Senator Tom George made the following statement on the Senate floor on March 6, 2008:
I rise to comment on the State Board of Canvassers’ recent certification of the initiative to legalize smokeable marijuana for medical use. I oppose this measure because I find that it is unnecessary. The proponents, the Michigan Coalition for Compassionate Care, have misused medical studies in arguing that their measure is needed to treat symptoms in certain medical conditions.
Prior to joining you here in the Legislature, I worked for five years as a medical director for a hospice program in my district. I was board-certified in the specialty of hospice and palliative care. In this capacity, I made house calls and routinely treated the symptoms of dying patients. Occasionally, I prescribed medical marijuana. I was able to do this because it has been legal to prescribe marijuana in pill form in the United States since 1986. This oral form of marijuana is known as Marinol, and it has a very narrow use profile. It is used mostly as a third- or fourth-line therapy to treat persistent nausea or as an appetite stimulant. Its use is limited primarily because much more effective medications are available to treat pain, nausea, agitation, and loss of appetite.
Marinol is, however, better than smokeable marijuana because it does not contain the additional chemicals, impurities, or hazards associated with smoke. Also the resulting blood levels from Marinol and hence the effects are more predictable with Marinol than with smokeable marijuana.
Now the proponents might argue that smokeable marijuana has a special use in the treatment of nausea because patients who are nauseated have difficulty swallowing pills, but recent technology has now given us topical antinausea medicines that are absorbed through the skin. There are at least four of these preparations, and they are all more effective than smokeable marijuana. In addition, other delivery systems such as an oral spray and a metered inhaler device are being developed. Last year, the oral spray received FDA approval to begin clinical trials in the United States. So I’m telling you as a former hospice physician that it is of no benefit to legalize smokeable marijuana because more effective treatments are already available.
Additionally, if one reads the language of the petition initiative, you will see a reference to a 1999 National Academy of Sciences report given as evidence of the benefits of marijuana use. Also the spokesperson for the coalition in favor of the petition initiative cites a report by the American College of Physicians as supportive of legalizing medical marijuana.
I would advise you, colleagues, to read both of these reports. They are available online. Neither of them calls for legalization of medical marijuana. Both, in fact, call instead for more study of the effects of marijuana. The Institute of Medicine report, for example, says, “Purified cannabinoid compounds are preferable to plant products, which are of variable and uncertain composition.” Whereas, “smoke able marijuana is a crude delivery system that also delivers harmful substances.” Likewise, the American College of Physicians’ position paper supports further research and states it “encourages the use of non-smoked forms of marijuana that have proven therapeutic value.”
Both documents then, cited by the proponents, actually then support the position that the ballot initiative is unnecessary because marijuana’s therapeutic use is limited; and in the instances where it is beneficial, a non-smoked form, which is already available, should be prescribed.
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