It's 3 p.m. on a Monday, and Joe Gamble is struggling to make a cup of tea.
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His arm flails away from the counter several times before he's able to direct the sugar dispenser over the cup. The spoon twitches in his hand, banging against the sides of the mug.
Gamble pauses mid-sentence, unable to remember the ending of the story he just began telling.
Three hours have passed since Gamble, 33, last medicated himself. The symptoms of his multiple sclerosis are taking hold of his body.
Gamble takes a sip of tea and politely excuses himself. He shuffles to the door, climbs down two steps and plops down on the hood of the cherry red Porsche sitting in the driveway of his Liverpool home. He pulls a small marijuana pipe out of his pocket, brings it to his lips and inhales deeply.
A look of relief flashes across Gamble's face. He also looks a little guilty.
"Every time I light that pipe, I feel like a criminal," Gamble says. "I shouldn't have to. I'm way too sick for that."
A few puffs later and the change in Gamble is striking. The tension in his limbs lessens. His gait improves. He speaks clearly and freely.
"What am I supposed to do?" Gamble asks, almost pleading for approval. "Marijuana makes my life a little livable. I don't get stoned. I don't get that euphoric feeling. It just helps the tremors."
Two years ago, Gamble was diagnosed with primary progressive multiple sclerosis. Unlike other forms of the disease, Gamble's type of MS promises a steady progression of disability without relapse or remission. There is no cure.
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Michelle Gabel / The Post-StandardMarijuana is shown among Gamble's daily dose of medication.
Gamble remembers the exact moment he knew he was sick. He was flying a jet, doing 600 mph and climbing to 36,000 feet when his body went numb from the neck down.
Before being diagnosed, Gamble spent most of his waking hours flying: first, as an Army paratrooper, then as a transport pilot. During his almost 13 years in aviation, he flew the bodies of dead soldiers home to their families, carried travelers to their destinations as a commercial pilot for US Airways and shuttled celebrities, dignitaries and politicians to events on private planes.
"Now it's the politicians I used to fly that need to help me out, help out us sick people," Gamble said.
Grounded because of his illness, Gamble now uses his time to advocate for the legalization of medical marijuana. He recently traveled to Albany to tell lawmakers his story first hand.
"I used to be a hot-shot pilot," Gamble said. "Now, I'm all about the MS awareness."
Gamble is far from the stereotypical tie-dyed hippie pushing for pot. He's clean cut. He wears a crucifix around his neck and a dog tag engraved with the words, "God doesn't give what you can't handle."
He hopes his military experience gives him credibility.
"I'm not glad that I'm sick, but I'm glad that because of my background, maybe people will listen to me," Gamble said.
State lawmakers this year have introduced bills in both the Senate and Assembly to protect patients from being arrested if they use medical marijuana under a doctor's recommendation. Similar legislation passed the Assembly two straight years but died each session in the Senate.
"Medical marijuana's safety and efficacy in treating certain painful, often life-threatening diseases is a well-documented scientific fact," said Sen. Thomas Duane, D-Manhattan, the Senate sponsor of the bill. "There is no reason we can't establish common sense controls to ensure safe access to this medicine for suffering patients who have their doctors' recommendations while ensuring it doesn't wind up in the wrong hands."
"It is cruel to make seriously ill patients criminals for relying on medical marijuana for relief when their doctor recommends it," said Assemblyman Richard Gottfried, D-New York, the bill's Assembly sponsor.
Gamble understands some people's hesitation about medical marijuana. He recognizes that the drug isn't for everyone. If a legalization bill were passed, he said, education would have to be a key component.
Parents, for example, would need to treat medical marijuana as they would any prescription drug, locking it in a medicine cabinet and teaching their children to stay away.
Those concerns, however, aren't a reason to kill the bill, Gamble said.
"A lot of people abuse alcohol and they put it up on billboards," Gamble said. "Yes, it's illegal. But I'm not going to stop."
Thirteen states have enacted laws that remove criminal penalties for medical marijuana patients. Eleven of those states conducted before-and-after studies, and all have seen marijuana use by youths decline since passing medical marijuana bills, Duane said.
"The reason I think that I'm doing so well is because I smoke pot," Gamble said.
The marijuana helps restore Gamble's appetite. He has lost 20 pounds since being diagnosed. It also helps Gamble sleep. Without it, he said, his legs shake violently and his body locks up -- a frightening sensation, he said.
"If I don't smoke, I turn into a disaster," Gamble said. "It's embarrassing to me. I'm still getting used to being around people."
Marijuana also keeps Gamble off stronger narcotics. As it is, Gamble takes an assortment of almost a dozen drugs daily. His medication list fills half a notebook page, while a tally of his symptoms takes up the entire sheet.
So far, Gamble has avoided having to use a wheelchair, but he expects the bright yellow model he ordered to arrive any day.
