OF THE
COMMITTEE ON THE JUDICIARY
HOUSE OF REPRESENTATIVES
ONE HUNDRED FIFTH CONGRESS
FIRST SESSION
OCTOBER 1, 1997
STATEMENT OF JANET D. LAPEY, M.D., EXECUTIVE DIRECTOR, CONCERNED
CITIZENS FOR DRUG PREVENTION, INC.
Ms. LAPEY. Thank you, Mr. Chairman and
members of the
committee. I'm Dr. Janet Lapey, president-elect of Drug Watch
International. It is important to remember that in the past, many
unscrupulous doctors peddled unlabeled medicines which did more harm
than good. These Dr. Feelgood's potions often contained addictive
substances such as marijuana, cocaine, or morphine, and many people
unwittingly became addicts. In order to protect the public, laws were
enacted which ensure that no substance is marketed as medicinal until
proven to be both safe and effective.
Currently, there is a well-funded marijuana
lobby which consists of
groups such as the National Organization for the Reform of Marijuana
Laws, (NORML), on whose board Dr. Grinspoon serves, which aim to
legalize marijuana. In 1972, NORML litigated against the DEA in an
attempt to reschedule marijuana as medicine, but in 1994, the U.S.
Court of Appeals ruled in favor of the DEA. The Court noted that the
pro-marijuana parties, which included physicians connected to NORML,
such as Dr. Grinspoon, had relied on non-scientific anecdotes such as
he presented here today.
On the other hand, numerous highly qualified
experts testified that
marijuana's medicinal value has never been proven in sound scientific
studies as required by law. Nevertheless, pro-legalization groups such
as NORML have funded State referenda which aim to bypass our Federal
consumer protection laws and anti-drug laws. These referenda have
deceived the voters with advertisements fraudulently portraying
marijuana as a safe, effective medicine. These referenda were also
helped by blatantly biased media coverage.
At the same time, NORML funds free rock
concerts which target the
youth. A recent example occurred on September 20th this year when
40,000 young people were lured to Boston Common to hear rock music
glorifying drug use and to smoke marijuana openly. The tobacco industry
would never get by with this. The youth were sold hats and cartoon
t-shirt promoting marijuana and drug paraphernalia designed as toys.
There was a thick cloud of marijuana smoke over the Common, and
children as young as 12 explained to rs, some
physicians who are not knowledgeable about the harmful effects of
marijuana have advocated its use by the ill despite the lack of
scientific evidence of safety and efficacy. More informed physicians
have pointed out the fallacies and dangers in that type of reasoning,
as reported in the April 17th New England Journal, because it is wrong
to recommend an unsafe drug of unproved efficacy. Marijuana can make
sick people sicker.
The process by which drugs are approved begins
with studies of
their chemistry, and interchemical reactions must be known and
reproducible, and dosages must be measurable with exactitude. Marijuana
is not a pure substance. It's an unstable, varying, complex mixture of
over 400 chemicals, many of which are harmful substances which have not
been well studied, either alone or in combination with each other. When
smoked, marijuana produces over 2,000 chemicals including hydrogen
cyanide, ammonia, carbon monoxide, acetaldehyde, napthalene; well-known
carcinogens such as benz(a)pyrene, benz(a)anthracene, benzene, and
nitrosamines.
Marijuana is not the safe drug portrayed by the
marijuana lobby. It
is addictive; it adversely affects the immune system; leads to the use
of other drugs such as cocaine; is linked to cases of cancer; causes
respiratory diseases, mental disorders, including psychosis,
depression, panic attacks, hallucinations, paranoia, decreased
cognitive performance, disconnected thought, delusions, and impaired
memory. Marijuana use is a risk factor for the progression to
full-blown AIDS in HIV-positive persons, and HIV-positive marijuana
smokers have an increased incidence of bacterial pneumonia. My
submitted testimony contains scientific reference for all these effects.
In summary, those who aim to legalize marijuana
are preying upon
our most vulnerable citizens: the children, the sick, and the dying.
