Marinol Perscription

[Hangar18]

I would like to know if it is possible to get a perscription for Marinol rather than for Marijuana.

Reason being I have had lower back and right hip pain for almost 20 years. Problem is getting worse and Dr reccomends surgery. I do not want to go that route. I do not like takeing the Vicoden and Percocet meds unless I hurt really bad. My job inflames the pain but I do not want to go the dissability route either. I am 50 years old and would like to continue to work as long as possible.

Smoking marijuana does wonders for the spasams and pain. I am in Ohio so I cant smoke legaly, which is not that big of concern for me, but my job gives random urine tests and termination for a positive test. A friend of mine had access to Marinol awhile back and she gave me some to try. It actually worked better than smoking for my condition. Does anyone know of a Dr in Michigan that would prescribe Marinol? My Dr's won't because they say there are better Meds, such as Vicoden or Percocet. If anyone has any info that may help me I would greatly appreciate it. A Dr or clinic name would be fantastic.

 

Thanks

 

Tom

[Royal Smoke]

I don't know of any Doctor that's prescribing it, but I can offer this as an idea.

 

 

If you are able to secure a prescription for it, I would keep it on hand for job security purposes.

 

 

Then you can smoke and try medibles and have Marinol as your defense against drug tests at work!

 

 

I've never tried Marinol, but most medibles don't do anything for me. I wonder if it is similar to medibles.

[Kingdiamond]

When i looked into marinol i found out the cost for a 30 day supply was well over $500 and my insurance company would not be offering any co pay.

[Hangar18]

I don't know of any Doctor that's prescribing it, but I can offer this as an idea.

 

 

If you are able to secure a prescription for it, I would keep it on hand for job security purposes.

 

 

Then you can smoke and try medibles and have Marinol as your defense against drug tests at work!

 

 

I've never tried Marinol, but most medibles don't do anything for me. I wonder if it is similar to medibles.

 

 

I figured they would be able to tell the difference between smoking marijuana and the alternative marinol on a drug screen...

 

 

I am not familiar with medibles ?

 

 

Thanks

[Kingdiamond]

I figured they would be able to tell the difference between smoking marijuana and the alternative marinol on a drug screen...

 

 

I am not familiar with medibles ?

 

 

Thanks

Medibles are cannabis infused food.

 

As for the drug test knowing the difference i dont see how both have thc in them correct?

[Hangar18]

When i looked into marinol i found out the cost for a 30 day supply was well over $500 and my insurance company would not be offering any co pay.

 

 

I would gladly pay that for the medication as it is such a relief to my condition. I can not tolerate the way muscle relaxors and pain meds make me feel. My only problem is finding a Dr that will perscribe the medicine that I can tolerate. I did smoke when I was much younger quite a bit but gave it up when I joined the Air Force in the 80's. Maybe that is why I can tolerate the Marinol, I don't know.

 

Thanks

[rockinlespaul]

When i looked into marinol i found out the cost for a 30 day supply was well over $500 and my insurance company would not be offering any co pay.

 

 

Thats cheap, they told me 800 a month. Um.....NO. LOL

[Hangar18]

Medibles are cannabis infused food.

 

As for the drug test knowing the difference i dont see how both have thc in them correct?

 

 

I was under the impression that Marinol was a synthetic form of THC. But, maybe a drug screen can't tell the difference. I would much rather use the Marinol as it seemed to work very well for me. I would smoke though as it is much better than the alternative pain meds my Dr is now perscribing, providing I had an out with my employer.

[LongHairBri]

my friend had a marinol script (before he died). I tried them and didn't care for it. had to eat 3-4 brown ones to feel anything and then you felt like you were on something. not dismissable like smoking. more like old school Tab T, not that pleasant.

 

as for the drug test,they can't tell the difference. he was on probation for weed. they tried to violate him for getting caught with weed again, the lab said clean pee test w/script and the new lawyer argued that the mj was no different than marinol and he only used it to strech out the script. a medical dismissal w/time served in Redford over 10 years ago. I saw it!

[Royal Smoke]

If I were you I would try to get my hands on some medibles (marijuana infused food, candy, or soda pop) and see how that works for you.

 

 

My guess is that they would work for you better than Marinol.

 

 

I would still get the script and Marinol if you can afford it. Just keep a few in case of work drug tests. I don't think they can tell the difference in a drug test. I would get more opinions on that though. Don't take my word.

[Hangar18]

If I were you I would try to get my hands on some medibles (marijuana infused food, candy, or soda pop) and see how that works for you.

 

 

My guess is that they would work for you better than Marinol.

 

 

I would still get the script and Marinol if you can afford it. Just keep a few in case of work drug tests. I don't think they can tell the difference in a drug test. I would get more opinions on that though. Don't take my word.

 

I would like to try the medibles you are talking about. I just need to find a Dr to perscribe the marinol. If I can find a Dr, I have 20 years of medical records to prove I have a serious condition. I could give up and go on social security, but I would rather keep working.

[Ms Chocolate]

Marinol (fake marijuana) s now offered as a generic called Dronabinol. Each capsule is about $5. Many health insurance will now cover the generic. Any doctor in any state can write a script. The question is: will they!

[+EdwardGlen]

I would like to know if it is possible to get a perscription for Marinol rather than for Marijuana.

Reason being I have had lower back and right hip pain for almost 20 years. Problem is getting worse and Dr reccomends surgery. I do not want to go that route. I do not like takeing the Vicoden and Percocet meds unless I hurt really bad. My job inflames the pain but I do not want to go the dissability route either. I am 50 years old and would like to continue to work as long as possible.

Smoking marijuana does wonders for the spasams and pain. I am in Ohio so I cant smoke legaly, which is not that big of concern for me, but my job gives random urine tests and termination for a positive test. A friend of mine had access to Marinol awhile back and she gave me some to try. It actually worked better than smoking for my condition. Does anyone know of a Dr in Michigan that would prescribe Marinol? My Dr's won't because they say there are better Meds, such as Vicoden or Percocet. If anyone has any info that may help me I would greatly appreciate it. A Dr or clinic name would be fantastic.

 

Thanks

 

Tom

 

 

Find another Doctor

[neilheist]

Any doctor can right a script, but most wont. It takes a different type of prescription apparently, and although I would be an ideal candidate for it, I've had more than 10 doctors tell me NO because they said they don't risk writing that script unless the patient has HIV/AIDS.

 

I have my card, but have been searching for a marinol script to cover me on work related drug tests if I ever needed it to. It WILL cover you on any regular concentra type drug test, just let them test you first, then produce your script after. I say show it after because there are different ways to test. One test will test only for THC (which marinol covers you for), and another will test for THC as well as CBD's CBC's CBN's which marinol does NOT contain and will not cover you for.

[phaquetoo]

my friend had a marinol script (before he died). I tried them and didn't care for it. had to eat 3-4 brown ones to feel anything and then you felt like you were on something. not dismissable like smoking. more like old school Tab T, not that pleasant.

 

as for the drug test,they can't tell the difference. he was on probation for weed. they tried to violate him for getting caught with weed again, the lab said clean pee test w/script and the new lawyer argued that the mj was no different than marinol and he only used it to strech out the script. a medical dismissal w/time served in Redford over 10 years ago. I saw it!

 

 

Hey long hair bri!

 

there is prob only a few of us on here that even remember tab t!! Oops showing my age! how bout rocket fuel?

 

as far as medibles, I make brownies with my used vape mm, and i take about a 1/3 more not vaped! Bang your sleeping and in no pain!

