“It Has Come to This: Ignore the C.D.C.” So read the headline on the 8/31/20 op-ed in the New York Times by Dr. Harold Varmus, director of the National Institutes of Health under Bill Clinton, and Rajiv Shah, current head of the Rockefeller Foundation.
As we mourn the loss of respect for Science at the CDC (and FDA and EPA), let’s not forget that NIDA has put the interests of Big Pharma above the public interest —on orders from whichever Administration was in power— since its inception in 1974. When California voters legalized marijuana for medical use in November, 1996, the Clinton Administration’s first response came from Drug Czar Barry McCaffrey —flanked at a press conference by Attorney General Janet Reno, Secretary of Health & Human Services Donna Shalala, and NIDA head Alan Leshner. Doctors were warned that approving marijuana use by patients “will lead to administrative action by the DEA to revoke the practitioner’s registration.”
A month later —January 30, 1997 the New England Journal of Medicine ran an editorial by Jerome by Jerome Kassirer, MD, entitled “Federal Foolishness and Marijuana,” in which the editor-in-chief described the U.S. government’s policy as “misguided,” “hypocritical,” “out of step with the public,” and “inhumane.” The NEJM for reclassifying marijuana from Schedule 1 ) to Schedule 2 (which includes drugs deemed medically useful despite being potentially addictive, like and cocaine and codeine). Kassirer decried “the absolute power of bureaucrats whose decisions are based more on reflexive ideology and political correctness than on compassion.”
Also on January 30, 1997 —what a coincidence!— NIH Director Harold Varmus announced that a special conference had been called to resolve “the public health dilemma” raised by the passage of Prop 215. “I don’t think anyone wants to settle issues like this by plebiscite,” said Varmus, calling instead for “a way to listen to experts on these topics.”
The conference was organized by Alan Leshner of NIDA, which is a branch of the NIH. It was held February 19-20 in Bethesda and the experts concluded that the safety and effectiveness of marijuana in treating numerous illness is unproven.
“Analgesia: No clinical trials involving smoked marijuana have been performed in patients with naturally occurring pain… Neurological and movement disorders: Evidence that marijuana relieves spasticity produced by multiple sclerosis and partial spinal cord injury is largely anecdotal… There is scant information on the use of marijuana or other cannabinoids for the actual treatment of epilepsy… Nausea and Vomiting Associated With Cancer Chemotherapy: Since the approval of dronabinol in the mid 1980s, more effective antiemetics have been developed, such as ondansetron, granisetron, and dola-setron, each combined with dexamethasone. The relative efficacy of canninoids versus these newer antiemetics have not been evaluated…. Appetite Stimulation: Marijuana is reported to increase food enjoyment and the number of times individuals eat per day… There are no controlled studies of marijuana in the AIDS wasting syndrome, nor have there been any systematic studies of the effects of marijuana on immunological status in HIV-infected patients.”
The experts behind the Beltway called for “more and better studies.” Out in California, Dr. Tod Mikuriya called their conference “A stall in the name of science.” When he said it I pictured a “four-cornered stall,” like the one designed by the North Carolina coach Dean Smith to hold on to the basketball when his Tarheels were ahead at the end of a close game (before there was a shot-clock). NIDA to DEA to FDA to the PHS. The neo-prohibitionist strategy to deny their opponents a shot at proving their point.
In 1989 Varmus, then a professor at UCSF Medical Center, and Chancellor Michael Bishop won the Nobel Prize in Medicine for their discovery of the cellular origin of retroviral oncogenes. I took this picture after their celebratory press conference. —Fred Gardner
A decade later, still editing Synapse at UCSF, I encountered Alan Leshner, heavily pomaded and made up just to give a talk at Cole Hall.