[The prepared statement of Ms. Lapey follows:]
PREPARED STATEMENT OF JANET D. LAPEY, M.D., EXECUTIVE DIRECTOR,
CONCERNED CITIZENS FOR DRUG PREVENTION, INC.
WHY ISN'T MARIJUANA A MEDICINE?
By federal law, a substance may not be marketed
as a medicine until
it has scientifically been shown to be safe and effective. Marijuana
has never been shown scientifically to be a safe effective medicine for
the treatment of any condition.1\
WHY MUST A SUBSTANCE BE SHOWN TO BE SAFE AND EFFECTIVE?
Before 1906, the prevailing philosophy was
''caveat emptor'' (let
the buyer beware), as many unscrupulous doctors peddled unlabeled
medicines which did more harm than good. These ''snake oil'' salesmen's
potions often contained addictive substances, such as marijuana,
cocaine, or morphine, and many people unwittingly became addicts. In
order to protect the public from such scams and quackery, laws were
enacted which ensure that no substance is marketed as medicinal until
proven to be both safe and effective: the 1906 Pure Food and Drug Act
required that ingredients be listed on the label; then the Food, Drug
and Cosmetic Act of 1938 gave the Food and Drug Administration (FDA)
the authority to require that manufacturers prove their products'
safety. In 1962 this requirement was expanded to include both safety
and efficacy.
IF THE INGREDIENTS OF MARIJUANA WERE LISTED ON THE LABEL, WHAT WOULD
THIS LIST INCLUDE?
Marijuana is not a pure substance but is an
unstable, varying,
complex mixture of over 400 chemicals, many of which are harmful
substances which have not been well-studied either alone or in
combination with each other. New harmful chemical components of
marijuana are still being discovered.2\
When smoked, marijuana produces over 2000 chemicals, including hydrogen
cyanide, ammonia, carbon monoxide, acetaldehyde, acetone, phenol,
cresol, naphthalene, and well-known carcinogens such as benz(a)pyrene,
benz(a)anthracene, benzene, and nitrosamines. Many of these
cancer-causing substances are present in higher concentrations in
marijuana smoke than in tobacco smoke.3\
WHAT ARE THE HARMFUL EFFECTS OF MARIJUANA?
Marijuana is addictive;4\ it
adversely affects the immune system,5\ leads to the use of
other drugs, such as cocaine,6\ and is linked to cases of
cancer, especially in the young, including cancer of the lungs, mouth,
throat, lip, and tongue.7\ Marijuana also causes respiratory
diseases8\
and mental disorders, including psychosis, depression, panic attacks,
hallucinations, paranoia, hostility, depersonalization, flashbacks,
decreased cognitive performance, disconnected thought, delusions, and
impaired memory.9\ Since marijuana impairs coordination and
judgment, it is a major cause of accidents.10 Babies born to
women who smoke marijuana during pregnancy have an increased incidence
of leukemia,11 low birth weight,12 and other
abnormalities.
HOW IS A DRUG APPROVED AS A MEDICINE?
The process by which drugs are approved begins
with studies of
their chemistry, pharmacology, and toxicology. Interchemical reactions
must be known and reproducible, and dosages must be measurable with
exactitude. After a potential medicine is tested in animals, there are
several required phases of testing for safety and efficacy in healthy
human volunteers and later in patients. These clinical trials must be
carefully controlled and conducted by qualified scientists.
HAVE THERE BEEN ANY STUDIES ON MARIJUANA AS A MEDICINE?
Although
marijuana continues to be available for research, over 12,000
scientific studies of marijuana have been published, and the drug has
never been shown to be a safe effective medicine. In June 1991, the
U.S. Public Health Service ordered a study of this issue by scientists
at the National Institutes of Health (NIH). The report, issued in March
1992, concluded that scientific studies have never shown marijuana to
be a safe effective medicine and that there are better, safer drugs
available for all conditions considered.13 Another recent
review by another NIH panel came to the same conclusion, namely that
marijuana has never been shown scientifically to be a safe effective
medicine.14
WHY IS MARIJUANA A SCHEDULE I DRUG?