I wonder what kind of fillere they put in the marinol pills? oh man im thinkin like the new grow geeks!

 

Best of luck to ya!

Merry Christmas

Peace

FTW

Jim

[phaquetoo]

Marinol (fake marijuana) s now offered as a generic called Dronabinol. Each capsule is about $5. Many health insurance will now cover the generic. Any doctor in any state can write a script. The question is: will they!

 

 

I have only seen it wrote to hiv/aids and cancer patients! and most did not like how it felt!

 

Peace

FTW

Jim

[Hangar18]

Well it looks like I have several choices to choose from.

 

Stick it out on my present job and continue to take these darn narcotics, and keep looking for a Dr with the balls to write a scrip for the Marinol.

 

Quit my job and move north, get a card, and try and find a job that don't give random drug tests that pays 80,000 bucks a year to replace my present job. Yea, I hear you all laughing! Fat chance of that.

 

Go on social security and become one more burden on society. Don't want to do that, but I have been working full time since 1977, which includes 8 years in the military. Not like I haven't payed my dues I guess, just not my style.

 

If someone has any info that they would like to share but not on here for all to see I will leave my email address below.

 

Thanks for all the info guys!

Happy Holidays to all...

 

Tom

 

Hangar18@EmbarQmail.com

[DenturesLost]

I have only seen it wrote to hiv/aids and cancer patients! and most did not like how it felt!

 

Peace

FTW

Jim

Marinol is prescribed mainly as an antiemetic for cancer patients and as an appetite booster for aids patients or others with chronic wasting or similar problems. The problem would be getting a doc to prescribe it for off-label use as it isn't considered a pain killer. As far as drug testing, from what I have heard it depends on the type of testing done. Certain drug tests can detect a difference between marinol and mj from what I understand.

[TomcatJones]

Marinol and the generic and just synthesized THC. no CBDs with natural ratios that the plant itself will have.

 

THC is not the only active ingredient MMJ

 

here is a woman using THC in a controlled experiment.

[herbnurse]

To anwser your orginal question, no you most likley cannot get a scipt for marinol for pain. I have a few patients on it but they have caner. I have never heard or seen it prescribed for pain. I am fairly certain that you will never find a doctor to prescribe you Marinol for pain. The only options you have would be to use cannibis illegally and keep synthetic urine on hand (can buy a producted called a number 1 and wear it around your waist under your underwear to work everyday 'it is surprisingly comfortable') or to move to a state that allows medical cannibis use.

[Kingdiamond]

Hey long hair bri!

 

there is prob only a few of us on here that even remember tab t!!

 

 

 

Dont remind me i forgot half of the 70s because of it lol.

[Croppled1]

From the desk of Homerx

 

