published Saturday, April 24th, 2010

Debate fires up over medical marijuana use

by Emily Bregel
Audio clip

Tamar Todd

In a recurring dream, John Donovan can run without pain. He races down a football field as he did in middle school and glides down a flight of stairs with ease.

But in reality, the 25-year-old Red Bank resident wakes up to a relentless aching in his joints, mainly his hips, knees and ankles.

Just a few months after the onset of juvenile rheumatoid arthritis, when he was 16, Mr. Donovan struggled to run or even walk quickly, he recalled. He now walks with a heavy limp and spends some days in bed, trying to move as little as possible.

For Mr. Donovan -- who doesn't drink alcohol or smoke cigarettes -- daily hits of marijuana from a glass pipe lessen his pain, without inflicting the severe nausea and other side effects he experiences from prescribed painkillers.

  • photo
    Staff Photo by Angela Lewis/Chattanooga Times Free Press John Donovan smokes marijuana to ease pain caused by juvenile rheumatiod arthritis. He advocates the legalization of medical marijuana.

He spends $400 to $600 a month to buy an ounce of marijuana from friends, and he usually smokes the illegal plant in the afternoon to remain "clear headed" in the daytime, he said.

"I'd much rather go to a pharmacy, but right now my choice is I have to go and partake in an illegal activity to acquire something that could be beneficial to me," he said. "That's not a choice that I want to make."

Mr. Donovan, who qualifies for TennCare under a disability category, said he is an avid proponent of a bill pending in the Tennessee General Assembly that would legalize medical marijuana use for people with certain conditions, such as cancer, multiple sclerosis and epilepsy, with a physician's recommendation.

Chattanooga oncologist Dr. B.W. Ruffner said he never has felt the need to suggest marijuana to a cancer patient.

"I don't think there are any benefits that you can't get in other ways," he said.

For nausea control, a synthetic form of THC -- the active ingredient in marijuana -- is available legally in pill form as Marinol, said Dr. Ruffner, president of the Tennessee Medical Association.

"That's a cleaner, safer way to give somebody cannabinoids if that's what you want to do," he said.


The Tennessee bill, pending in the House Health and Human Resources committee, has no real chance of passing this session, as its counterpart in the Senate has not been debated yet, said the House sponsor, Rep. Jeanne Richardson, D-Memphis. She's hopeful about the bill's chances next session.

Next week the House committee likely will consider amending the bill to create a study committee on the issue, she said.

The suggestion of further study was made by Rep. Joey Hensley, R-Howenwald, who opposes the bill. The family medicine doctor said he's concerned about the lack of clinical guidelines for doctors to follow in recommending marijuana to patients.

"I'm a physician myself, and I have no idea how to prescribe marijuana and what it's really for," he said. "I don't deny that it probably does help with nausea for people with cancer, but I don't know about all these other things it's claimed to help."

Rep. Richardson said she's fully in support of a study committee on the issue.

"The study can't hurt us, because the more you objectively look at it, the more you understand" the benefits of medical marijuana, she said. "I've read the studies. I know what's out there, and I think if we can get people to do the same, I think it will pass."

A supporter of the bill, Rep. JoAnne Favors, D-Chattanooga, said she's heard from many pain medicine specialists who believe medical marijuana should be available to their patients.

"It has less side effects than many of the legal narcotics that we have prescribed for us, the hydrocodone and some of the others that have caused considerable addiction," said Rep. Favors, who is a registered nurse.

Rep. Stacey Campfield, R-Knoxville, voted against the bill when it was in the House government operations committee. He worried the bill would result in the "free-for-all" of the medical marijuana program in California, where he said people easily can access marijuana when it is not medically warranted. California became the first U.S. state to legalize medical marijuana in 1996.

"As it was written, (the bill) was too wide open for me," Rep. Campfield said.

Tennessee's bill would create one of the more highly regulated programs in the nation, said Tamar Todd, staff attorney for the New York-based Drug Policy Alliance, which advocates for the reform of drug laws, including legalized medical marijuana.

About 300,000 sick people in Tennessee are living with conditions that could qualify them for the proposed access program, proponents of the bill say.

Mr. Donovan might be able to qualify to use medical marijuana under the category of chronic, debilitating pain, bill supporters say.


Marijuana has been used therapeutically for at least 5,000 years, first recorded in ancient China. The mild hallucinogen was a part of the U.S. pharmacological list from the late-1800s to 1942, according to a 1999 Institute of Medicine report exploring the therapeutic uses of the drug.

Under a federal law passed in 1970, marijuana today is classified alongside drugs such as heroin and LSD as a Schedule I drug. That classification indicates marijuana has high potential for abuse and no known medical benefits.

The American Medical Association and American College of Physicians have requested a reassessment of marijuana's classification, since it hinders future research into the drug's medical benefits. The Institute of Medicine reported in 1999 that a range of biological studies show a number of therapeutic potentials for marijuana-based drugs but that clinical data is scarce due to legal constraints.

Marijuana's medical uses already documented range from an appetite stimulant and nausea suppressant for cancer patients to recent findings that the chemicals in cannabis can inhibit the growth of tumors in prostate cancer patients, according to a 2009 British Journal of Cancer article.

