A Tale Of Two Surgeons General: Greg Bledsoe & Joycelyn Elders Split On Medical Marijuana

Aug 31, 2016

Former U.S. Surgeon General Joycelyn Elders and Arkansas Surgeon General Greg Bledsoe.
Credit Jacob Kauffman / KUAR

Arkansans very well may have two medical marijuana ballot measures to vote on in November, with the battle firmly immersed in both political and scientific debates. 

KUAR’s Jacob Kauffman explores the divide on the medicinal merits of marijuana as seen by the state’s current surgeon general and one who rose to the national stage in 1993.

“A lot of physicians are concerned about labeling a plant that’s not FDA approved as medicine,” says state Surgeon General Greg Bledsoe.

Dr. Bledsoe is voice of the anti-medical marijuana campaign this election. He says most national medical associations are generally behind him, as is the science.

“Originally, when I started looking into this about a year go I thought there was a split. The more I’ve researched this and done background reading I think there’s less of a split as there is confusion over how you define the terms,” says Bledsoe.

Arkansas Surgeon General Greg Bledsoe during a Health Care Task Force meeting in 2016.
Credit Jacob Kauffman / KUAR

Governor Asa Hutchinson used to be top brass at the U.S. Drug Enforcement Agency. He’s no stranger to the debate over marijuana’s uses. But Hutchinson has largely deferred to his surgeon general to communicate opposition on these ballot items. Medical marijuana has popular support in recent polling.

“Any efforts in relation to voter education, in reference to opposition, should be from the medical community, from physicians. Those are trusted voices that the people of Arkansas would listen to,” said Hutchinson after the measure made the ballot.

But the scientific community is not squarely lined up behind the Republican governor.

“If a doctor feels that smoking a plant, or chewing and eating a plant, or however they consume it is helpful for their patients with certain chronic diseases and it makes them feel better, why not? Why not let them be as comfortable as they could be for as long as they could be? To me that’s what medicine is about,” says former U.S. Surgeon General Joycelyn Elders.

Dr. Elders never was the state’s surgeon general but was the U.S. Surgeon General in 1993, after 35 years in the healthcare field and six directing the Arkansas Department of Health. She has explored medical marijuana’s uses since the AIDS crisis in the 1980s.

“I came from a very research, scientifically based background. If I had a strong opinion it was based on science,” says Elders.

While Dr. Bledsoe opposes legalizing medical marijuana he isn’t in total disagreement with Elders. He too believes there are promising medicinal properties in cannabis, he just wants the FDA to refine it and approve it before voters do.

“I know very few, very few physicians who are concerned about using the compounds from the marijuana plant and purifying them and applying it to patient care. I don’t have a problem with that,” says Bledsoe. “When you look back at the history of the development of pharmaceuticals some of the best products we still have were derived from herbal remedies.”

However, in an unprocessed form Bledsoe says medical marijuana is just too distant from modern medicine to make him comfortable. He also argues it allows pharmaceutical companies to avoid the time and cost of an FDA study.

“When you define medical marijuana as a joint, the chemical compounds that are not pure, and the fact you can’t titrate the dose, and you’re giving one person one thing, another person another thing,” contribute to what Bledsoe suggests is an irregular application of an unrefined product.

Dr. Joycelyn Elders reviewing medical marijuana ballot proposal in her home.
Credit Jacob Kauffman / KUAR

Elders offers a rejoinder that medical marijuana will still go through doctors, and says under her preferred proposal – of the two – the Arkansas Medical Cannabis Act, the Department of Health would supervise. But Elders agrees with Bledsoe that the research could be better. She blames the federal government’s war on drugs for hampering a legitimate effort at medicinal research.

“The reason for it not being really considered was more of a racial, judicial decision as opposed to truly a medical one,” says Elders.

In light of these impediments, Elders thinks it’s appropriate for citizens to act – especially since 24 states have a legalized form of medical marijuana, as early as 1996 with California - often with state medical groups showing support for use in cases of pain, glaucoma, epilepsy, and a host of chronic conditions.

“We should not stand in line to make sure we’re last all the time. These states considered the use of medical marijuana. It’s been considered, it’s been used. Allow it to be studied, allow it to be approved by the FDA and put on the formulary. But until then take what we have learned,” says Elders.

One provision of the Medical Cannabis Act draws particular scorn from Bledsoe. It differs with the Arkansas Medical Marijuana Amendment by allowing certain patients to grow their own if faced with obstacles like distance to a dispensary. Bledsoe finds that idea is many bridges too far. But home grown doesn't bother Elders.

“I think everybody knows about my gardening. My tomatoes failed this year…you have to learn how to grow almost anything – even grass.”

The public’s opinion about medical marijuana – on four different state ballots - will be pulled and tugged at by electoral, political forces this fall. They may be joined by a litany of medical opinions this time too.

“Doctors should get up and get involved,” says Elders.

Bledsoe says, “Providing information to groups is a big part of the focus I should be involved with.”

KUAR will have more on the differences between the two ballot measures next month. The Arkansas Medical Cannabis Act initiative’s placement on the ballot is under legal challenge and the Arkansas Medical Marijuana Amendment, a constitutional amendment, is awaiting verification from the Secretary of State’s office.