Marinol (dronabinol) is the only US FDA-approved synthetic cannabinoid. It is often marketed as a legal pharmaceutical alternative to natural cannabis. <BR itxtvisited="1"><BR itxtvisited="1">Marinol is manufactured as a gelatin capsule containing synthetic delta-9-tetrahydrocannabinol (THC) in sesame oil. It is taken orally and is <BR itxtvisited="1">available in 2.5mg, 5mg and/or 10mg dosages. Marinol may be prescribed for the treatment of cachexia (weight loss) in patients with AIDS and for the treatment of nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments. <BR itxtvisited="1"><BR itxtvisited="1">Despite FDA approval, Marinol typically provides only limited relief to select patients, particularly when compared to natural cannabis and its cannabinoids. Marinol should remain a legal option for patients and physicians; however, federal and state laws should be amended to allow for those patients who are unresponsive to synthetic THC the ability to use natural cannabis and its cannabinoids as a medical therapy without fear of arrest and/or criminal prosecution. By prohibiting the possession and use of natural cannabis and its cannabinoids, patients are unnecessarily restricted to use a synthetic substitute that lacks much of the therapeutic efficacy of natural cannabis. <BR itxtvisited="1"><BR itxtvisited="1">I. Marinol Lacks Several of the Therapeutic Compounds Available in Natural Cannabis <BR itxtvisited="1"><BR itxtvisited="1">Chemical compounds in cannabis, known as cannabinoids, are responsible for its numerous therapeutic benefits. Scientists have identified 66 naturally occurring cannabinoids. <BR itxtvisited="1"><BR itxtvisited="1">The active ingredient in Marinol, synthetic delta-9-tetrahyrdocannabinol (THC), is an analogue of one such compound, THC. However, several other cannabinoids available in cannabis -- in addition to naturally occurring terpenoids (oils) and flavonoids (phenols) -- have also been clinically demonstrated to possess therapeutic utility. Many patients favor natural cannabis to Marinol because it includes these other therapeutically active cannabinoids. <BR itxtvisited="1"><BR itxtvisited="1">For example, cannabidol (CBD) is a non-psychoactive cannabinoid that has been clinically demonstrated to have analgesic, antispasmodic, anxiolytic, antipsychotic, antinausea, and anti-rheumatoid arthritic properties. <BR itxtvisited="1"><BR itxtvisited="1">Animal and human studies have shown CBD to possess anti-convulsant properties, particularly in the treatment of epilepsy. Natural extracts of CBD, when administered in combination with THC, significantly reduce pain, spasticity and other symptoms in multiple sclerosis (MS) patients unresponsive to standard treatment medications. <BR itxtvisited="1"><BR itxtvisited="1">Clinical studies also demonstrate CBD to be neuroprotective against glutamate neurotoxicity (i.e. stroke), cerebral infarction (localized cell death in the brain), and ethanol-induced neurotoxicity, with CBD being more protective against glutamate neurotoxicity than either ascorbate (vitamin C) or alpha-tocopherol (vitamin E). Clinical trials have also shown CBD to possess anti-tumoral properties, inhibiting the growth of glioma (brain tumor) cells in a dose dependent manner and selectively inducing apoptosis (programmed cell death) in malignant cells. <BR itxtvisited="1"><BR itxtvisited="1">Additional cannabinoids possessing clinically demonstrated therapeutic properties include: cannabinol (anticonvulsant and anti-inflammatory activity); cannabichromine (anti-inflammatory and antidepressant activity); and cannabigerol (anti-tumoral and analgesic activity). Natural cannabis' essential oil components (terpenoids) exhibit anti-inflammatory properties and its flavonoids possess antioxidant activity. Emerging clinical evidence indicates that cannabinoids may slow disease progression in certain autoimmune and neurologic diseases, including multiple sclerosis (MS), Amyotrophic Lateral Sclerosis (Lou Gehrig's disease) and Huntington's Disease. <BR itxtvisited="1"><BR itxtvisited="1">Clinical data indicate that the synergism of these compounds is likely more efficaciousthan the administration of synthetic THC alone. For example, McPartland and Russo write: "Good evidence shows that secondary compounds in cannabis may enhance beneficial effects of THC. Other cannabinoid and non-cannabinoid compounds in herbal cannabis ... may reduce THC-induced anxiety, cholinergic deficits, and immunosuppression. Cannabis terpenoids and flavonoids may also increase cerebral blood flow, enhance cortical activity, kill respiratory pathogens, and provide anti-inflammatory activity." In an in vitro model of epilepsy, natural cannabis extracts performed better than THC alone.In human trials, patients suffering from multiple sclerosis experienced greater symptomatic relief from sublingual natural cannabis extracts than from the administration of oral THC. In 2005, Health Canada approved the oral spray Sativex-- which contains precise ratios of the natural cannabinoid extracts THC and CBD, among other compounds -- for prescription use for MS-related symptoms. <BR itxtvisited="1"><BR itxtvisited="1">II. Marinol is More Psychoactive Than Natural Cannabis <BR itxtvisited="1"><BR itxtvisited="1">Patients prescribed Marinol frequently report that its psychoactive effects are far greater than those of natural cannabis. Marinol's adverse effects include: feeling "high," drowsiness, dizziness, confusion, anxiety, changes in mood, muddled thinking, perceptual difficulties, coordination impairment, irritability, and depression. These psychoactive effects may last four to six hours. About one-third of patients prescribed Marinol report experiencing one or some of these adverse effects. <BR itxtvisited="1"><BR itxtvisited="1">Marinol’s oral route of administration is responsible, in part, for its heightened psychoactivity compared to inhaled cannabis. Once swallowed, Marinol passes from the stomach to the small intestine before being absorbed into the bloodstream. Following absorption, Marinol passes through the liver where a significant proportion of the drug is metabolized into other chemicals. One of these chemicals, 11-hydroxy-THC, may be four to five times more potent than natural THC, and is produced in greater quantities.Thus, patients administered Marinol experience the psychoactive effects of both THC and 11-hydroxy-THC, greatly increasing the likelihood that they will suffer from an adverse psychological reaction. By comparison, only minute quantities of 11-hydroxy-THC are produced when cannabis is inhaled. Moreover, Marinol lacks the compound cannabidiol, which possesses anxiolytic activity and likely modifies and/or diminishes much of THC's psychoactivity in natural cannabis. <BR itxtvisited="1"><BR itxtvisited="1">III. Cannabis Vaporization Offers Advantages Over Orally Administered THC <BR itxtvisited="1"><BR itxtvisited="1">Vaporization is an alternative method of cannabis administration that holds distinct advantages over both smoking and oral administration. Cannabis vaporization suppresses respiratory toxins by heating cannabis to a temperature where cannabinoid vapors form (typically around 180-190 degrees Celsius), but below the point of combustion where noxious smoke and associated toxins (i.e., carcinogenic hydrocarbons) are produced (near 230 degrees Celsius). Although a comprehensive review of cannabis and health conducted by the National Academy of Sciences Institute of Medicine found "no conclusive evidence that marijuana causes cancer in humans, including cancers usually related to tobacco use," studies have found that heavy cannabis smokers face a higher risk of contracting bronchitis and respiratory illnesses. This risk is likely not due to the inhalation of cannabinoids, but rather to the exposure of noxious smoke. Because vaporization can deliver therapeutic doses of cannabinoids while reducing the users intake of pyrolytic smoke compounds, it is considered to be a preferred and likely safer method of cannabis administration than smoking. <BR itxtvisited="1"><BR itxtvisited="1">In practice, cannabis vaporization offers considerable advantages over oral THC consumption. While the oral ingestion of Marinol avoids the potential risks of smoking, it has significant drawbacks. Because of synthetic THC's poor bioavailability, only 5-20 percent of an oral dose ever reaches the bloodstream and the drug may not achieve peak effect until four hours after dosing. Moreover, because Marinol is metabolized slowly, its therapeutic and psychoactive effects may be unpredictable and vary considerably, both from one person to another, and in the same person from one episode of use to another. By contrast, cannabis vaporization delivers cannabinoids to the bloodstream almost instantaneously. Vaporization's rapid onset also allows patients to self regulate their dosage of cannabinoids by immediately ceasing inhalation when/if their psychoactive effects become unpleasant.After oral administration of Marinol, patients have no choice but to experience the full psychoactive effects of the dose consumed. These dysphoric effects may last several hours. <BR itxtvisited="1"><BR itxtvisited="1">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. Cannabis vaporization also offers a unique advantage to patients suffering from nausea and vomiting because it allows them an alternative delivery route to swallowing. Cancer and HIV/AIDS patients often report that their stomachs cannot hold down Marinol capsules during bouts of severe nausea and many rely on natural cannabis and cannabinoids for symptom control. In a 1994 survey of oncologists, respondents ranked synthetic THC ninth on a list of available antiemetic medications. In another survey of oncologists, 44 percent of respondents said that they believed natural cannabis to be more efficacious than oral synthetic THC; only 13 percent of respondents rated Marinol more effective. A 1997 survey of physicians found that a majority preferred megestrol acetate over Marinol as an appetite stimulant in patients with HIV/AIDS. <BR itxtvisited="1"><BR itxtvisited="1">As a result of Marinol's slow onset and poor bioavailablity, scientists are now in the process of developing a new formulation of pulmonary dronabinol, delivered with a pressurized metered dose inhaler. In a Phase I study, pulmonary Marinol delivered via an inhaler provided rapid systemic absorption. Unlike oral synthetic THC, it's possible that pulmonary Marinol "could offer an alternative for patients when a fast onset of action is desirable." However, FDA approval of pulmonary Marinol and/or its inhaler remains years away. Sativex, an oral cannabis spray consisting of natural cannabinoid extracts, has greater bioavailability and is faster acting than oral synthetic THC. Clinical trials comparing its bioavailability and time of peak onset compared to vaporized cannabis have not been performed, though anecdotal reports indicate that vaporized cannabis and its cannabinoids likely possess greater bioavailability and are faster acting than the Sativex spray. <BR itxtvisited="1"><BR itxtvisited="1">IV. Marinol is More Expensive Than Natural Cannabis <BR itxtvisited="1"><BR itxtvisited="1">Synthetic THC is a costly and difficult compound to manufacture. Much of this cost is passed on to the patient consumer, particularly if the full cost of Marinol (approximately $200 to $800 per month, depending on the dosage) is borne out of pocket. 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. <BR itxtvisited="1"><BR itxtvisited="1">V. Patients Ultimately Prefer Natural Cannabis to Marinol <BR itxtvisited="1"><BR itxtvisited="1">In the 1970s and 1980s, several states conducted patient trials of natural cannabis' effectiveness as an anti-emetic in cancer patients unresponsive to conventional therapies. Some state protocols allowed patients to choose between inhaled cannabis and synthetic THC. In those studies which compared natural cannabis to dronabinol, inhaled cannabis was equal to or better than the oral administration of synthetic THC. <BR itxtvisited="1"><BR itxtvisited="1">For example, researchers at 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. <BR itxtvisited="1"><BR itxtvisited="1">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," they concluded. <BR itxtvisited="1"><BR itxtvisited="1">Researchers at the California Board of Pharmacy found that inhaled cannabis and oral THC produced similar results in patients. However, physicians still rated natural cannabis as slightly more effective than oral THC as an anti-emetic. <BR itxtvisited="1"><BR itxtvisited="1">A 1988 New York State pilot study comparing inhaled cannabis to oral THC in cancer chemotherapy patients who were unresponsive to standard antiemetic agents found: "Twenty-nine percent of patients who failed oral THC responded to the cigarette form. ... Our results demonstrate that inhalation marijuana is an effective therapy for the treatment of nausea and vomiting due to cancer chemotherapy." <BR itxtvisited="1"><BR itxtvisited="1">Today, several patient populations continue to use natural cannabis and its cannabinoids in large numbers despite its illegality and the availability of Marinol. A 2005 British survey of more than 500 HIV/AIDS patients found that one-third of respondents use natural cannabis for symptomatic relief, with more than 90 percent of them reporting that it improves their appetite, muscle pain and other symptoms. A previous US survey found that approximately one out of four patients with HIV had used natural cannabis medicinally in the past month. <BR itxtvisited="1"><BR itxtvisited="1">Cannabis use is also prevalent among patients with neurologic disorders. Nearly four out of ten Dutch patients with prescriptions for "medical grade cannabis" (cannabis provided by Dutch pharmacies with a standardized THC content of 10.2 percent) use it to treat MS or spinal cord injuries, according to survey data published in 2005 in the journal Neurology.Perceived efficacy is greater among respondents who inhale cannabis versus those who ingest it orally, the study found. <BR itxtvisited="1"><BR itxtvisited="1">A 2002 British survey of MS patients found that 43 percent of respondents used natural cannabis therapeutically, with about half admitting they used it regularly. Seventy-six percent said they would do so if cannabis were legal. A Canadian survey of MS patients found that 96 percent of respondents were "aware cannabis was potentially therapeutically useful for MS and most (72 percent) supported [its] legalization for medicinal purposes." Sixteen percent of respondents answered that they use natural cannabis for medical purposes to treat symptoms of anxiety/depression, spasticity and chronic pain. <BR itxtvisited="1"><BR itxtvisited="1">A more recent Canadian survey published in Neurology reported that 14 percent of MS patients and 21 percent of respondents with epilepsy had used medical cannabis in the past year. Among epileptics, twenty-four percent of respondents said that they believed that cannabis was an effective therapy for the disease. A 2002 survey of patients with Parkinson's Disease (PD) found that 25 percent of respondents had tried cannabis, with nearly half of those saying that it provided them symptomatic relief. <BR itxtvisited="1"><BR itxtvisited="1">Conclusion <BR itxtvisited="1"><BR itxtvisited="1">Oral synthetic THC, legally available by prescription as Marinol, often provides only limited relief to a select group of patients, particularly when compared to natural cannabis and its cannabinoids. Patients often experience minimal relief from Marinol and many experience unwanted side effects. In addition, many physicians are hesitant to prescribe the drug, and some patients are unable to afford it. Despite Marinol's legality, many patient populations continue to risk arrest and criminal prosecution to use natural cannabis medically, and most report experiencing greater therapeutic relief from it. <BR itxtvisited="1"><BR itxtvisited="1">The active ingredient in Marinol is a synthetic analogue of only one of the compounds in cannabis that is therapeutically beneficial to patients. By prohibiting the possession and use of natural cannabis and its cannabinoids, patients are unnecessarily burdened to use a synthetic substitute that lacks much of the therapeutic efficacy of natural cannabis and its cannabinoids. <BR itxtvisited="1"><BR itxtvisited="1">Marinol should remain a legal option for patients and physicians and the development of additional cannabis-based pharmaceuticals should be encouraged. However, federal and state laws should be amended to allow for those patients who are unresponsive to synthetic THC, or simply desire an alternative to oral dronabinol, the ability to use natural cannabis and its cannabinoids as a legal medical therapy without fear of arrest and/or criminal prosecution.

