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Ailing elderly new face of drug
Many turning to pot to ease pain


By ERIC BAILEY
Los Angeles Times


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May 05. 2005 8:00AM


SEATTLE - Betty Hiatt's morning wake-up call comes with the purr and
persistent kneading of the cat atop her bedspread. Under predawn gray,
Hiatt blinks awake. It is 6 a.m., and Kato, an opinionated Siamese who
Hiatt swears can tell time, wants to be fed.

Reaching for a cane, the frail grandmother pads with uncertain steps to the
tiny alcove kitchen in her two-room flat. Her feline alarm clock gets his
grub, then Hiatt turns to her own needs.

She is, at 81, both a medical train wreck and a miracle, surviving cancer,
Crohn's disease and the onset of Parkinson's. Each morning, Hiatt takes
more than a dozen pills. But first she turns to a translucent orange
prescription bottle stuffed with a drug not found on her pharmacist's shelf
- marijuana.

Peering through owlish glasses, Hiatt fires up a cannabis cigarette with a
wood-stem match. She inhales. The little apartment - a cozy place of
knickknacks and needlepoint - takes on the odor of a rock concert.

"It's like any other medicine for me," Hiatt says, blowing out a cumulus of
unmistakable fragrance. "But I don't know that I'd be alive without it."

With the U.S. Supreme Court poised to soon rule on whether medical
marijuana laws in California and nine other states are subject to federal
prohibitions, elderly patients such as Hiatt are emerging as a potentially
potent force in the roiling debate over health, personal choice and states'
rights.
No one knows exactly how many old folks use cannabis to address their ills,
but activists and physicians say they probably number in the thousands. And
unlike medical marijuana's younger and more militant true believers, the
elderly are difficult for doubters to castigate as stoners.

Their pains are unassailable. Their needs for relief are real. Most never
touched pot before. As parents in the counterculture '60s, many waged a
generation-gap war with children getting high on the stuff. Now some of
those same parents consider the long-demonized herb a blessing.

Patients contend cannabis helps ease the effects of multiple sclerosis,
glaucoma and rheumatoid arthritis. It can calm nausea during chemotherapy.
Research has found that cannabinoids, marijuana's active components, show
promise for treating symptoms of Parkinson's disease and Alzheimer's,
perhaps even as anti-cancer agents.

A recent AARP poll found that 72 percent of people age 45 or older believed
adults should be allowed to use cannabis with a physician's recommendation.
(The poll found a similar proportion staunchly opposed to legalizing
recreational pot.) Even conservative elders such as commentator William F.
Buckley and former Secretary of State George Shultz have supported
marijuana as medicine.

Hiatt and those like her are "more and more the face of the marijuana
smoker," said Ethan Nadelmann of the Drug Policy Alliance, which advocates
treating cannabis like alcohol: regulated, taxed and off-limits to teens.

"There's this sense that when you get old enough, you've earned the right
to live your own life,"Nadelmann said. "The mantra of the drug war has been
to protect our kids. But the notion of a drug war to protect the elderly?
That's ludicrous."

Congress and federal drug regulators have repeatedly rebuffed pleas to
legalize medical use of cannabis, which is classified as a dangerous
Schedule I drug, along with heroin and LSD.

Stories of suffering elders are not lost on John Walters, President Bush's
point man for the war on illegal narcotics. But as he beats the drum for
psychotropic abstinence, the drug czar doesn't mince words.

"The standard of simply feeling different or feeling better" does not make
pot safe and effective medicine, said Walters, director of the White House
Office of National Drug Control Policy. People who abuse illegal drugs such
as crack cocaine feel a similar burst of euphoria, he noted, "but that
doesn't make crack medicine."

Walters argues there is not a whiff of clinical proof qualifying smoked pot
as medicine. Any beneficial compounds that do exist in the leafy plant, he
said, should be synthesized, sent through the rigors of the regulatory
process and packaged as a pharmaceutical, not smoked like black-market weed.