A Schedule I drug, such as LSD, is a drug which
is highly abusable
with no medicinal value. A Schedule II drug, such as cocaine, is also
highly abusable, but has limited medicinal use. In 1972, the National
Organization for the Reform of Marijuana Laws (NORML), a pro-marijuana
legalization group, and related organizations commenced litigation
against the Drug Enforcement Administration (DEA) in an attempt to
reschedule marijuana from Schedule I to Schedule II. On February 18,
1994, the U.S. Court of Appeals (D.C. Circuit) ruled in favor of the
DEA. The Court noted that the pro-marijuana parties, which included
physicians connected to NORML, relied on non-scientific anecdotal
testimonials, as did the late DEA administrative judge Francis Young,
who had been overruled by the DEA Administrator. On the other hand,
supporting the DEA Administrator were numerous highly qualified experts
who testified that marijuana's medicinal value has never been proven in
sound scientific studies. In addition to the NIH, the FDA, the American
Medical Association, the American Cancer Society, the American Academy
of Ophthalmology, the National Multiple Sclerosis Society, and the
American Glaucoma Society all stated that marijuana has never been
shown scientifically to be a safe effective medicine. Thus, marijuana
remains a Schedule I drug: highly abusable, with no medicinal use.15
WHAT IS THE THC PILL AND WHY IS IT SCHEDULE II?
A synthetic form of
delta-9-tetrahydrocannabinol, THC, the main
psychoactive ingredient of marijuana, was approved by the FDA in 1985
as an anti-nausea agent for cancer chemotherapy patients who had failed
to respond to other drugs. In 1992 it was approved as an appetite
stimulant for patients with AIDS Wasting Syndrome. Synthetic THC
(''Marinol '') is available by prescription in pill form and is a
Schedule II drug: highly abusable, with limited medical use. Unlike
marijuana, Marinol fits the definition of a modern pharmaceutical in
that it is a stable, well-defined, pure substance in quantified dosage
form. The medical use of THC (Marinol) is very restricted because of
harmful side effects, such as addiction and mental disorders, which are
dose-related, as noted in the Physicians' Desk Reference.16
Fortunately, newer, better anti-emetic medications have been developed
recently. Only a very low dose of Marinol is recommended for appetite
stimulation, since larger doses increase adverse effects without
increasing efficacy. Smoking marijuana produces higher plasma THC
levels than are obtained when THC is taken in pill form, and therefore
harmful side effects are greater. The recent NIH panel report, noting
the harm that smoking, including secondhand smoke, causes to society,
has called for the rapid development of an FDA-approved THC inhaler as
an alternative to oral FDA-approved THC.17
WHY DO SOME PEOPLE CLAIM THAT MARIJUANA HAS MEDICAL BENEFITS?
Due to a placebo effect, a patient may
erroneously believe a drug
is helpful when it is not. This is especially true of addictive,
mind-altering drugs like marijuana. A marijuana withdrawal syndrome
occurs, consisting of anxiety, depression, sleep and appetite
disturbances, irritability, tremors, diaphoresis, nausea, muscle
convulsions, and restlessness.18
Often, persons using marijuana erroneously believe that the drug is
helping them combat these symptoms without realizing that actually
marijuana is the cause of these effects. Therefore, when a patient
anecdotally reports a drug to have medicinal value, this must be
followed by objective scientific studies. For instance, in 1990, Dr. J.
P. Frankel conducted a study of the effect of smoked marijuana on his
patients with Parkinson's Disease because one of the patients had
claimed the drug to be beneficial. Dr. Frankel's study showed that the
drug did not improve the symptoms of Parkinson's Disease in any
patient, including the patient who had originally believed it useful.19
Similarly, anecdotal reports had claimed that marijuana caused
improvement in multiple sclerosis. However, a scientifically-controlled
1994 study by Dr. H. S. Greenberg showed that smoking marijuana makes
symptoms of multiple sclerosis worse.20
WHAT GROUPS ARE TRYING TO CLAIM THAT MARIJUANA IS A MEDICINE?
