Medical marijuana will be available in the District of Columbia starting at some point in 2011, under tight restrictions. In August, Mayor Adrian Fenty’s administration issued a detailed set of rules, which will be taken up by the D.C. Council this fall.
At the time, Fenty said, “All District residents deserve access to the full slate of medical treatments available. My administration will work to ensure that medical marijuana is dispensed safely and efficiently.”
The rules call for the creation of five dispensaries, where marijuana will actually be obtained, and 10 cultivation centers, where the plants will be grown. The dispensary sites have not been chosen yet, but there has been talk of Adams Morgan, Georgetown, Petworth, and Takoma Park, among other places.
The D.C. law permits physicians to recommend marijuana for patients with cancer, glaucoma, and other conditions that cannot be treated effectively by other means. It also permits the prescription of marijuana for HIV/AIDS -- but one doctor who treats patients with HIV thinks that’s a bad idea.
“Medical marijuana, although a popular concept among patients and activists, has not been shown in clinical trials to be beneficial for those infected with HIV,” says Andy Catanzaro, an infectious diseases physician practicing in the District. “It may benefit other patients, but in my practice there are none infected with HIV who would derive benefit from using marijuana.”
Catanzaro says that when the District first voted on medical marijuana in 1998, “effective treatments for HIV were just beginning to be widely used by those of us in practice. Patients were dying, wasting away from the disease and needed measures to end their lives in comfort.”
But in 2010, he says, “we are blessed to have dozens of options to treat HIV. Thanks to careful and deliberate research on these medications, very few patients die from AIDS.”
Catanzaro points out that a 26-year-old HIV-positive patient treated with medications now available has a life expectancy of 70 years. “People in the District do still die of AIDS,” he says, “but thankfully nearly all on medications can lead healthy lives.”
But why not make marijuana available to provide for these patients’ comfort?
Catazaro says smoking any substance is unhealthy, and that regular marijuana use can result in depression. The release of canniboids from smoking marijuana can “suppress the immune cells which are destroyed by HIV,” he adds. And while marijuana-related memory loss is a staple of comedians everywhere, Catazaro says in some of his patients, marijuana-related memory loss has been so severe that they forget to take their medications.
Catanzaro concedes that “popular sentiment for medical marijuana is strong,” but says that, “however good the intentions are of advocates, we should avoid using popular sentiment to shape medical treatment.”
Catanzaro says the legalization of marijuana for HIV/AIDS patients sends “a message to marijuana smokers that our city council believes there is an indication for its use in HIV.” In fact, he says his patients have said that they interpret the passage of the law as an endorsement by the District government of marijuana as a treatment for HIV.
“I am not in favor of legalizing marijuana as a treatment for these patients,” he says. “Since there are already tolerable, safe and effective treatments, claiming that medical marijuana is treatment for AIDS patients misconstrues the evidence using outdated arguments.”
Follow P.J. Orvetti on Twitter at @PJOinDC