"This is not like growing a rosebush in your yard," Walters said. "This is
a plant the products of which are used for serious and expensive abuse
among illegal drugs."

Hiatt isn't seeking a recreational high at this early hour, with much of
Seattle asleep.

She received a diagnosis of breast cancer in 2001. Chemotherapy left her a
wreck. She threw up anti-nausea drugs, so her oncologist suggested
cannabis, legal for medical purposes in the state of Washington.

"I thought he was a little off track," she recalls. "I had never done
anything like that. I was very uneasy."

A few puffs of pot smoke each morning help quell the nausea caused by her
prescription drugs, she said. Her appetite is restored and she never gets
high.

Her two granddaughters, ages 18 and 20, display a ho-hum attitude about
Granny toking up.

"It's just totally the norm," said Jessica, the older of the two.

Hiatt's son Doug, a defense attorney, endorses his mother's use of medical
pot, picking up her cannabis every few weeks from a collective.

Her other son doesn't share that unfettered faith. Dan Hiatt, an assistant
district attorney in Atlanta, was shocked to learn his mother was seeking
relief from a drug that has landed many a pusher behind bars, his mother
recalled. (Dan Hiatt declined to be interviewed.)

But he never tried to talk her out of it, Betty Hiatt said. "I don't think
he likes it, but he accepts it. He loves me. He knows I wouldn't be doing
it for fun."

Hal Margolin, 73, claims the same dependency.

Pain drove the Santa Cruz, Calif., man to the drug. It began a decade ago,
as the cervical vertebrae at the top of Margolin's back calcified,
strangling a bundle of nerves and producing a searing sensation in his
extremities. His feet can feel as if scalded by boiling water.

Margolin tried to address the unrelenting agony the standard way, buying
maxi-packs of Advil and Aleve. An operation made things worse. He lost the
feeling in his fingers and the soles of his feet, and at times he was
reduced to crawling to the bathroom. Despite a prosperous retirement, a
good marriage and two happy grown children, Margolin contemplated suicide.

He tried pot at a friend's urging. A few tokes and the pain seemed to
recede to the background, Margolin said. "I was no longer obsessing" about it.

Finding marijuana early on was no easy task. At times, the bald and
bespectacled retiree was forced out on the streets to score his weed.

Dressed in a cardigan sweater against the coastal cool, he would amble
along the ramshackle blocks adjacent to the town's beachfront Boardwalk.
Mustering his courage, Margolin would approach one of the street kids he
figured was dealing. Most of the time they scoffed.

"They thought I was some kind of undercover cop," he said.

Now he gets his cannabis from a Santa Cruz dispensary serving 200 patients,
many terminally ill. In a decade of operation, the cannabis cooperative has
lost more than 150 clients to cancer, AIDS and other ills. A woman who used
pot to tame the painful aftereffects of polio died last year at 93.
Margolin now is among the oldest.

For him, marijuana has been "the difference between clinical depression
from the pain, and carrying on with my life."

Although it was part of the U.S. pharmacopeia early in the 20th century,
cannabis was outlawed during the Depression. In recent decades, advocates
have repeatedly failed to gain federal approval for doctors to prescribe
the herb.

An exhaustive 1999 study by the National Academy of Science's Institute of
Medicine concluded that marijuana can help curb pain, nausea and
AIDS-related weight loss. The study warned against the toxic effects of the
smoke, but said cannabis could be given under close doctor supervision to
patients who don't respond to other therapies.

Now several small drug companies are pressing forward with prescription
forms of the drug, such as the cannabis mouth spray that G.W.
Pharmaceuticals of Britain is expected to soon begin marketing in Canada.

During the buildup to prescription forms, the raw plant shouldn't be
ignored, said Dr. Raphael Mechoulam, a pioneer in cannabinoid chemistry at
Hebrew University of Jerusalem. If it helps the elderly fight pain until
prescription drugs are available, he said, "then why not?"

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------ End of article

By ERIC BAILEY

Los Angeles Times

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