proteins. Studies of the receptors in in vitro model systems have revealed some interesting differences between the effectiveness of various cannabinoids in activating the receptors. In particular Ä9THC appears to act as only a partial agonist at the CB1 receptor (i.e. it cannot elicit a maximum response). Cannabidiol, one of the most abundant plant alkaloids, on the other hand appears to act as an antagonist at the CB1 receptor. 4. The CB1selective antagonist drug SR141716A and the related CB2selective antagonist SR144528 from the French pharmaceutical company Sanofi were the subject of many papers, and these compounds have proved to be important new research tools for probing cannabinoid functions. Scientists from Sanofi revealed that they are developing SR141716A for clinical trials, with schizophrenia as their first target (on the rationale that high doses of THC can cause a schizophrenialike psychosis). A novel CB1 antagonist CP272871 from Pfizer was described for the first time; it has properties similar to those of SR141716A. 5. The CB2 receptor, located principally on cells in the immune system, has attracted attention from a number of major pharmaceutical companies as a potential target for discovering novel antiinflammatory or immuno-suppressant drugs. There has been progress in identifying CB2selective drugs (by Merck Frosst, GlaxoWellcome, and Smith Kline Beecham) but so far there is little confidence that this target will prove useful. Dr Nancy Buckley (US National Institutes of Health) described the "CB2 knockout mouse" in which as a result of genetic engineering the CB2 receptor is no longer expressed. These mice seem remarkably normal in their immune cell population and in immune function and have not so far assisted in understanding the role normally played by the CB2 receptors. Adverse effects 6. D. Tashkin (UCLA) reported that treatment of mice with THC (5 mg/kg four times a week) led to more rapid growth of implanted lung cancer cells and decreased survival. He suggests that THC may suppress immunemediated eradication of tumour cells. 7. A session sponsored by the US National Institute on Drug Abuse focused on the effects of long-term cannabis use on frontal lobe function in man. A series of studies using imaging, cerebral blood flow and electroencephalographic measurements indicated depressed frontal lobe function in long-term cannabis users, and there were accompanying subtle deficits in sensory and cognitive processing, the so-called "executive functions" of the brain. There was little evidence that any of these effects persisted after cessation of drug intake. 8. Billy Martin et al (Virginia, USA) described an animal model of cannabis dependence. When dogs were treated with high doses of THC for 714 days and then challenged with the CB1 antagonist SR141716A clear physical signs of withdrawal became apparent; these included trembling, shaking, restlessness, vomiting and diarrhoea. By using the antagonist challenge model it has become much clearer that physical dependence and withdrawal can occur with THC, at least in animals. Furthermore, de Fonseca et al (Madrid) reported that the administration of SR141716A to morphinedependent animals elicited a behavioural and endocrine syndrome similar to that seen in opiate withdrawal, although considerably milder. Conversely some withdrawal signs could be elicited in cannabinoid-dependent animals when challenged with the opiate receptor antagonist naloxone, suggesting an interaction between the opioid and cannabinoid systems in the brain. Possible applications of cannabinoids 9. The interaction of opiate and cannabinoid mechanisms was also highlighted by Sandra Welch (Medical College of Virginia, USA) who reported that low doses of THC significantly potentiated the painrelieving effects of morphine and other opiates in a mouse model of arthritislike pain. Higher doses of THC were also by themselves fully effective in causing analgesia in this model. She is planning a clinical trial (with the approval of the US Food & Drug Administration) of low doses of THC (dronabinol) in conjunction with selfadministered morphine in patients suffering from cancer pain, in the hope that the drug combination may make morphine more effective in such patients. 10. D. Piomelli ( San Diego, USA) described powerful analgesic effects of anandamide when injected directly into the rat paw in an inflamed paw model of inflammatory pain. The mechanism appeared to involve both CB1 and CB2 receptors located on sensory nerve fibres in the skin, and when a combination of CB1selective and CB2selective compounds was injected there was synergy between them. Experiments using radiolabelled anandamide showed that >90 per cent of the injected dose remained in the paw, and very little entered the brain or spinal cord. These results are highly original and suggest the possibility that cannabinoids can exert painrelieving actions without having to penetrate into the central nervous system. 11. P. Consroe and R. Musty (University of Arizona, USA) described the results of an anonymous survey of 106 patients with spinal cord injuries who were selfmedicating with smoked marijuana. Patients smoked an average of 4 joints a day, 6 days a week and had been doing so for >10 years. More than 90 per cent reported that cannabis helped improve symptoms of muscle spasms of arms or legs, and improved urinary control and function. Around 70 per cent reported pain relief. The results of this survey and a similar one conducted with R. Pertwee in MS patients may help to pinpoint the relevant symptoms to focus on as outcome measures in future clinical trials of cannabis or cannabinoids. 