Marijuana Made Easy
Only time will tell whether Marinol can capture the medical-marijuana market. But Roxane isn't taking any chances. Since 1996, when Californians first endorsed medical marijuana, the company has been waging a high-powered PR campaign. According to Querry, the company retained Hill & Knowlton "to educate the physicians and the public and the legislatures" about Marinol, because the drug is often mischaracterized by advocates of medical marijuana. Roxane describes this activity as public education, not lobbying.
The company also sought out respectable doctors who would tour states where marijuana initiatives were being launched. The lineup it settled on included Dr. Gary Cohan, an HIV specialist who helps run the Pacific Oaks Medical Group in Beverly Hills; Dr. David Smith, an HIV specialist who founded the Haight-Ashbury Free Clinics in San Francisco; and Dr. Lonnie Bristow, a San Pablo-based internist. In September 1997 Drs. Cohan, Smith and Bristow met with the editorial board of the Tacoma, Washington, News Tribune to sing the praises of Marinol. Their arguments were repeated in a long opinion piece by the News Tribune's chief editorial writer, who noted, "Roxane was footing the bills for the trip, but the physicians in question cannot be dismissed as mere shills."
By the spring of 1998, Dr. Cohan had become ubiquitous on the marijuana policy circuit. Within about a year, he testified in a federal court case involving marijuana in California, spoke at a "Marijuana Education Summit" in Florida and represented Roxane's interests at a legislative hearing on marijuana in Colorado, along with Drs. Bristow and Smith. Meanwhile, Dr. Smith was doing his part on the research front, thanks to a grant from Roxane's partner, Unimed Pharmaceuticals, to the Haight-Ashbury Free Clinics. In June 1998 Roxane announced the results of a nine-month study conducted by Smith that found "no evidence" that Marinol had ever been abused or sold as a street drug. A year later, when the DEA moved Marinol to Schedule III, the agency cited Smith's study but did not disclose that the study was partly funded by the very company that would profit from the rescheduling and that has helped the government keep marijuana on the blacklist.
Like Dr. Smith, Dr. Cohan has continued to represent Roxane's interests without fanfare. In March, after the Institute of Medicine announced that THC has a distinct therapeutic value, Cohan appeared on CNBC's Rivera Live as an authority on HIV. He dismissed the idea of "allowing people to smoke a crude plant material to get a medicine of unknown dose with lots of contaminants"--but did not disclose his financial ties to Roxane.
A Roxane spokesperson, asked about the doctors' apparent conflict of interest, said that doctors like Cohan and Smith get many speaking invitations and that the company occasionally picks up the expenses. But, he said, the American Medical Association does not require doctors to disclose any affiliation with industry, except in the context of continuing medical education. Asked about the Smith study, he pointed out that drug manufacturers typically pay for clinical trials and that paying for a study does not mean a company can influence the conclusions.
A DEA spokeswoman said the agency based its decision to reschedule Marinol on many factors, of which the Smith study was just one. If only the government would give the same credence to the voluminous evidence that marijuana is good medicine, too.