 

 

http://ehealthforum....is-t138082.html

 

30 day supply of two 10's a day $1400 + at our local Krogers $24 per pill . Cost of growing Cannabis at home for same amount and better dosing control per individual starts at $50-80 for 30 days plus seeds or clones .

[Croppled1]

To anwser your orginal question, no you most likley cannot get a scipt for marinol for pain. I have a few patients on it but they have caner. I have never heard or seen it prescribed for pain. I am fairly certain that you will never find a doctor to prescribe you Marinol for pain. The only options you have would be to use cannibis illegally and keep synthetic urine on hand (can buy a producted called a number 1 and wear it around your waist under your underwear to work everyday 'it is surprisingly comfortable') or to move to a state that allows medical cannibis use.

 

Things are changing and there are pain patients being prescribed it that have histories of severe chronic pain ...but their aren't many of us and it is usually prescribed where there is need to go out of State at a moments notice . Quite frankly it helps but I find its a band aid at best compared to real Cannabis food products and or inhalation with very rare emergency break through pain med use that is sometime hard to implement in severe pain . Amost as hard as just shutting down and resting the nerve or nueropathic pain away in order to survive and remain sane ;-) .

 

 

Like most posters here have said the main reason nobody recommends it is insurance doesnt cover it in all cases and the cost . I think this is why most are so adamant here as patients that we never loose the right to grow even when the FDA finnly catch up ,admit the medical efficacy of Cannabis and start to develop along with contol drugs based on it .

[Croppled1]

I found this article it is complimetory and easier to read then the first I posted on Marinol especially since I couldn't get the HTML programing out of that one for those scared to hit or who have difficulty opening links . I have also been taking it as percribed for severe chronic pain while out of State on a emergency . It was very helpful but I feel like it is habbit forming comparied to Cannabis . I need a half hour to hour to be able to safely drive on it after dosing when first starting up . The directions with it were not like found on the net but simply exercise caution when driving or operating machinery . I think the net information is becoming tainted . It often states avoid all driving period nowadays . It never said that before our country started the zero tolerance towards cannabis policies and driving that I can remember .

 

I prefer to take it a few hours before bedtime avoiding driving when able until the next day . I did not get a feeling of increased appetite anywhere as strong as I do with my regular strain . I hope the following article helps someone . I see a real use for this when in a situation where I cannot use medicinal Cannabis but it is way to expensive and appears to have less positive effects and more detrimental ones . However i only used it for a week or so to visit a sick family member recently . I use no other pain meds and have been using the marinol when my pain is very high in emergencies because it gets that bad and I can't move around to pursue Cannabis . It works but it does have a withdrawl if you don't keep it in your system way stronger to me then natural Cannabis . Similar to the dependency of many other medications patient's take .

 

I am including a link to the article crediting the author and if you like it please visit the site . I am always confused about crediting authors and proper ediquette online and more interested in getting information out that was enjoyable and educational .

 

.Marinol vs. Marijuana: Politics, Science, and Popular Culture

by Kambiz Akhavan

 

INTRODUCTION

 

Marijuana has been used as a medicine for millennia by cultures spanning the globe. Ever since 1937, that medical necessity has fallen in America to political pressure, and the cannabis plant remains illegal regardless of intended use. Since then, patients have continued demanding marijuana’s therapeutic effects, thus prompting the pharmaceutical industry to find a legitimate means of meeting their needs without violating federal law. This quest for "legal weed" resulted in the introduction of dronabinol (a synthetic drug commonly referred to by its trade name Marinol), into contemporary American pharmacopoeia. However, this "solution" to the medical marijuana question now poses a double standard: whereas, medical marijuana users still face severe penalties, including loss of property and mandatory incarceration, for therapeutically using an illegal substance, Marinol users enjoy the benefits of marijuana’s active ingredient, tetrahydracannibidol (THC), without the criminal penalties or the social stigma. With this paradox in mind, I intend to examine the vastly different public perceptions of these two essentially similar substances, marijuana and Marinol, while framing this complex analysis within a broader historical and theoretical structure. This examination will focus first on each of these two drugs individually, and will then illustrate the disparate public discourse in American pop culture surrounding natural and synthetic THC, respectively. Without taking a definite position on this hotly debated issue, this analysis will reveal how politics influence science, how marijuana has garnered such a distinctively negative reputation, and how Marinol has successfully appeased the anti-marijuana American public.