Just as there is a powerful tobacco lobby,
there is a well-funded
marijuana lobby which consists of groups, such as NORML, which aim to
legalize marijuana. In 1979, Keith Stroup, NORML's founder, told an
Emory University audience that they would be using the issue of
medicinal marijuana as a red herring to give marijuana a good name.21
The tobacco industry also promoted cigarettes as medicine until the
Federal Trade Commission halted the practice in 1955. ''Camels'' were
said to prevent fatigue and aid digestion, and ''Kools'' were said to
prevent the common cold.22 Currently, these pro-legalization
groups have funded state referenda which bypass our consumer protection
and anti-drug laws. These groups also fund free rock concerts which
target the youth and feature the sale of drug paraphernalia, hats and
cartoon T-shirts promoting illegal drugs, marijuana jewelry, etc. A
recent example occurred on September 20, 1997, when 40,000 young people
were lured to Boston Common to hear rock music glorifying drug use and
to smoke marijuana openly.23
Dr. Lester Grinspoon, a psychiatrist the board
of NORML, is a long-time advocate of drug legalization. His 1993 book, Marijuana,
the Forbidden Medicine,
promotes marijuana for myriad conditions, including pain, itching,
menstrual cramps, asthma, insomnia, depression and other psychiatric
conditions which marijuana is actually known to cause.24
This book downplays marijuana's harmfulness, referring to its addictive
and gateway properties as a ''hoary myth.'' It was similar
misinformation from Grinspoon downplaying the harmful effects of cocaine25
which was pinpointed by many experts26
as a cause of the nation's cocaine epidemic. Dr. John Morgan is another
physician on the board of NORML who advocates drug legalization.
WHAT WAS THE FEDERAL COMPASSIONATE USE PROGRAM?
In the late seventies, pro-marijuana activists
pressured the
federal government into providing marijuana cigarettes as ''medicine''
for conditions they claimed it benefited. Following the NIH report, the
Bush Administration stopped accepting new customers for the
governmental marijuana hand-out program in 1992. The Clinton
Administration reviewed the policy and came to the same conclusion in
July 1994. Indeed, there is evidence that marijuana makes sick people
sicker. For instance, studies show that HIV-positive smokers progress
to full-blown AIDS twice as fast as non-smokers,27 and
HIV-positive marijuana smokers have an increased incidence of bacterial
pneumonia compared to non-marijuana smokers.28
Regardless, some physicians, who are not knowledgeable about the
harmful effects of marijuana, have advocated its use by the ill despite
the lack of scientific evidence of safety and efficacy. More informed
physicians have pointed out the fallacies and dangers in that type of
reasoning.29
SUMMARY:
Our government has a very crucial role to play
in protecting the
public from the modern day snake oil salesmen. Those who aim to
legalize marijuana are preying upon our most vulnerable citizens: the
children, the sick, and the dying. Marijuana should be subjected to the
same rigorous scientific evaluations for safety and efficacy as are all
other drugs submitted for FDA approval.
NOTES:
1\ Voth EA, Schwartz RS, Ann Int
Med 126:791–798, 1997.
2\ Yamamoto I et al. Pharm
Biochem Behav 40:465–469, 1991.
3\ Huber G. Pharm Biochem Behav
40:630, 1991.
4\ Gold MS. Marijuana,
NY:Plenum Medical Book Co., p. 227, 1989.
Tanda G et al, Science 276:2048–2050, 1997.
De Fonseca FR et al, Science 276:2050–2054, 1997.
5\ Sherman MP et al, Am Rev Resp
Dis 144:1351–1356, 1991.
Spector S et al. Adv Exp Med Bio 288:47–56, 1991.
Djeu J et al. Adv Exp Med Bio 288: 57–62, 1991.
Watzl B et al. Adv Exp Med Bio 288: 63–70, 1991.
Cabral GA et al. Adv Exp Med Bio
288: 93–105, 1991.
