Wednesday, March 17, 1999

WASHINGTON (Reuters) - A U.S.-commissioned report released Wednesday strongly backed the medical use of marijuana, declaring that for some people with serious diseases such as AIDS it may be one of the most effective treatments available.

The widely anticipated report by the Institute of Medicine (IOM) was commissioned by the White House Office of National Drug Control Policy and looked likely to prompt a thorough review of U.S. efforts to ban almost all marijuana use as dangerous drug abuse.

IOM investigators declared that marijuana was not particularly addictive and did not appear to be a "gateway" to the use of harder drugs such as heroin. They also said there was no evidence to indicate that approved medical use of marijuana would increase public abuse of the drug.

The IOM report, the product of more than 18 months of research, highlighted continued concerns over marijuana, noting that the common practice of smoking the drug was medically dangerous and asking for more studies on how the drug really works on the human body.

But on almost every front the independent medical review of scientific research and patient experience found "substantial consensus" to indicate that, for some people, the potential medical benefits of marijuana outweigh its risks.

"Smoked marijuana should not generally be recommended for long-term medical use," the report said. "Nonetheless, for certain patients such as the terminally ill or those with debilitating symptoms, the long-term risks are not of great concern."

The focus of the report was on "cannabinoid" drugs such as THC, the main active element in marijuana.

Research over the last 16 years has provided new insight into how these drugs work on both the brain and the body, where they can help to modulate pain, and alleviate other symptoms of serious illness such as anxiety, lack of appetite, and nausea.

The report said one focus of new medical and pharmaceutical research should be to design a "non-smoked, rapid onset" delivery system for the drug which could mimic the speedy action of a smoked marijuana cigarette.

But the report's authors also noted that some desperately ill patients may not want to wait. "We acknowledge that there is no clear alternative for people suffering from chronic conditions that might be relieved by smoking marijuana such as pain or AIDS wasting," they said.

To help these patients, the report suggested that doctors be allowed to launch one-by-one clinical studies of marijuana, informing each test subject of the potential risks and rewards of smoking the drug.

The IOM report lands amid an increasingly bitter U.S. debate over medical marijuana, launched in 1996 when California became the first state to pass a local initiative aimed at allowing patients with AIDS, cancer, and other serious diseases to use the drug.

While federal authorities have used their power to block implementation of the California measure, voters in six more states passed similar initiatives in 1998 -- boosting pressure on the Clinton Administration to consider removing marijuana from the ``Schedule I'' list of dangerous narcotics.

Barry McCaffrey, Clinton's anti-drug "czar" and long an outspoken opponent of relaxing anti-marijuana law, ordered the IOM report in 1997 to give a scientific basis to the discussion, and his office Wednesday responded to the IOM findings with a call for more research.

"We will carefully study the recommendations and conclusions contained in this report," the Office of National Drug Control Policy said in a statement.

"We look forward to the considered responses from our nation's public health officials to the interim solutions recommended by the report."

Supporters of the medical marijuana movement declared the IOM report an unequivocal victory.

Bill Zimmerman, director of Americans for Medical Rights, the sponsor of six 1998 state marijuana initiatives, said the IOM's findings would radically rework the public image of what has long been one of the United States' most demonized drugs.

"They are in effect saying that most of what the government has told us about marijuana is false ... it's not addictive, it's not a gateway to heroin and cocaine, it has legitimate medical use, and its not as dangerous as common drugs like Prozac and Viagra," he said.

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