 

MARIJUANA

 

Marijuana boasts a long and pertinent history of medicinal use, based in the earliest known civilizations. The first recorded use of medical cannabis dates back to 2800 B.C., when the Chinese Emperor Shen-nung used it as a muscle relaxant and painkiller. The ancient Egyptians also found medical benefits in cannabis, as evidenced by their usage of it to quell the pangs of childbirth. Numerous other civilizations, including the Assyrians, Persians, Zulu, Spaniards, and countless others, have since established traditional medical applications of cannabis. Underlying this historical trend is the simple fact that the medical benefits of marijuana have and continue to serve numerous cultures.

 

Certainly, the medical use of marijuana was once commonplace in America, as well. Over one hundred articles recommending cannabis were published between 1840 and 1900 alone. In fact, marijuana was a prominent part of the pharmacopoeia from 1870 up until 1937, when the Marijuana Tax Act effectively banned the plant from public consumption regardless of intended use. Employed primarily as a painkiller during childbirth, as a treatment for asthma and gonorrhea symptoms, and as a relaxant for anxiety-prone patients, marijuana was formerly a well-documented drug in standard texts on pharmacology and therapeutics. When Congress first considered banning the cannabis plant, the respected American Medical Association (AMA) testified before federal committees in defense of marijuana’s medical applicability. Despite the AMA’s efforts, the political motivations behind outlawing the plant far outweighed any medical considerations, and in 1937, cannabis became illegal. The sudden and severe public reaction to this "new" drug was surprising, considering that no one in America had even hear the word "marijuana" until the late 1920s. A closer examination of marijuana’s entry into the American public reveals the source of its stigmatization..

 

The term "marihuana" (later spelled "marijuana") was invented in the early 1930s to confuse Americans who had positive associations with hemp, a major cash crop, and cannabis, a well-known medicine and mild intoxicant. By ascribing various social ills to the heavily maligned drug "marihuana," politicians used this term, with which the public was unfamiliar, to pass legislation banning an otherwise commonly known substance. Numerous theories exist about the motives behind the sudden vilification of cannabis; however, I will limit my analysis to those aspects of vilification which underscore the strange relationship between politics and medicine. For example, many newspapers reported that "degenerate Mexicans" smuggled the evil "marihuana" into America, raping Anglo women, or murdering innocent citizens while under its influence. These newspapers, ranging from well-known national journals like the Christian Science Monitor and the Washington Herald to little-known local papers like the Rocky Mountain Times, contributed heavily to the growing anti-marijuana hysteria, by identifying marijuana-crazed ethnic minorities as the root cause of crime in America. The Federal Bureau of Narcotics offered this statement to corroborate these claims:

 

Police officials in cities of those states where it [marihuana] is most widely used estimate that fifty per cent of the violent crimes committed in districts occupied by Mexicans, Spaniards, Latin-Americans, Greeks, or Negroes may be traced to this evil.

 

Evidently, the medical necessity of cannabis could not withstand the onslaught of such negative associations with marijuana, and political motives ultimately swallowed medical concerns entirely.

 

Marijuana remained illegal in America for several years, although medical and recreational use did not disappear whatsoever. Retaining popularity among American subcultures, such as Black musicians in the 1940s, Beatniks in the 1950s, and Hippies in the 1960s (just to name a few), marijuana remained a prominent aspect of social life despite its prohibition. In fact, cannabis consumption reached well beyond the subcultures of these eras and into the American mainstream. Many people from varying social backgrounds and ideologies used marijuana at some point, solely for recreation, including current President Bill Clinton, Vice-President Al Gore, Speaker of the House Newt Gingrich, and countless doctors, lawyers, professors, and engineers, among others. While recreational use remained popular, new medical uses for marijuana were also discovered, prompting many suffering people to illegally medicate themselves. The treatments of glaucoma, chemotherapy induced nausea, spastic disorders, AIDS wasting away syndrome, and other less severe illnesses were significantly aided with the therapeutic use of marijuana. Those same officials who tried the drug recreationally now subject people with an obvious medical need for marijuana to the constant threat of arrest for violating U.S. federal law.

 

Although authorities have perpetuated the vilification of marijuana since its prohibition in 1937, they nonetheless responded partially to growing demands for medical marijuana in 1969 by supplying researchers with government-grown marijuana for scientific experimentation. The "pot farm" at the University of Mississippi in Oxford raised thousands of cannabis plants (and still grows them today) behind a 12 foot tall barbed wire fence for the National Institute of Drug Abuse (NIDA), the federal agency which retains sole rights to supply marijuana to researchers. Barrels of the low-grade marijuana get shipped to the Research Triangle Institute in Raleigh, North Carolina where the dried leaves are rolled at a cost of $2 per joint for patients participating in experimental programs. This system of farming has resulted in a "highly standardized …reliable and reproducible method of administering the drug." according to Dr. Monroe Wall of the Research Triangle Institute. Thanks to research conducted with government pot acknowledging marijuana’s medical benefits, New Mexico boldly strayed from federal drug policy in 1978 and passed the first state law recognizing the medical value of marijuana. Comparable medical needs around the country prompted over 30 states to enact similar legislation within the next few years. Glaucoma patient and medical marijuana user, Robert Randall, remembers, "By the summer of 1980, there was building pressure on the federal government to provide marijuana through an experimental program." The most remarkable example of this growing trend for medical marijuana consumption involved California’s request for one million joints from NIDA. Rather than accept the obvious solution to increase production at the "pot farm" in order to meet the growing demand (a remedy deemed "imponderable" by anti-marijuana government officials), bureaucrats decided to pursue a pharmaceutical alternative. They hoped to encourage the giant pharmaceutical industry to create a synthetic drug with properties similar to cannabis.

 

The first attempt to synthetically reproduce the medical effects of marijuana failed miserably. The Eli Lilly pharmaceutical company had responded quickly to the federal challenge by manufacturing nabilone, otherwise known as Cesamet, which soon became hailed as the "great white drug" that would replace marijuana. In 1978, they began double-track testing on cancer patients as well as animals in order to gain FDA approval quicker; however, their lofty aspirations came crashing down tragically, when dogs on nabilone suffered convulsions and dropped dead. The door remained open, anticipating another pharmaceutical product to fill the marijuana demand.

 

 

 

 

 

MARINOL

 

In pertinence to the history of medical marijuana, Congress’ passing of the Controlled Substances Act of 1970 added a new dimension to the cannabis as medicine controversy. Upon ranking the various drugs according to levels of danger, the Act placed marijuana in Schedule I, the most dangerous category. In order to attain Schedule I classification, a drug must meet three requirements: 1) high potential for abuse; 2) no accepted safety even under supervision; and most significantly, 3) no medical use. In placing marijuana in Schedule I, the government not only ignored cannabis’ previous medical use in this country, but also overlooked the numerous experiments proving the drug’s therapeutic efficacy. Still, bureaucrats needed to help severely ill patients without acknowledging marijuana as a potential therapeutic agent. The government prayed for a pharmaceutical alternative to marijuana, and with Marinol’s entrance into the medical arena, their prayers were adequately answered.

 

In 1980, the National Cancer Institute (NCI) began experimental distribution of a new drug called Marinol, an oral form of THC (the primary active ingredient in marijuana), to cancer patients in San Francisco. Simultaneously, six states conducted studies comparing smoked marijuana to oral THC in cancer patients who had not responded to traditional antivomiting medication. These state-sponsored studies revealed that thousands of patients found marijuana safer and more effective than synthetic THC. Meanwhile, the NCI experiments showed that some patients responded well to Marinol, although one patient reportedly stormed into her doctor’s office and accused him of trying to poison her with the drug (the doctor later dropped out of NCI’s experimental program). Confronted with two different medical recommendations, the government chose to dismiss the state studies and give Marinol the green light. In 1981, the government sold the Marinol patent to a small pharmaceutical company named Unimed based in Somerville, New Jersey. By 1985, after one unsuccessful attempt at FDA approval, Marinol was finally approved as a Schedule II drug (a relatively quick approval by FDA standards). Thus, Unimed, with government backing, began targeting terminal cancer patients in order to accumulate profit.