6\ Kleber HD. J Clin Psych
49:2(Suppl), p. 3–6, 1988.
7\ Donald PJ Otolaryn Head &
Neck Surg 94:517–521, 1986.
Ferguson RP et al. JAMA 261:41–42, 1989.
Taylor FM. South Med J 81:1213–1216, 1988.
Donald PJ. Adv Exp Med Bio 288:33–46, 1991.
8\ Tashkin DP. West J Med
158:635–637, 1993.
Polen MR et al West J Med 158:596–601, 1993.
9\ American Psychiatric Association,
Diagnostic and Statistical Manual of Mental Disorders (DSM IV),
May 1994.
Schwartz RH. Pediatric Clinics of North America
34:305–317, 1987.
Cherek DR et al. Psychopharmacology 111:163–168, 1993.
Andreasson S et al. Lancet
2:1483–1485, 1987.
Schwartz RH et al. Am J Dis Child 143:1214–1219, 1989.
10 Soderstrom CA et al. Archives
of Surg 123:733–737, 1988.
Williams AF et al. Public Health Report 100:19–25, 1985.
Department of Transportation. National Transportation Safety
Board Report, Washington DC, February 5, 1990.
Brookoff D et al. New Eng J Med 331:518–522, 1994.
Leirer VO et al. Aviat Space Environ Med 62:221–227, 1991
11 Robison LL et al. Cancer
63:1904–1910, 1989.
12 Zuckerman B et al. New Eng J
Med 320:762–768, 1989.
13Journal of the National
Cancer Institute 84:475, April 1, 1992.
14 National Institutes of Health
Panel Report, Medical Utility of Marijuana, August 8, 1997
15Federal
Register 54:53783, December 29, 1989.
Federal Register 57:10499, March 26, 1992.
16Physicians' Desk Reference,
Medical Economics Company, Oradell, NJ, 1996.
17 National Institutes of Health
Panel Report, Medical Utility of Marijuana, August 8, 1997.
18 Gold MS. Marijuana,
NY:Plenum Medical Book Co., p. 103, 1989.
22 Ecenbarger W. The
Philadelphia Inquirer, November 17, 1991.
The Boston Globe, September
21, 1997.
Feder, Don, Boston Herald, September 24, 1997.
24 Grinspoon L, Bakalar JB. Marijuana,
the Forbidden Medicine, Yale University Press, New Haven, 1993.
25 Grinspoon L, Bakalar JB. Drug
Dependence. In: Kaplan HI et al, eds. Comprehensive Textbook of
Psychiatry, 3rd Ed., Baltimore: Williams & Wilkins, 1980.
26 Gawin FH, Ellinwood EH. New
Eng J Med 318:1173–1182, 1988.
Kleber HD, op. cit.
27 Nieman RB et al. AIDS
7:705–710, 1993.
Caiaffa WT et al, Am J Respir Crit Care Med
150:1493–1498, 1994.
28AIDS Weekly, p. 19, June
28, 1993.
Tindall B et al, Aust N Z J Med 18:8–15, 1988.
29 Tashkin DP et al, New Eng J
Med 336:1186, 1997
Tilelli JA, New Eng J Med
336:1185–1186, 1997.
Kanof PD, New Eng J Med 336:1184, 1997.
Domino L, New Eng J Med 336:1185, 1997.
Taub A, New Eng J Med 336:1185, 1997.
58955bm.eps
SUMMARY
WHY IS MARIJUANA NOT A MEDICINE? In the
past,
unscrupulous doctors peddled unlabeled quack medicines which did more
harm than good and often contained addictive substances, such as
marijuana or cocaine. The Pure Food and Drug Act then required that
ingredients of medicines be listed on the label, and the Food, Drug and
Cosmetic Act gave the Food and Drug Administration (FDA) the authority
to require that manufacturers prove their products' safety and
efficacy. Marijuana is not FDA-approved because it has never been shown
scientifically to be a safe effective medicine for the treatment of any
condition.
WHAT ARE THE RESULTS OF STUDIES ON MARIJUANA?