12. D. Pate (University of Kuopio, Finland) described promising results in the reduction of intraocular pressure when a metabolically stable anandamide analogue was applied topically to normal rabbit eye. This effect appeared to involve a local CB1 receptor mechanism as it could be blocked by pretreating the animals with the antagonist SR141716A. In order to deliver the waterinsoluble lipid derivative to the eye it was dispersed in an aqueous solution containing a betacyclodextrin carrier. Miscellaneous 13. M. El Sohly (University of Mississippi, USA) summarised results obtained from the analysis of confiscated marijuana samples, a service which has been running since 1980 and which involves the analysis of samples from all regions of the United States. Data from 35,312 samples were available. The potency of marijuana leaf samples (the commonest in US seizures) rose from around 1.5 per cent THC content in 1980 to around 3 per cent in the 1980s and most recently to 3.87 per cent in 1996 and 4.15 per cent in 1997. The THC content of sinsemilla (the female plant flower head) rose from around 6.5 per cent in 1980 to 9.22 per cent (1996) and 11.53 per cent (1997). The increases are thought to be due to improved culture conditions rather than to any genetic improvements. Analysis of samples of cannabis resin or oil revealed few discernible trends, with figures ranging from 3 per cent to 19 per cent THC content. 14. J. Khodabaks and O. Engelsma (Maripharm, Netherlands) described their development of "The standardised medical grade marihuana plant". Until recently this group has been supplying Dutch pharmacists with medical grade marijuana, but its legal status has recently been questioned. The laboratory cultivates standard cannabis plants selected for a high yield of THC and low content of other cannabinoids; these are cloned by propagating (by cuttings) from female plants. The plants are grown under standard conditions and the female flower heads harvested and vacuum-sealed for storage and then gammairradiated to sterilise the preparations. Samples are routinely checked for THC and other cannabinoids and to ensure that they are free of pesticides. The THC content in different batches was highly consistent at 10.7 ± 0.1 per cent (standard deviation). Interestingly, in the light of discussions about the relevance of other cannabinoids in herbal cannabis, cannabidiol and cannabinol were present in only minor amounts (<0.1 per cent) in these samples. APPENDIX 5 Abbreviations ACMD ACT AMA BMA CMO CPS DETR DH HC HL FSS IDMU ISDD LMMSG MCA MRC MS MSSoc NDPA NHS NTIS POST RCGP RCPath RCPsych RPharmSoc THC WA WHO UNAdvisory Council on the Misuse of Drugs UK Alliance for Cannabis Therapeutics American Medical Association British Medical Association Chief Medical Officer Crown Prosecution Service Department of the Environment, Transport and the Regions Department of Health House of Commons (Hansard) House of Lords (Hansard) Forensic Science Service Independent Drug Monitoring Unit Institute for the Study of Drug Dependence London Medical Marijuana Support Group Medicines Control Agency Medical Research Council Multiple sclerosis Multiple Sclerosis Society National Drug Prevention Alliance National Health Service NHS National Teratology Information Service Parliamentary Office of Science and Technology Royal College of General Practitioners Royal College of Pathologists Royal College of Psychiatrists Royal Pharmaceutical Society of Great Britain Tetrahydrocannabinol (Ä9tetrahydrocannabinol unless otherwise specified) Written Answer (in Hansard) World Health Organization United Nations
------------------------------------------------------------------- Concern Over Drug Testing At Work (Two letters to the editor of The Times, in Britain, rebut an enthusiastic recent op-ed endorsing urine testing of workers for illegal drugs.) Date: Wed, 11 Nov 1998 20:07:11 -0800 From: email@example.com (MAPNews) To: firstname.lastname@example.org Subject: MN: UK: 2 PUB LTEs: Concern Over Drug Testing At Work Sender: email@example.com Reply-To: firstname.lastname@example.org Organization: Media Awareness Project http://www.mapinc.org/lists/ Newshawk: Steve Young Source: Times, The (UK) Contact: email@example.com Website: http://www.the-times.co.uk/ Pubdate: 11 Nov 1998 Authors: Anthony Morton-Hooper and Stephen Young CONCERN OVER DRUG TESTING AT WORK From Mr Anthony Morton-Hooper: Sir, Dr Patrick Dixon enthuses about the efficacy of workplace drug testing (Feature, "Why we must have drug tests at work," November 5). Sensibly, he acknowledges the importance of education and the primacy of deterrence over punishment. The experience of drug testing in sport offers some guidance and warnings to businesses, and also schools, where drug testing is being introduced. The world of sport has struggled for decades to get its policies right and that world is as much infected by the persistent errors and injustices committed by over-zealous governing bodies who fail to accept the limitations and fallibilities of their drug testing policies as by the activities of the cheating player or athlete. It is only when the consequences of those errors and injustices are considered that sufficient attention will be paid to the need for