"If I didn't have the marijuana, I'd probably be getting prescribed Hydrocodone, Morphine, Vicodin, and those are the drugs people are abusing," Gamble said. "They're quick to give you the pain pills at the hospital, but I think I'm doing the right thing. I'm doing my best to stay off the heavy stuff, the stuff that makes me completely numb."
"It's not a cure," Gamble explained of the marijuana. "I'm still in pain. It's just a remedy for a couple of hours. If there was something else they could give me to help, I'd take that."
More than a dozen national and state medical organizations support medicinal marijuana use, including the Medical Society of the State of New York (which has lobbied in Albany for a medical marijuana bill), the National Academy of Sciences' Institute of Medicine and the American College of Physicians.
"Cannabinoids (the active ingredient in marijuana) have been shown to ease pain, help with muscle spasms, help with appetite, help with mood state," said Dr. Gregory Carter, professor of rehabilitation medicine at the University of Washington and author of "Marijuana Medical Handbook: Practical Guide to Therapeutic Uses of Marijuana." "Even more interesting, we're now seeing cannabinoids can help nerves protect against toxins and can have an anti-inflammatory effect."
That could be key to helping patients with such diseases as Alzheimer's and rheumatoid arthritis, Carter said.
Synthetic marijuana drugs, such as Marinol, pale in comparison to the real thing, Carter said.
"They're not as effective at all," he said. The synthetics take longer to absorb, and patients have little ability to control their dosage.
Ironically, Marinol contains 100 percent pure THC (the active ingredient in marijuana) and can be prescribed with a simple phone call from a doctor, whereas natural cannabis contains 20 percent THC but is considered a Schedule 1 substance, meaning the U.S. Drug Enforcement Administration considers it as having a high potential for abuse with no accepted medical use.
"It's just ridiculous," Carter said. "It's mind-boggling how stupid the laws are, how they have ruined people's lives and how much they have cost the government. They're just absolutely insane."
"I think the DEA and FDA need to stop being guided by propaganda," he continued. "Rational minds need to drive drug policy, separating myth from fact, right from wrong, and responsible medicinal use from other uses."
Because marijuana is illegal in New York state, Gamble must buy his stash on the black market. Two of his "dealers" are an older couple, one of whom is dying of cancer. They sell marijuana on the side to pay their bills.
"Instead of paying $200 an ounce, why can't I go to a dispensary and pay a $50 co-pay?" Gamble asked.
For Gamble, the biggest challenge is fighting people's assumptions that he's just some pot-head kid.
"I look normal," he said. "But I'm not."
More than worrying about himself, Gamble says he fears for the old lady who has no access to marijuana to ease her pain.
Legalization could even help close the state's budget deficit, Gamble suggested.
"I mow my lawn. I pay my taxes. I visit my family. I don't want to feel like what I'm doing is wrong," Gamble said. "You don't know what this is like. I'm doing the best I can to be a law abiding citizen. But there's too much pain."
For reasons still not fully understood, an MS patient's immune system attacks the protective sheath that surrounds the body's nerve fibers. The damage shows up as scar tissue (sclerosis), which can disrupt signals sent by the brain. That disruption leads to symptoms that range from mild, such as numbness, to severe, such as blindness and paralysis.
In Gamble's case, lesions have peppered his brain. The biggest measures 9 millimeters in diameter and sits at the top of his brain stem. Gamble used to keep copies of his MRI's posted on his kitchen wall, with the lesions highlighted in red glitter paint, but he decided the artwork was too morbid.
As far as smoking pot, Gamble says he generally chooses to smoke in private, but he's not worried about getting caught. Nurses encourage him to do whatever makes him feel better, he said. Friends in law enforcement turn a blind eye.
"I have not had one person say, 'That's wrong, don't do it,'Â¤" Gamble said.
With Democrats in control of the state Senate for the first time in decades, Gamble believes this could be the year a medical marijuana bill passes in Albany. He said lawmakers received him very well during his recent trip to the Capitol.
"They seem pretty optimistic, upbeat, positive," he said. "I think it helped having me there."
Both the Senate and Assembly bills are moving through the committee process now. Gamble hopes lawmakers bring the legislation to a vote before this year's session ends in June.
"This should be the year," Gamble said. "I don't want to be a criminal anymore."
The state Senate has yet to vote on the issue, but medical marijuana bills have passed the Assembly twice -- in 2007 and 2008. Each time, votes followed party lines.
Democrats approved the legislation, while Republicans voted against it. The trend included Central New York lawmakers.
Why the "no" votes?
Assembly Minority Leader Brian Kolb, R-Canandaigua, said he believes legalization is a federal issue.
"Nationally, it's against the law to purchase and distribute marijuana, period," Kolb said. "Right now, if we set up a mechanism for marijuana to be sold, it would be in (conflict with) federal law. If Congress wants to set national policy on something of this nature, that's fine. But I don't think it's up to individual states to determine drug policy."
by Delen Goldberg
Monday May 18, 2009, 5:00 AM
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Should marijuana be legally prescribed as a pain reliever in New York?