A 1992
report by scientists at the National Institutes of Health (NIH)
concluded that scientific studies have never shown marijuana to be a
safe effective medicine and that there are better, safer drugs
available for all conditions considered. The federal government then
halted its ''compassionate use'' program; it was determined that it is
not compassionate to pass out harmful drugs of unproven efficacy. For
instance, studies show that HIV-positive smokers progress to full-blown
AIDS twice as fast as non-smokers, and HIV-positive marijuana smokers
have an increased incidence of bacterial pneumonia compared to
non-marijuana smokers. Marijuana is an unstable, varying, complex
mixture of over 400 chemicals, many of which are toxic. When smoked,
marijuana produces over 2000 chemicals, including hydrogen cyanide,
ammonia, carbon monoxide, and well-known carcinogens, such as
benz(a)pyrene, benz(a)anthracene, benzene, and nitrosamines. Marijuana
is addictive; it depresses the immune system, leads to the use of other
drugs, such as cocaine; it causes respiratory diseases, is linked to
cases of cancer of the lungs, mouth, throat, lip, and tongue; it causes
mental disorders, such psychosis, depression, panic attacks,
hallucinations, paranoia, decreased cognitive performance, disconnected
thought, delusions, and impaired memory; it impairs coordination and
judgment and is a major cause of accidents. Prenatal exposure causes
low birth weight and an increased incidence of leukemia.
WHAT IS THE THC PILL?
A synthetic form of delta-9-tetrahydrocannabinol (THC), the main
psychoactive ingredient of marijuana, has been approved by the FDA as
an anti-nausea agent for cancer chemotherapy patients and as an
appetite stimulant for patients with AIDS Wasting Syndrome. Unlike
marijuana, synthetic THC (''Marinol'') is a stable, well-defined, pure
substance in quantified dosage form.
WHO IS BEHIND THE MARIJUANA AS MEDICINE
MOVEMENT?
There is a well-funded marijuana lobby which consists of groups, such
as the National Organization for the Reform of Marijuana Laws (NORML),
which aim to legalize marijuana. In 1979, Keith Stroup, NORML's
founder, announced that they would be using the issue of medicinal
marijuana as a ''red herring'' to give marijuana a good name.
Psychiatrist Lester Grinspoon, on the board of NORML, is a long-time
advocate of drug legalization and promotes marijuana for myriad
conditions, such as pain, itching, menstrual cramps, asthma,
childbirth, insomnia, depression and other psychiatric disorders which
marijuana actually known to cause. NORML and other pro-marijuana groups
petitioned the Drug Enforcement Administration (DEA) in an attempt to
reschedule marijuana as medicine, but the U.S. Court of Appeals (1994)
ruled in favor of the DEA. The Court noted that whereas the physicians
connected to NORML relied on non-scientific anecdotal testimonials,
numerous highly qualified experts, as well as the FDA, the American
Medical Association, the American Cancer Society, the American Academy
of Ophthalmology, the National Multiple Sclerosis Society, and the
American Glaucoma Society, all testified that marijuana's medicinal
value has never been scientifically proven.
WHY-DO SOME PATIENTS BELIEVE TEAT MARIJUANA
IS BENEFICIAL?
Due to a placebo effect, a patient may erroneously believe a drug is
helpful when it is not and may fail to observe its harmful effects.
This is especially true of an addictive, mind-altering drug like
marijuana. Therefore, when a patient anecdotally reports a drug to have
medicinal value, this must be followed by objective scientific studies.
For instance, anecdotal reports had claimed that marijuana caused
improvement in multiple sclerosis, yet a scientifically-controlled 1994
study by Dr. H. S. Greenberg showed that smoking marijuana makes
symptoms of multiple sclerosis worse. Thus, marijuana should be
subjected to the same rigorous scientific evaluations for safety and
efficacy as are all other drugs submitted for FDA approval.
Concerned Citizens for
Drug Prevention, Inc.,
Hanover, MA, October 2, 1997.