proper safeguards. The only system of testing deserving public confidence is one which balances toughness of purpose with scrupulous fairness. Drug testing procedures must protect the innocent, the whole process must have integrity (errors in sample collection will determine the analytical result), there can be innocent explanations for microscopic traces of banned compounds, and there must be recourse for the victim of the "false positive". Drug testing in the workplace and in our schools may become the norm. However, if the errors and misjudgments seen in the sports world are repeated by businesses and schools there will be a substantial risk of failing to realise the underlying and legitimate objectives of the policy and a loss of public confidence. Yours sincerely, TONY MORTON-HOOPER, Mishcon de Reya (solicitors), 21 Southampton Row, WC1B 5HS. November 6. *** From Mr Stephen Young: Sir, Calling it a "huge success", Patrick Dixon tries his best to paint a friendly face on mass drug testing, now an institution here in America. He offers little consideration, however, of employees who have done nothing to provoke such a degrading procedure. And what of the fears of employees hesitant to reveal medical conditions to employers? Drug screenings can detect legal drugs, as well as illegal drugs. Innocent employees can experience false positives, and drug-using employees may know how to generate false negatives. Perhaps there are fewer positive drug test results now, as Dixon claims, but it would be ridiculous to assume that the process has had any actual impact on the American drug problem. Drug testing has been a success only as a business, profiting from a form of alchemy by which, at last, urine can be turned into gold with little expense, as long as an employee's dignity and privacy are overlooked as costs. Yours faithfully, STEPHEN YOUNG, Roselle, Illinois 60172 firstname.lastname@example.org November 7.
------------------------------------------------------------------- Judge gives 30 days on drug charge (The Bangor Daily News says a judge in Ireland rejected a prosecutor's call for extended jail time and sentenced John Thompson of Frankfort, the town's road commissioner, to 30 days in jail for unlawful trafficking in scheduled drugs. Waldo County Superior Court Justice William S. Brodrick indicated that the Food and Drug Administration had determined that marijuana was less addictive than caffeine.)Date: Wed, 11 Nov 1998 11:03:00 -0600 From: "Frank S. World" (email@example.com) Reply-To: firstname.lastname@example.org Organization: Rx Cannabis Now! http://www.geocities.com/CapitolHill/Lobby/7417/ To: "DRCTalk Reformers' Forum" (email@example.com) Subject: caffeine was more harmful than marijuana? Sender: firstname.lastname@example.org An interesting article relating to the coffee/marijuana discussion: The Bangor Daily News Wednesday, November 11, 1998 Judge gives 30 days on drug charge By Walter Griffin, Of the NEWS Staff-BELFAST - Suggesting that caffeine was more harmful than marijuana, Waldo County Superior Court Justice William S. Brodrick rejected the prosecution's call for extended jail time and sentenced an admitted pot smoker to 30 days. Brodrick sentenced John Thompson, 40, of Frankfort, the town's road commissioner, to one year in jail with all but 30 days suspended, a $1,000 fine and two years probation after Thompson pleaded guilty to unlawful trafficking in scheduled drugs. Assistant Waldo County District Attorney Leane Zainea had argued for a four-year sentence with all but one year suspended. The sentencing occurred in Waldo County Superior Court on Monday. According to Zainea and defense attorney Christopher MacLean of Camden, Thompson admitted having 2.6 pounds of processed marijuana in his possession when arrested at home in February 1997. Thompson told the court that he had used marijuana for years. During the sentencing phase of the hearing, Justice Brodrick indicated that the Food and Drug Administration had determined that marijuana was less addictive than caffeine. "I think justice was served,'' MacLean said Tuesday. "The court made the proper ruling.'' That was not the interpretation of Detective Gary Boynton of the Waldo County Sheriff's Department. While reluctant to criticize Justice Brodrick, Detective Boynton said the department spent a lot of time and effort on the Thompson case and expected a tougher sentence. He noted that Thompson had two prior marijuana convictions on his record. Attorney MacLean said Thompson was convicted in 1982 of possessing more than 190 marijuana plants and was fined $200. In 1988, he was convicted of possessing 179 plants and received a 90-day suspended jail term and one year probation. MacLean said it was unreasonable to escalate a criminal's sentence from suspended jail time to the one year in prison the district attorney had wanted. He said the punishment should fit the crime and that Thompson deserved a sentence incremental from those he received earlier. "He is an admitted user of marijuana,'' MacLean said. "There were no allegations that he was selling to children or anything like that, just to his friends.'' While District Attorney Zainea declined to comment on Justice Brodrick's comparison between marijuana and caffeine, she indicated that she believed Thompson deserved a more lengthy jail term. -------------------------------------------------------------------
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