MEDICAL MARIJUANA: IOM Study Finds ‘Moderate’ Benefits

     "[M]edical marijuana is getting strong, new support from a most unlikely corner, a government commission study. Marijuana, illegal under federal law, is now viewed as good treatment for the terminally ill, adding new fire to the debate over legalization and fear that it opens the door to more widespread use," NBC's Kelly O'Donnell reports ("Nightly News," NBC, 3/17). The active ingredients in marijuana appear to have medical benefits for patients suffering from advanced stages of AIDS and cancer, according to a long-awaited study released yesterday by the National Academy of Sciences' Institute of Medicine. The report marks the "most comprehensive analysis to date of the medical literature about marijuana," and comes at the request of White House drug czar Barry McCaffrey. In their "delicately worded" report, the 11 scientists concluded that medical marijuana would not increase illicit use in the general population, nor would it serve as a "gateway" to harder drugs. However, they warned that smoking marijuana carried its own health hazards, including lung disease, and recommended the drug be given "on a short-term basis under close supervision, to patients who did not respond to other therapies." In the meantime, the authors said smokeless methods -- capsules, inhalers and patches -- should be developed to deliver the active compounds without toxic side-effects of the smoke (Stolberg, New York Times, 3/18). The IOM review recommended that researchers:

• Investigate the effects of cannabinoids on the body to determine how the compound relieves pain, suppresses nausea and stimulates the appetite;
• Conduct clinical trials to develop new delivery methods;
• Evaluate the drug's psychological effects, "such as euphoria, anxiety reduction and sedation, to see whether they affect the perception of medical benefits in patients";
• Study the individual health risks of marijuana smoke;
• Require that marijuana receive medical review board approval, so that patients can receive it for six months or less;
• Require that patients use the drug as a last resort and under "careful medical supervision" (Larson, Washington Times, 3/18).

Fuel for the Fire
      McCaffrey commended the thoroughness of the report, but said, "I would note, however, that the report says 'smoked marijuana has little future as an approved medication.'" He said, "You should not expect to go into an ICU ... in 15 years and find someone with prostate cancer with a 'blunt' stuck in his face as a pain management tool" (Brown, Washington Post, 3/18). But proponents of states' efforts to legalize the drug nonetheless called on McCaffrey and the Clinton administration to ease opposition to the initiatives. Robert Kampia, executive director of the Marijuana Policy Project, said that in the past, medical marijuana advocates encountered resistance in Congress and state Legislatures because "of the myth that there was no medical value." But now, he said, "we can say, 'Here is the science, it was commissioned by the bad guys, and it shows that marijuana is good medicine'" (Curtius/Boxall, Los Angeles Times, 3/18). Bill Zimmerman, executive director of Americans for Medical Rights, predicted the report will spur legal and political efforts to legalize the drug, saying, "Government agencies, medical schools and Congress will debate this. There will be mounting pressure on the Clinton administration" to reschedule the drug (Haynes, Chicago Tribune, 3/18).

Everyone's a Critic
      Some advocates, including the National Organization for the Reform of Marijuana Laws and Harvard Medical School professor Lester Grinspoon, called the report "tepid" and "political" because it dismissed the fact that many long-term marijuana users have not suffered harmful consequences. And while battles over medical marijuana have taken center stage since California legalized it for medicinal purposes in 1996 -- followed by Arizona, Alaska, Oregon, Nevada and Washington -- some anti-drug groups "seemed to signal a softening in their strong public stance against medical marijuana." Steve Dnistrian, executive vice president of the Partnership for a Drug Free America, said, "We support all the recommendations. Who are we to contradict what doctors and scientists say?" (McFarling, Philadelphia Inquirer, 3/18). But "[D]on't look for the White House anytime soon to embrace the medical use of marijuana," said CNN's John King (Inside Politics, 3/17). The study is unlikely to change federal law, the New York Times reports, and HHS issued a written statement yesterday indicating "simply that it would continue to finance the work" of rescheduling medical marijuana (3/18). Click here to access the IOM Report.