About 21 years have gone by since George McMahon landed in the University of Iowa hospital.
He was suffering from kidney failure, a fractured spine, nausea and extreme pain. Doctors had not yet discovered the root of his problems, a rare genetic disorder called nail-patella syndrome. But they told him one thing: He probably wouldn't live through the night.
That evening, McMahon smoked a joint — given to him by someone visiting an ailing cancer patient — with the thought “Why not?” Later that night, he was able to eat. Ten days later, he left the hospital.
Now 59, the north-central Iowa man is one of four remaining members of a federal program that provides them with marijuana cigarettes every month.
McMahon smokes the joints several times a day to manage the symptoms caused by nail-patella syndrome, which causes abnormalities of bone, joints, fingernails and kidneys.
For McMahon, things are crystal clear: Marijuana is medicine, and it's the one treatment that has allowed him to live his life.
But the matter is far from settled.
This month, the Iowa Board of Pharmacy will hold the first of four public hearings to take arguments for and against allowing the use of marijuana as medicine. The board could make a recommendation to the Iowa Legislature based on the results. The last of the hearings will be Nov. 4 at Harrah's Casino & Hotel in Council Bluffs.
State Sen. Joe Bolkcom, D-Iowa City, hopes the hearings give momentum to a bill he introduced this year that would have legalized medical marijuana. That bill stalled in committee. In 1993, a similar bill received unanimous approval in the Senate before dying in the House.
Thirteen states have legalized medical marijuana, though marijuana remains illegal under federal law. Medicinal marijuana is not legal in Nebraska.
One Omaha anti-drug advocate pointed to medical marijuana dispensaries that have cropped up in California and other states, which some critics say have made marijuana easier to access by those with no medical need for it.
Paul Carter, executive director of PRIDE Omaha, doesn't want to see that happen just across the river, in Council Bluffs. He said the worst message that legalizing medicinal marijuana can send is that it is a harmless or even helpful drug.
“It's saying, ‘If my grandma can smoke it for her cancer, it'd be great for me to do.' That's the totally wrong thing,” Carter said.
McMahon, the nail-patella syndrome sufferer, and Barbara Douglass, who has multiple sclerosis and lives near Storm Lake, Iowa, are among the four remaining participants in a national program called the Compassionate Investigational New Drug program.
Under that program, the federal government not only allows them to smoke marijuana, but it also provides about 300 joints to each of them every month for free. At its peak, the program had about 30 participants, but President George H.W. Bush closed it to new patients in 1991.
In Iowa, the pharmacy board is specifically looking for comment from scientific, medical and legal perspectives.
In the medical community, however, the topic has hardly been addressed.
The Iowa Medical Society, the Iowa Oncology Society and the Iowa Academy of Ophthalmology have not taken positions for or against medicinal marijuana.
The American Medical Association has recommended further studies on the effects of marijuana on treating pain and other symptoms. But pending such work, the AMA believes marijuana has a high potential for abuse and no accepted medical use.
Dr. George Kovach, a Davenport, Iowa, oncologist, said he doesn't see a compelling reason for legalization.
“I'm not sure the quality and quantity of marijuana can be delivered accurately compared to an FDA drug that has been approved,” said Kovach, president of the Iowa Oncology Society.
Federally approved drugs have side effects, McMahon said. Marijuana alleviates his pain and tamps down his nausea, allowing him to eat, drink and sleep.
“If I'm ill, if I'm rolled up in a spasm, if pain wakes me up, then I get up, I go smoke and I begin my day,” McMahon said.
For patients who would benefit from the anti-nausea effects of marijuana, Kovach recommended Marinol, an FDA-approved drug that contains synthetic THC, the active ingredient in marijuana.
Douglass, 53, was diagnosed with multiple sclerosis when she was 32. She is now blind and unable to walk.
She has a full prescription of Marinol, in her refrigerator, that she never touches. The drug is too expensive, she said, and it doesn't work as well as the marijuana cigarettes she receives free from the federal government each month.
“I could have all these drugs they give people for MS,” Douglass said. “I don't want to. Needles? No way. Smoking a joint is a lot easier.”
While the pharmacy board likely will hear from people such as Douglass and McMahon, who say marijuana has made their lives bearable, they will also hear from current and former law officers, many of whom are against the idea.
“I will never support this. I will fight it till the end,” said State Rep. Clel Baudler, R-Greenfield, a former Iowa Highway Patrol trooper.
The Iowa Department of Public Safety opposed Bolkcom's bill, which would have created a marijuana registry and allowed those with qualifying medical conditions to obtain marijuana through new facilities called compassion centers.
Under that bill, marijuana would not have been distributed through licensed pharmacies. “There is obviously potential for abuses,” said Ross Loder of the Department of Public Safety.
Baudler is worried that legalizing marijuana for the sick is not the end game for proponents.
“It's just a nose of the camel under the tent to legalize marijuana totally,” Baudler said. “It's just the first step.”
Carl Olsen of Iowans for Medical Marijuana would like to see marijuana legal for everyone, but he'll settle for the drug being an option for people who are suffering from pain.
“To me, that's just a civil rights issue,” Olsen said.
Bolkcom said the bill he proposed had some problems, but he plans to amend it to make it more acceptable to law enforcement and others.
“The ultimate goal is to help people better manage their pain,” he said.
BY ELIZABETH AHLIN
August 9, 2009