Based on patient surveys, it's likely that 25,000 patients in Tennessee with cancer, AIDS-HIV, hepatitis-C or multiple sclerosis already are using marijuana illegally, often with the quiet consent of their medical providers, said Bernard Ellis, a former National Institutes of Health official and public health epidemiologist, who wrote the Tennessee legislation.

For years Mr. Ellis grew cannabis on his farm outside Santa Fe, Tenn., to ease his pain from fibromyalgia, and he said he also quietly provided marijuana to a network of cancer and AIDS/HIV patients. In 2002, he faced federal prosecution and was put on probation after he refused to sell marijuana to a local drug dealer, who reported him to the authorities, he said.


Supporters of the legislation in Tennessee say the momentum toward legalization of marijuana for medical uses is growing nationwide.

Despite federal law prohibiting the use of marijuana, 14 states allow medical marijuana use, and at least 14, including Tennessee, are considering legislation to do so, Rep. Richardson said.

"This is no longer a fringe issue," Rep. Richardson said when introducing the bill last week to the House health and human resources committee.

Medical marijuana is not about "Cheech and Chong smoking a bong. That is not what we're talking about here. We're talking about compassion," she told legislators.

About 81 percent of Americans support legalizing the use of marijuana for medical purposes, according to a recent ABC News/Washington Post poll.

Dr. Gene Huffstutter, a local rheumatologist, said the medical data for the drugs' benefits for arthritic patients such as Mr. Donovan is very limited. But the drug's classification as a Schedule I drug is a barrier to more research, he said.

"There are some potential legitimate uses for it and, unless we're allowed to study it and capture that data, we won't know," Dr. Huffstutter said.

Mr. Donovan says he feels compelled to take a stand on the issue of medical marijuana.

"If it were just me, I probably would continue to just use illegally, because I can get the product," he said. "But it does affect so many people, so many lives."


Under the House bill, H.B. 2562, patients could be eligible for a doctor's recommendation to use medical marijuana if they have one of the following conditions: cancer, Hepatitis-C, multiple sclerosis, epilepsy, glaucoma, severe debilitating chronic pain, severe nausea, Crohn's disease, Alzheimer's, Lou Gehrig's disease, wasting syndrome or if they are enrolled in end-of-life care through hospice.

Any Tennessee farmer could apply to be licensed and overseen by the state Department of Agriculture as a supplier. The state Board of Pharmacy would regulate processors who package the drug, and the Tennessee Department of Health would license and oversee dispensaries. Patients and caregivers would not be permitted to grow their own marijuana.


This year an ABC News poll found that 81 percent of Americans support legalizing use of marijuana for medical purposes. A 2004 AARP poll found that almost three-quarters of 1,706 adults 45 and older surveyed said they believe adults should be allowed to use marijuana legally if a physician recommends it.

The bill could make an ounce of pot available to patients for as little as $60 an ounce, supporters say. Within five years, proponents say the program could bring an estimated $450 million in revenues annually, $85 million of which would be excess revenues for the state.


In Tennessee, possession of an ounce or less of marijuana is a misdemeanor offense punishable by up to 11 months and 29 days in jail or a fine of $250. Any amount over half an ounce is presumed as a "resale" quantity and can be classified as felony possession, punishable by a $2,000 fine and between one and six years in jail, depending on one's prior record. Possession of 20 to 99 marijuana plants also is considered a felony.

Source: Jerry Sloan, assistant district attorney, Hamilton County

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Continue reading by following these links to related stories:

Article: Weighing the pros and cons of using marijuana

Article: Many felony pot cases getting tossed out of court

Free Press Editorial: Crime and 'medical' marijuana

Article: California pot vote isn’t just hippies versus cops

about Emily Bregel...

Health care reporter Emily Bregel has worked at the Chattanooga Times Free Press since July 2006. She previously covered banking and wrote for the Life section. Emily, a native of Baltimore, Md., earned a bachelor’s degree in American Studies from Columbia University. She received a first-place award for feature writing from the East Tennessee Society of Professional Journalists’ Golden Press Card Contest for a 2009 article about a boy with a congenital heart defect. She ...

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MountainJoe said...

Don't we have actual crimes to pursue in TN? You know, murder, rape, robbery, and bad stuff like that? No need to prosecute patients for taking medicine that eases their symptoms and harms no one else.

April 24, 2010 at 12:20 a.m.
Humphrey said...

I agree - if someone is in pain and it helps them out, it isn't hurting anyone else. I don't smoke it, but I know that we humans are fragile and we can find ourselves with physical conditions we didn't expect - if someone finds some peace let them have it.

April 24, 2010 at 8:45 a.m.

Think about it, if you were a police officer which would you rather attempt to arrest, a violent possibly armed criminal or a mellow stoner? It's the easy way out for the cops, to them an arrest is an arrest. Capture a murderer or arrest someone with a joint, it's all the same to them. Go ahead murder, rape, or rob it's OK, the police have a hippy to persue.

