News Briefs
News Briefs
Medical marijuana
Maine voters approve medical marijuana
An overwhelming majority of Maine voters approved a measure in the November elections supporting the medical use of marijuana.
The question, "Do you want to allow patients with specific illnesses to grow and use small amounts of marijuana for treatment, as long as such use is approved by a doctor?" was approved by 61% of voters. The law takes effect Jan. 1, 2000.
Exempt from prosecution under state laws would be patients in the following classifications:
• receiving a diagnosis from a physician as suffering from persistent nausea;
• experiencing vomiting;
• suffering from wasting syndrome or loss of appetite as a result of AIDS;
• undergoing chemotherapy;
• experiencing seizures associated with chronic, debilitating disease such as multiple sclerosis.
"We think it’s clear Maine people have taken a stronger stand for a compassionate drug policy than has the federal government," says Craig Brown, coordinator of the Portland-based Mainers for Medical Rights, the leading proponent of the proposal.
Patients will be allowed to cultivate their marijuana or purchase it. Patients are limited to 1¼ ounces of harvested marijuana, or six plants. If they choose to grow the crop, no more than three can be mature, flowering plants.
Maine is the sixth state to legalize the medical use of marijuana by voter initiative — the first state east of the Mississippi River to do so. States with existing laws are Alaska, Arizona, California, Oregon, and Washington. Bills are pending in Hawaii and Minnesota, and one will be submitted to Maryland’s legislature soon. Colorado voters will decide on the issue in November 2000.
The U.S. Justice Department, however, is challenging voter-aproved laws.
It will take decades — if ever — for medical marijuana to be approved by the U.S. Food and Drug Administration in Rockville, MD. That’s what critics at the Washington, DC-based Marijuana Policy Project say about new guidelines from the U.S. Department of Health and Human Services, which went into effect Dec. 1, 1999. The guidelines are for procedures to provide marijuana for medical research.
The guidelines are too cumbersome and will restrict research projects because there are too many government agencies in the chain of approving a request, says Chuck Thomas, director of the lobbying group. The group’s ultimate goal is the federal legalization of medical marijuana.
"It’s much more difficult to get permission to do medical marijuana research than it is to get permission to study any other pharmaceutical substance," adds Thomas. The group also accuses the Clinton administration of not being truthful when it says the doors are "wide open" for research on medical marijuana.
"A growing coalition of health and medical groups, doctors, scientists, and members of Congress disagree with the Clinton administration’s claim that the door is wide open for research," says Thomas. Further, the new guidelines reject the Institute of Medicine’s (IOM) recommendation for immediate patient access to marijuana through federal "compassionate use" programs. The IOM panel concluded that marijuana can help fight pain and nausea and should be tested further in scientific trials. The report was not released without controversy, however. (See Medical Ethics Advisor, April 1999, p. 40.)
Thomas and fellow activists also say the new guidelines place a greater burden on med ical marijuana researchers than on drug com panies that develop and study synthesized pharmaceuticals.
Less-intensive care not linked to deaths of elderly
Does lower treatment intensity explain shorter survival in elderly patients? That’s what researchers suspected when analyzing data on more than 9,000 patients. Results were published in the Nov. 16, 1999, issue of Annals of Internal Medicine.
What the researchers found, however, was that hospital resources were less likely to be available to older patients, and the likelihood of deciding to withhold life-sustaining treatments increased with patient age. For the purposes of predicting survival, however, researchers found that factors such as diagnosis and severity of illness were more important than age or intensity of treatment.
In an accompanying editorial, Steven Schroeder, MD, of the Princeton, NJ-based Robert Wood Johnson Foundation, which funded the study, congratulates the researchers for their findings. The study results, Schroeder says, will challenge the conventional wisdom of caring for the elderly ill.
Nursing homes will need hospice services
Nursing homes are increasingly providing hospice services to their residents, and the trend is expected to continue in the competitive long-term care industry, according to a recent report in the journal Gerontologist.1
An estimated 13,369 Medicare hospice beneficiaries reside in Medicare/Medicaid-certified facilities on any given day. For the most part, the study says, hospice beneficiaries are being served in nursing homes that do not have specialized hospice units because only about 1.3% of nursing homes have such units. Nevertheless, residents of those nursing homes are more likely to receive hospice care.
Is the trend deliberate?
The authors conclude that U.S. nursing homes are increasingly providing hospice services. They suggest the trend represents a deliberate management strategy for ensuring organizational survival in a rapidly long-term care market. Their investigation further suggests that the economically motivated path and potential profit motive in health care may give rise to unequal service and access.
Nursing homes with higher percentages of residents receiving the hospice benefit are more likely to be for-profit, belong to a chain, and not provide full-time physician coverage, the authors say. The proportion of residents receiving the hospice benefit increased in counties with fewer certified nursing home beds and in areas with more certified hospices, for-profit hospices, or larger hospices, they note.
The report’s authors assert, however, that those developments are occurring in the absence of much-needed outcomes data. While the significant variation in the distribution of hospice beneficiaries among states may be influenced by state Medicaid reimbursement rates and coverage policies, the findings of this study do not permit conclusions regarding the impact on individual residents.
Also, because research has shown that in many health care settings, "practice makes perfect," concentrating hospice patients in a relatively small number of facilities may be appropriate. The authors recommend further examination of the access and quality implications of providing hospice care to dying nursing home residents in order to inform future public policy.
Reference
1. Petrisek AC, Mor V. Hospice in nursing homes: A facility-level analysis of the distribution of hospice beneficiaries. Gerontologist 1999; 39:3.
First genetics, now proteins
Effort may change the future of health care’
Armonk, NY-based IBM is launching a new endeavor similar to the supercomputer developed to play chess, but this time the human body’s the focus of the computer’s effort.
A computer will be built of "staggering power" according to a company statement to solve the mystery of the structure of proteins. Proteins are considered the building blocks of the body.
"With this project we have a chance not only to change the future of computing, but also the future of health care," says Paul Horn, senior vice president of research at IBM.
IBM estimates it will take four to five years to build the estimated $100 million Blue Gene computer, which will be a million times faster than the average desktop computer. It will perform an estimated 1 million billion mathematical operations per second. The computer will be built and operated at IBM’s Watson Research Center in Yorktown Heights, NY.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.