 

With Marinol’s acceptance behind them, executives at Unimed launched a massive sales enterprise in conjunction with their distributor Roxanne Laboratories, a subsidiary of pharmaceutical giant Boehringer-Ingelheim. A combined sales force of about 60 people roamed the country promoting Marinol to oncologists and AIDS doctors. Building from early profits, Unimed invested money into testing new uses for Marinol. In 1992, the drug received approval as an appetite stimulant for patients with AIDS cachexia, otherwise known as wasting away syndrome. This new use coupled with Marinol’s recent approvals in various international markets, like South Africa (where it is marketed under the trade name Elevat) with its incredibly high AIDS rate, along with Canada, Puerto Rico, Israel, and Australia, significantly boosted Unimed’s profits and prestige. Furthermore, the FDA granted Marinol the highly prized Orphan Drug Status, a privilege that allowed Unimed exclusive manufacturing rights to Marinol, as well as protocol assistance, and tax breaks for its investors. As a business, Unimed still specializes primarily in niche pharmaceutical markets, namely AIDS drugs. However, among the few drugs manufactured by Unimed, Marinol easily garners the highest profits, drawing in over 90% of total revenues. Unimed has reported greater sales nearly every year since 1985, reaching a high of $9.7 million in 1995. President and CEO Stephen Simes predicted that sales will reach between $50-100 million by the year 2000. Based on their growth rate, this figure seems unlikely; however, the company clearly has high hopes.

 

Despite enormous financial backing and rapid FDA approval, few proponents of Marinol are aware of the intricate, physical processes involved in manufacturing synthetic THC. Unlike marijuana which requires only light, water, and some nutrients to grow, Marinol manufacture involves numerous time-consuming steps, the efforts of several companies, and multiple complex chemical processes. Unimed contracts Norac Industries in Azusa, California to manufacture the synthetic THC which is then shipped to Roxanne Laboratories in Columbus, Ohio where it is encapsulated and sent to pharmacies around the country. Intrigued by the process of synthetically reproducing a natural psychoactive product, I interviewed an informant at Norac extensively. Apparently, the basic elements of delta 9 tetra-hydra-cannibidol, marijuana’s primary—though by no means only—active ingredient, are derived from the compounds tempere olivitol and paramenthide (PMD). Norac used to purchase olivitol from Aldrich Labs, but opted to manufacture it themselves in order to save money. Norac also used to acquire its other raw material, PMD, from the German lab Ferminic until frequent explosions caused the company to halt its PMD production. As of 1993, Norac was forced to produce its own PMD as well. My informant at Norac explained that they too have experienced explosions due to the highly unstable characteristics of PMD, but that the volatile compound currently remains largely in check. The final synthetic THC solution is approximately 98% pure—a very high concentration compared to that of the cannabis plant, where THC amounts normally range between 2% and 10%. Since the Orphan Drug Status for chemotherapy related nausea expired in 1992, I assumed that other pharmaceutical companies would attempt to infiltrate Marinol’s markets by producing their own versions of synthetic THC. However, my source at Norac explained that manufacturing THC is a very expensive, and thus cost-prohibitive, process. The encapsulation procedure also requires elaborate and expensive chemical processes that use fairly common preservatives like methylparaben and propylparaben, as well the whitening agent titanium dioxide, in a sesame oil capsule. The once unstable synthetic THC compound now has a long shelf-life in the sesame oil capsules, although all Marinol products are marked with 6 month expiration dates for added safety. Obviously, reproducing marijuana’s therapeutic effects is no easy task, even with today’s most cutting-edge technologies.

 

Since marijuana and Marinol derived from two entirely different processes (arguably polar opposites), it seems ironic that Marinol functions as the only legal alternative to marijuana. Considering their vastly disparate backgrounds, one can logically conclude that the therapeutic effects must also differ, but according to many researchers, the results are essentially the same. In fact, the two drugs’ reported side effects are quite similar, although advocates of medical marijuana claim that Marinol produces more damaging side effects. Marinol proponents argue, in turn, that marijuana possesses more undocumented side effects. Upon analyzing a 1995 product brochure explaining the benefits and possible effects of using Marinol, I discovered new information that completely undermined my original assumptions about Marinol.

 

Considering that Marinol is legal while marijuana is not, I assumed that Marinol would have far fewer side effects than those attributed to marijuana; however, this assumption and numerous others proved quite inaccurate. According to the 1995 product insert, Marinol may be habit forming, a condition commonly linked with cannabis. In addition, Marinol may cause the following side effects: feeling "high" (i.e. easy laughing, elation, and heightened awareness), abdominal pain, dizziness, confusion, depression, nightmares, speech difficulties, chills, sweating, and even psychological and physiological dependence. Some of these potential side effects seem quite serious for any legal pharmaceutical. Even less comforting, the 1992 product insert explains what to do in case of accidental overdose:

 

A potentially serious oral ingestion, if recent, should be managed with gut decontamination. In unconscious patients with a secure airway, instill activated charcoal via a nosagastric tube. A saline cathartic or sorbitol may be added to the first dose of activated charcoal. Patients experiencing depressive, hallucinatory or psychotic reactions should be placed in a quiet area and offered reassurance.

 

Considering the enormous sales of Marinol, patients must desperately need medication to risk such potentially severe reactions. While marijuana may produce such side effects as: euphoria, laughter, anxiety, dry mouth, red eyes, sleepiness, clumsiness, increased appetite; these conditions pale in comparison to those attributed to Marinol. A 1985 edition of The Medical Letter listed the side effects of Marinol as "disorientation, depression, paranoia, hallucinations, and manic psychosis." A 1986 Marinol product insert explains that even patients on low doses of the drug may experience "a full-blown picture of psychosis;" this reference was conspicuously dropped from their later product inserts. Given the intensity of Marinol’s side effects, marijuana appears less dangerous than its synthetic Schedule II counterpart.

 

Many patients believe that the much higher THC content in Marinol produces these more extreme side effects. Robert Randall, a glaucoma patient who currently receives a legal supply of marijuana from the government, describes his experiences with Marinol, "It was way too psychoactive. When I took Marinol, I found it anxiety-provoking and intense, like I had wandered into a short story by Flannery O’Connor." He further explains, "I talked to hundreds of AIDS patients, and only one preferred Marinol to marijuana. It’s not just that marijuana helps them gain weight—it’s that Marinol is so scary." Dr. Robert Gorter, a San Francisco AIDS expert, corroborated Randall’s anecdotal conclusions in the Journal of the Physicians Association for AIDS where he stated, "Again and again patients have testified that they preferred marijuana above dronabinol [the scientific term for Marinol]…" Further evidence citing the potential dangers of Marinol exists in the 1995 Marinol product insert itself, which warns against giving dronabinol to children and to the elderly (although Unimed is currently in Phase III testing for approval of Marinol in the treatment of Alzheimer’s patients) because of the drug’s "psychoactive effects." It seems odd that Marinol supposedly functions better as a medicine than marijuana, a substance casually consumed by millions of Americans without such debilitating side effects.