Hon. BILL MCCOLLUM, Chairman,
Subcommittee on Crime,
Committee on the Judiciary,
House of Representatives, Washington, DC.
DEAR CHAIRMAN MCCOLLUM: As an addendum
to my testimony
at the October 1, 1997 Subcommittee on Crime hearing on medicinal uses
of marijuana, I would like to comment on the interchange which occurred
when you quoted Dr. Lester Grinspoon's entry in the 1985 Comprehensive
Textbook on Psychiatry
which stated, ''If used moderately and occasionally, cocaine creates no
serious problems.'' You asked, ''Is that an accurate statement?'' Dr.
Grinspoon replied, ''That is an accurate statement.''
However, that is not an accurate statement.
Indeed, in the Journal of Clinical Psychiatry
49:2 (Suppl) February 1988, Herbert D. Kleber, MD quoted this exact
statement by Dr. Grinspoon as an example of his many statements which
downplayed the dangers of cocaine and fueled the cocaine epidemic.
Cocaine used ''moderately and occasionally'' may result in serious
problems. For example, an article in The New England Journal of
Medicine
321:1557–1562, 1989 entitled ''Cocaine-Induced Coronary Artery
Vasoconstriction'' pointed out that even small amounts of cocaine may
cause spasm in the arteries bringing blood to the heart. It is also
well known that cocaine is very addictive, that compulsive use
generally begins with casual use, and that this process may have a very
rapid onset.
The
importance of this is that we are concerned with reducing the demand
for drugs. By falsely promoting marijuana as a safe medicine and
downplaying the dangers of marijuana, cocaine, etc., the public is
encouraged to use drugs, and there is a consequent rise in addiction
and rise in the demand for drugs. This was pointed out in two articles:
First, in Dr. Kleber's article quoted above, he writes that there are
six causes for increased use of cocaine, ''They are myths concerning
its safety, the relationship to marijuana use, the media, celebrity
endorsements, changes in the routes of administration, and the
reinforcing effects of the drug itself.
''Despite earlier cocaine problems, some
influential, contemporary
scientific writings reflected the noncritical opinions about cocaine
that existed before 1910. For example, in the 1980 Comprehensive
Textbook on Psychiatry (ref: Grinspoon L, Wilkins & Wilkins,
Baltimore, pp 1614–1628) the following passage is found:
'Used no more than two or three times a week, cocaine creates no
serious problems. In daily and fairly large amounts, it can produce
minor psychological disturbances. Chronic cocaine abuse usually does
not appear as a medical problem.'
It should be noted that in the 5 years preceding this quotation,
1974–1979, cocaine use had doubled.
''The 1985 edition of the same textbook (ref:
Grinspoon, L, pp
1003–1015) reflected little change in this remarkably benevolent
attitude about cocaine's dangers:
'High
price still restricts consumption for all but the very rich and those
involved in trafficking. . . . If used moderately and
occasionally,
cocaine creates no serious problems.'
Authoritative statements such as these fostered the myth that cocaine
was safe and contributed to the increase in its use.''
A second article in The New England Journal
of Medicine
318: 1173–1182, 1988 entitled ''Cocaine and Other Stimulants'' by Frank
H. Gawin, MD and Everett H. Ellinwood, Jr., MD stated, ''Seven years
ago, cocaine was claimed to be a relatively safe nonaddicting
euphoriant agent. (ref: Grinspoon, L., 1980 Comprehensive Textbook
on Psychiatry,
Wilkins & Wilkins, Baltimore) . . . Believing the drug
was safe,
millions of people tried cocaine, and cocaine abuse exploded.''
Since the medicinal marijuana referenda passed
because of similar
misinformation, I believe that this is a very crucial issue in the
debate. Thank you very much for inviting me to testify.
Sincerely,
Janet D. Lapey, M.D.
Mr. MCCOLLUM. Thank you very much, Dr.
Lapey. I
realize you are going to have to go to the Senate in a few minutes. If
you have to excuse yourself early, please do. However, we're going to
have questions in just a couple moments and if you can stay, we'd love
to have you.