April 24, 2010 at 8:55 a.m.
nucanuck said...

A majority in the US now favor treating marijuana the same as alcohol. The sooner we get there,the better for the country.

April 24, 2010 at 9:29 a.m.
Sailorman said...

Sorry NC can't do that. Look at the effects:

A lot less for the DEA to crow about busting those nasty maryjane loons

More tax revenue (can't believe the thieves in DC don't want this one)

A dramatic drop in prison population

A clog in the court system removed

Government leaving a substantial portion of the populace alone instead of hassling them.

Hmmm maybe it wouldn't be so bad.

April 24, 2010 at 10:42 a.m.
nucanuck said...

Yea,you're right SM,what was I thinking?

April 24, 2010 at 5:12 p.m.
MountainJoe said...

If nucanuck and I can come together on this issue (and somehow the earth didn't implode) then maybe our politicians can get a clue for once ... ?

April 24, 2010 at 9:30 p.m.
paulkuhn said...

Dr. B. W. Ruffer claims Marinol is "...a cleaner, safer way to give somebody cannabinoids" compared to natural marijuana. His view is wrong for several reasons as my late wife found when she evaluated alternatives before beginning high-dose chemotherapy.

First, Marinol, a powerful synthetic drug developed in cooperation with the DEA, contains a single cannabinoid, THC. Marijuana contains more than 60 naturally occurring cannabinoids. Clinical data demonstrate the synergism of the many cannabinoids found in marijuana is more efficacious than THC alone.

Second, Marinol is more psychoactive than natural marijuana and this causes great discomfort in many patients.

Third, Marinol is administered orally while marijuana can be inhaled by vaporization or smoking. Because of its rapid onset, vaporized cannabis is more desirable than Marinol for patients requiring a fast-acting therapeutic agent, such as those combating oncoming attacks of nausea, seizures or muscle spasms.
Fourth, patients report they prefer natural marijuana to Marinol. When Tennessee had a medical marijuana program in the 1980s, the Tennessee Board of Pharmacy found a "23 percent higher success rate among those patients smoking than among those patients administered THC capsules" in the treatment of nausea and/or vomiting associated with cancer chemotherapy. Researchers in New Mexico observed similar findings: "When the routes of [drug] administration were analyzed separately, it was found that inhalation was far superior to ingestion: 90.39 percent of the patients in the group that inhaled the marijuana showed improvement while only 59.65 percent of the patients in the group that orally ingested the delta-9-THC showed improvement."
Sixth, Marinol is more expensive than natural marijuana. Patients, particularly those with chronic conditions, often report that Marinol's market cost limits their use of the drug. Doctors also report that Marinol's high cost dissuades them from prescribing it to patients. In one survey of HIV/AIDS specialists, among respondents who had never prescribed Marinol to their patients, 33 percent cited the high cost of the drug as the reason. Natural cannabis, even at its inflated black market value, often remains far less costly for patients than oral synthetic THC and Tennessee’s Safe Access to Medical Cannabis Act further reduces the cost of natural marijuana. Finally, Marinol is potentially fatal. Natural marijuana is incapable of causing death by overdose. I would wager that because of it many disadvantages, Dr. Ruffner rarely prescribes Marinol. Unfortunately for his patients, he has no interest in being able to prescribe a compound that is superior to Marinol in virtually every respect.

April 25, 2010 at 9:39 a.m.
MountainJoe said...

Well put paulkuhn. There is no defensible moral basis for denying patients the most effective medicine for their condition.

Those who oppose medical marijuana want their fellow human beings to suffer and perhaps die needlessly. That is morally reprehensible.

April 25, 2010 at 10:34 p.m.
doctorK said...

I am glad that medical marijuana industry is “emerging”. Indeed, medical marijuana is very helpful in a variety of medical conditions to such an extent that Canadian Government even pays for this medicinal plant for their veterans. American Medical Association now supports medical marijuana and urges the Government to change its classification, because its current DEA classification as Schedule I drug is contrary to all scientific reality. As opposed to most other medications, controlled or even over-the-counter, medical marijuana is not associated with lethal overdoses or physical withdrawal syndrome. I worked as a Program Physician in several drug-addiction clinics of Philadelphia, and the only pure "marijuana addiction" cases I saw were those referred by Parole or Probation Departments after failing a drug test. Not the best way to spend taxpayer money, if you ask me. The so-called "gateway drug" theory is by now completely discredited by the science of addiction medicine, so politicians need to stop acting as if it were valid. Cannabis use has, on the other hand, been shown to suppress violent behavior. Of course, there will be problems related to medical marijuana in general, but these problems should not divert our attention from the remarkable medicinal qualities of Cannabis Sativa. Perhaps a quote from a true expert will summarize this situation: “Cannabis will one day be seen as a wonder drug, as was penicillin in the 1940s. Like penicillin, herbal marijuana is remarkably nontoxic, has a wide range of therapeutic applications and would be quite inexpensive if it were legal”. Dr. Lester Grinspoon, professor of psychiatry at Harvard Medical School, Los Angeles Times, May 5, 2006 ”

April 29, 2010 at 10:44 a.m.
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