 

Hoping to discover specific patient complaints against Marinol, and not just potential side effects or anecdotal information, I contacted the Food and Drug Administration (FDA) for more information on adverse effects caused by Marinol. I was told that this information was confidential, and that only by using the Freedom of Information Act (and enclosing a check for $70) could I attain limited access to this knowledge, and even then, certain details would remain censored. By contrast, if I needed information on marijuana’s adverse effects, I could contact hundreds of sources (including elected officials, rehabilitation centers, law enforcement, internet sites, parent groups, local libraries, pharmacies, etc.) from whom I could receive a deluge of free information. Another medical paradox exposing the sharp contrast between the popular conception of marijuana and Marinol involves carcinogenic studies. Anti-marijuana government studies had very tentatively linked marijuana smoke (and not ingested marijuana) with lung cancer in an unpublished report (although a recent panel of scientists re-examined that report and found that marijuana was actually found to prevent malignancies not cause them). Despite the presence of THC, common to both marijuana and Marinol, no carcinogenic studies have been performed on Marinol. Culturally, marijuana continues to face vilification while Marinol enjoys legitimacy and government backing. Sick people face harsh criminal penalties for self-medicating with natural THC, while patients using synthetic THC get insurance coverage and freedom from persecution and prosecution. The influential role that politics plays in science and medicine can explain the enormous rift in the cultural perception of these two essentially similar substances. Only a close examination of political influence in medicine can explain popular culture’s polarity regarding marijuana and Marinol perception.

 

POLITICS AND MEDICINE

 

Medicine may seem like a domain completely outside of political debate, but the information garnered in this examination thus far suggests otherwise. Scientists and medical researchers compete for funding from government agencies and private business. If the government has strong anti-marijuana policies, then logically, the studies which they fund will attempt to further indict marijuana. John Falk, a researcher from Rutgers University, explains,

 

Policy can be a closed, self-validating system, almost impervious to scientific facts: While science considers new facts and alternative explanations and rejects them on logical or empirical grounds, policy can be dismissive of facts and alternatives simply on the grounds that they are distasteful.

 

Governments regularly accept or reject scientific studies based on their relation to desired policies. For example, President Richard Nixon hand-picked a federal commission to determine an improved marijuana policy. After several years of research, the commission concluded that decriminalization of marijuana was the best drug policy option. Since this result was intolerable to the drug warrior Nixon, he ignored the recommendations of his own counsel. Another example of government ignoring science involves the Compassionate Investigative New Drug (IND) program which supplied government grown medical marijuana to a handful of patients from 1978 until 1992. Due to a rising number of applications from AIDS patients, President George Bush terminated the program, not because it harmed people or led to increased drug abuse, but because he wanted a "zero-tolerance" stance towards all illegal substances in his War on Drugs, and because the legal pot might "send the wrong message" to children. Only eight patients (known as the Acapulco Eight) continue to receive medication under that program thanks to a hard-fought grandfather clause; the rest have already died.

 

The terminology spouted by politicians in the War on Drugs further illuminates the often subtle (or not so subtle) relationship between politics and medicine. From the popular phrase of the 1930s referring to marijuana as the "assassin of youth," to contemporary use of such militaristic phrases as "war on drugs" or "combating the drug menace," such highly dramatic linguistic manipulation reveals an underlying attempt to influence the uncritical American public. In the 1930s, marijuana intoxication was popularly referred to as "reefer madness," implying insanity, unpredictability, and hyperactivity. Today, the terminology for that same state of intoxication has shifted 180 degrees to "amotivational syndrome," implying indolence and slovenliness. The complete inversion of negative accusations maligning marijuana only reveal how arbitrary and unfounded the indictments really are. Continuing the semantic war after the passage of Proposition 215 in California and Proposition 200 in Arizona, federal bureaucrats, including "Drug Czar" Barry McCaffrey, quickly claimed that voters were "duped" by wealthy "potheads" promoting "Cheech and Chong medicine." Anti-marijuana rhetoric continued streaming from the lips of politicians and from newspaper presses despite the majority approval of both propositions. Like medical authority, Stanton Peele, remarked, "To put it simply, saying bad things about drugs is never questioned, and disconfirming information never requires revision of original claims." Medical issues lay dormant under the political cloud raised by vociferous opponents of marijuana, while advocates only prayed that a strong grassroots effort would influence public opinion to the extent of changing policy. Even though voters approved both propositions, the Clinton administration announced that physicians prescribing marijuana were still subject to criminal punishment, proving that neither medical arguments, nor voter approval, can change an entrenched government policy.

 

During these medical marijuana debates, Marinol remained elusive, yet ever-present. Newspapers and magazines loosely referred to dronabinol as a legal alternative to smoked marijuana, although very few reporters commented on Marinol’s numerous side effects, or on patient claims that marijuana worked much better than synthetic THC. Unimed’s National Sales Director, Brian Jennings, explained to me in a telephone interview that Unimed knew about the propositions before hand but chose not to officially participate, because they felt medicine should remain outside of the political sphere. Jennings stated, "It is not for us to determine what should be medicine and what shouldn’t." When asked if Unimed had received thank you mail from recovering patients, Jennings exuberantly responded, "Yes! But you won’t hear that on the media," meaning positive representations of Marinol allegedly pale in comparison to those of marijuana, a favorite topic of journalists. Based on this telephone interview, it seemed as if Unimed was sincerely interested in helping sick people, and not in fanning the flames of marijuana hysteria, or simply in making larger and larger profits. However, after carefully reading their roughly 200 page investor portfolio, only one mention was made of assisting sick people in need. The bulk of their literature focused on profits, plans, and bottom lines.

 

To guarantee that they lost no precious profits to decriminalized marijuana, Unimed hired a top public relations firm during the West Coast medical marijuana debates. This publicity company sent news releases to every major newspaper in America explaining the existence of Marinol and its benefits over marijuana. Although Unimed’s National Sales Director informed me that his company preferred not to participate in the debates, he neglected to mention that they had hired someone to participate for them. In these press releases, much of the information was exactly accurate; however, several statements were simply untrue. Unimed claimed that "patients using Marinol do not experience a ‘high’ and are thus able to work and perform normal daily functions unimpaired." This claim directly contradicts Marinol’s 1995 product insert which explains that "dose-related ‘high’ has been reported by patients receiving Marinol…" Evidently, Unimed hoped to draw a clear distinction between Marinol and marijuana, and although numerous differences already exist, they chose to create false ones, hoping to capitalize on the further maligning of cannabis. Other examples of Unimed’s attempt to infiltrate mainstream media with marijuana lies include the blatantly false claim that Marinol pills are taken only once per day, while marijuana must be smoked several times per day, thereby causing inconvenience, lung damage, and other more serious complications. The user directions on Marinol’s product insert specifically state that two capsules per day are required as a starting dosage, after which more daily capsules are suggested. In addition, medical marijuana consumers self-medicate as needed; which, for patients using cannabis to prevent the nausea associated with chemotherapy, equals about one cigarette every few weeks.

 

Although the Unimed press release cites the absence of controlled clinical studies proving marijuana’s safety and effectiveness, such studies remain impossible to conduct because of NIDA’s refusal to grant cannabis to researchers who support medical marijuana. Dr. Donald Abrams of the San Francisco Community Consortium gained authorization from the FDA and the National Institute of Health (NIH) to study marijuana and Marinol’s effects in AIDS cachexia. Unfortunately, NIDA denied him access to their pot supplies. They claimed that if they granted marijuana to Dr. Abrams then they might become deluged by other research proposals requiring marijuana. This bureaucratic entanglement represents one aspect of drug policy in popular culture; however, to fully explore the scope of this issue, one must examine the debate through more mainstream media sources.

