THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Tuesday, November 5, 1996 TAG: 9611050279
SECTION: LOCAL PAGE: B1 EDITION: FINAL
SOURCE: BY DEBRA GORDON, STAFF WRITER
LENGTH: 91 lines
Portsmouth native Irvin Rosenfeld doesn't think today's California ballot initiative that would legalize medicinal use of marijuana is worded appropriately.
He should know.
Rosenfeld smokes 10 to 15 marijuana cigarettes a day - courtesy of the federal government - to control chronic pain from a rare bone disorder he has suffered since childhood.
The 43-year-old stockbroker, who now lives in Fort Lauderdale, Fla., was instrumental in getting a similar law passed in Virginia nearly two decades ago - and in persuading the federal government to grow and supply the leafy plant he smokes.
The Virginia law permits possession or distribution of marijuana for medical purposes, and allows doctors and pharmacists to prescribe and dispense it.
But the California law, Rosenfeld said, is too lenient because it doesn't require a doctor's prescription for a person to possess the drug.
Rosenfeld first discovered the therapeutic benefits of pot smoking while he was a freshman in a Miami college in 1971. Upon his return to Portsmouth, where he owned a furniture store, he went to the police, he said, and asked if they would give him their confiscated marijuana.
They couldn't, so he bought it on the street.
After the 1979 law passed, he got a prescription from his doctor and took it to a pharmacy.
``He couldn't fill it, it was a very gray area. But at this point, I felt I was complying with Virginia law,'' Rosenfeld said in a phone interview. So he continued buying the drug on the streets, always armed with his prescription.
In 1982, he was one of the first people approved for a government program to supply the drug on a ``compassionate'' basis.
The National Institute of Drug Abuse grows a small patch of marijuana in Oxford, Miss., for the program. In 1992, however, the program was flooded with requests from AIDS patients for marijuana - which stimulates the appetite - and the government closed the program, grandfathering in Rosenfeld and seven other people.
The drug doesn't have any effect on him - other than to take away his pain, he said. All his clients and the people he works with know he smokes it.
``It wouldn't do to have someone say I lost their money because I was high,'' he said.
He'd prefer not to smoke pot. ``I hate smoking. It's nasty. But I can't eat (the marijuana), it doesn't work for me that way. I would love to have another medicine that works for me.''
In Virginia these days, doctors rarely, if ever, prescribe marijuana. Instead, they usually prescribe Marinol, a pill form of synthetic THC, the active ingredient in marijuana. It is usually given for nausea or pain. And even those uses may be going by the wayside.
``The whole debate (over legalized marijuana for medicinal purposes) is a non-issue,'' said Dr. Paul R. Conkling, an oncologist with offices in Smithfield and Elizabeth City.
In the past two years, Conkling says, new drugs like Zofran and Kytril have shown excellent results in controlling nausea - one of the benefits for which pot is touted - without the resulting sleepiness or confusion that often results with Marinol or other anti-nausea drugs.
And, Conkling says, new narcotics, including a patch of Fentanyl, commonly used in anesthetics, have made it easier to control severe pain.
But these drugs are more expensive than pot, notes Norfolk pharmacist Jay Levine, of Atrium Pharmacy. Thirty pills of Zofran cost about $500, he said. So for nausea, marijuana - at a cost of about $50 to $100 per month - costs less, he said.
In recent years, Levine has seen Marinol prescribed more for AIDS patients, who use it to stimulate their appetites, much as marijuana provokes ``the munchies.''
There also is anecdotal evidence, touted by the California proponents, that suggests marijuana's effects on nausea and appetite are stronger when the drug is inhaled, rather than when THC is taken in pill form.
``It may not be the THC causing the effect; it may be in combination with some other ingredients,'' Levine said.
The whole debate has given Anas M. El-Mahdi, chairman of the radiation oncology department at Eastern Virginia Medical School, a sense of deja vu.
Twelve years ago, El-Mahdi was a leader in a statewide effort to legalize heroin in the treatment of terminally ill patients.
It's legal in Great Britain, where doctors prescribe the drug much as physicians here prescribe morphine.
``But the side effects (of heroin) are not the same as morphine,'' El-Mahdi said. ``The patient in severe pain doesn't have to suffer two to three hours with heroin. Their relief comes immediately.''
El-Mahdi supports the use of drugs like marijuana and heroin for terminally ill patients, although he's never prescribed marijuana or Marinol for his patients, most of whom are usually in the early stages of cancer. But if someone asked, and if it was the best way to control the symptoms, he would prescribe marijuana, he said.
``There's nothing wrong with having people who are terminally ill feeling good about themselves,'' he said. ``We refer to that as quality of life.''
KEYWORDS: MARIJUANA by CNB