 

Americans consistently support medical marijuana in polls, but that majority seems to disappear in the public sphere. While Rolling Stone magazine contends that the war on marijuana exists for political purposes completely outside of medical considerations, the New Republic argues that Proposition 215 serves as a front for drug legalization advocates and that medical cannabis clubs are populated by a "sorry lot of smokers who are not sick." This disparity in public opinion mirrors itself regularly throughout popular American culture. For example, a Los Angeles Times Column Right author, Charles Krauthammer, angrily exclaimed, "The cannabis clubs are a sham, an invitation to every teenager with a hangnail to come in and zone out." In contrast, the Los Angeles gay magazine 4Front ran a cover article titled, "Clinton/McCaffery Declare War on People With AIDS!!!," wherein they vehemently declare, "This two bit General [McCaffery] has declared war on people with AIDS. It’s outrageous that the President who ‘didn’t inhale’ is denying sick and dying people the relief that medical marijuana provides."

 

Further examples of the public polarizing around this issue abound throughout American pop culture. For instance, Newsweek magazine claimed that, "The problem with Marinol is that is doesn’t always work as well as smoking marijuana.", while my local newspaper, The Daily Breeze, printed an article claiming that, "With smoked pot, the dosage varies substantially, so it is usually a lot easier to prescribe a pill." Gary Trudeau, creator and cartoonist of Doonesbury, also joined the cultural melee by creating a Sunday comic strip about Proposition 215. When the main character, Zonker Harris, learns about California Attorney General Dan Lungren’s massive raid on the San Francisco Cannabis Buyer’s Club, he incredulously asks, "What country are we living in? Germany? Russia? Idaho?" Lungren must have realized that a major act of aggression against a medical supplier to severely ill patients would not earn him much popularity; however, Trudeau’s biting comic strip angered him so much that he demanded Doonesbury’s distributor, Universal Press Syndicate, to promptly remove the comic. Much to his chagrin, they refused.

 

Even advice columnist Ann Landers joined in the cannabis debate by stating, "I do believe that medical marijuana should be available for medical needs, since this serves a humane purpose." Although other contributors to her column challenged her position, citing marijuana’s alleged "gateway" effect leading to harder drugs. One respondent from La Grange, Illinois, sarcastically commented, "[the] idea of releasing marijuana prisoners is great, but…doesn’t go far enough. Let’s release all of the murderers too…Free the rapists. Then, put all the child molesters back on the streets." Clearly, passion underlines all opinions, but consensus seems hopeless.

 

The medical marijuana versus Marinol debate rages among medical practitioners as well. After DEA Associate Chief Counsel Steven Stone suggested that only a fringe group of oncologists accepted marijuana as an antiemetic, two Harvard scholars conducted a poll to verify that statement, and discovered a vastly different reality. They sent detailed questionnaires to over 2,000 registered oncologists, and found that 44% of respondents think that marijuana is safe and efficacious, and would prescribe it regardless of legality. Nearly 90% of respondents accepted the medical use of Marinol, thereby leaving dozens of doctors who reject its use. Interestingly, respondents who graduated from medical school during the "Just Say No" Reagan era were significantly less likely to favor medical marijuana, while those who graduated in the 50s, 60s, and 70s had higher rates of approval. Based on these findings, the study’s authors concluded that smoked marijuana remains superior to oral THC because:

 

The bioavailability of THC absorbed through the lungs has been shown to be more reliable than that of THC absorbed through the gastrointestinal tract, smoking offers patients the opportunity to self-titrate dosages to realize therapeutic levels with a minimum of side effects, and there are active agents in the crude marijuana that are absent from pure synthetic THC.

 

The two essential points that greater bodily absorption and greater self-medicating control are possible with medical marijuana use (and not Marinol use) cannot even be denied by much hyped anti-marijuana studies, like those of the notorious Dr. Gabriel Nahas. The argument that marijuana contains more than one active ingredient, thereby implying that Marinol cannot possibly replicate all of marijuana’s medical effects, finds favor among many physicians and physicians’ groups. Arthur Leccese of Gambier College further explains this sentiment, "Consideration of the basic pharmacology of marijuana reveals the error of public policy that denied therapeutic benefit to those who might profit from inhalation, or oral consumption of more than one psychoactive component of the crude marijuana plant." Since marijuana is composed of hundreds of compounds, it seems arbitrary for U.S. medical policy to only accept one of those compounds as medically valid. Many other respected organizations share this disapproval of current U.S. drug policy. For example, the following medical groups and journals favor medical marijuana over Marinol: National Academy of Sciences, American Public Health Association, California Academy of Family Physicians, San Francisco Medical Society, Federation of American Scientists, Psychopharmacology, and most recently, the New England Journal of Medicine. Although these organizations normally carry tremendous influence, the current government drug policy disfavors medical marijuana to such an extent, that even these organizations lose their voice.

 

With prominent medical organizations and journals being ignored by federal policy makers, and with many mainstream magazines and newspapers creating a general uproar over the medical marijuana issue, the recent furor in America sparked by the passage of Propositions 200 and 215 truly highlights the relationship between science and politics. Dennis Peron, the driving force behind Proposition 215, wonders, "What in the world is a retired Army general doing telling doctors what to do?" Regardless of their position on synthetic vs. natural THC, most doctors agree that government does not belong in their medical affairs. Some oncologists find it extremely hypocritical that someone can acquire terminal cancer by smoking cigarettes, yet they cannot medicate themselves with marijuana. Cancer specialist, Elizabeth Lowenthal, writes about this paradox in the Journal of the American Medical Association,

 

It is ironic to inform cancer patients that they cannot partake of marijuana to relieve their metastatic lung cancer associated anorexia and cachexia acquired from years of partaking in ‘the only consumer product sold legally in the United States that is unequivocally carcinogenic when used as directed.’

 

Prominent medical marijuana expert Lester Grinspoon, author of Marihuana: The Forbidden Medicine, illuminates another paradox in U.S. drug policy, stating that, "Cocaine and morphine, for example, have always been available as prescription drugs, but no one believes that availability is a significant cause of illicit use." Both cocaine and morphine have maintained Schedule II classification since the Controlled Substances Act began in 1970. Marinol also rests in Schedule II, although Brian Jennings, National Sales Director for Unimed, informed me, "I think it is well known that we are trying to place Marinol in Schedule III." By dropping down to Schedule III, Unimed can sell Marinol without completing the mandatory DEA paperwork required of all Schedule II drugs. In essence, it would remove another level of bureaucratic interference from sales, and it would make their product seem less potentially harmful. All of these sorts of medical, governmental, theoretical, policy-based, complex issues sit squarely in the borderlands shared between science and politics.

 

Having extensively analyzed the Marinol versus marijuana debate from a popular culture perspective, and within a historical and theoretical context, it is now apparent just how differently America treats two essentially similar substances. Marinol enjoys cultural and medical legitimacy from society, as well as tax breaks and open market privileges from the government. Marijuana users still risk incarceration and social marginalization, while simultaneously suffering from debilitating illnesses. Despite the wealth of scientific information and the bevy of organizational support illustrating marijuana’s numerous medical benefits, the federal government chooses to validate the inferior Marinol medication, and to continue its war on drugs and drug users. Considering America’s history of vilifying marijuana, and given the American penchant to promote pharmaceuticals over all other medicines, the current drug policy should not shock us, but it should disappoint us.

 

 

 

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