SMOKE SCREEN

The Government Has Loosened Its Restrictions On The Study Of Marijuana. Is
This A Step Toward Legalization -- Or Just A Ploy?

WAY DOWN SOUTH, deep down in river country, your Uncle Sam is known to grow
himself a little -- shhhhh -- pot. That's right: for years, the federal
government has funded its own honest-to-goodness marijuana farm, located on
the campus of the University of Mississippi at Oxford.

Mind you, this government pot isn't being used for dorm-room bong hits.
Most of the marijuana harvested in Oxford is supplied to a tiny handful of
scientific researchers working under the eye of the National Institutes of
Health (NIH). And a small amount is sent to North Carolina, where it is
rolled into cigarettes and supplied to the eight individuals who are
allowed by the federal government to smoke marijuana for medical purposes.

But that's about it. The Ole Miss marijuana farm is an extremely restricted
operation discussed on a need-to-know basis -- which is exactly how the
government has wanted it. Historically, it's been easier to get a pair of
courtside seats to the NBA finals than an ounce of pot from the feds.

That may change, however. Late last month, the US Department of Health and
Human Services (HHS) announced that privately funded researchers may now
buy the government's marijuana to use in their own independent studies. In
the past, only researchers armed with NIH grants could tap into the
Mississippi stash.

At first glance, this looks like a major breakthrough for proponents of
marijuana, especially those who favor its legalization for medical use. For
years, medical-marijuana supporters have chafed at the government's
resistance to allowing comprehensive outside study.

But instead of celebrating, most marijuana activists are complaining. They
argue that the government's loosening of research restrictions is more a
ploy than a genuine change of position. They maintain that the feds are
still more interested in stalling the medical-marijuana debate than in
advancing it. And they express anger that the federal government refuses to
back off its pledge to prosecute sick people who use marijuana and the
physicians who recommend it.

"There's a misconception that the government is turning around on medical
marijuana, as if these new guidelines are some sort of major step in the
right direction. But in reality, they are a small step," says Chuck Thomas,
the communications director of the Washington, DC-based Marijuana Policy
Project. "And they could be a trap which could ultimately make things worse."

THE FORCE behind the government's movement on medical-marijuana research
was the March report by the National Academy of Sciences' Institute of
Medicine (IOM), which concluded that marijuana possesses "potential
therapeutic value" for patients suffering from cancer, AIDS-related
wasting, and other conditions (see "Up in Smoke," News, March 26). The
report, which had been ordered by US drug czar Barry McCaffrey and cost
nearly $900,000, was a colossal embarrassment to the feds, who had
maintained that medical marijuana was junk science. (McCaffrey himself had
referred to it as a "cruel hoax.")

The IOM report recommended that the government relax its restrictions on
research of marijuana's potential medical benefits, allowing for private
study. It also recommended that these researchers attempt to create
"alternative delivery systems" to smoked marijuana that would replicate its
medical properties while avoiding the health risks associated with smoking.

But though Health and Human Services officials followed up on the IOM
report by deciding to allow private research, critics worry that the
federal government's rules are still too restrictive. For starters,
marijuana researchers have to jump through more hoops than a schnauzer at
the Westminster Dog Show. There's a peer project review, a review by the
National Institute of Drug Abuse, a review by the Drug Enforcement Agency,
and, lastly, a review by the Food and Drug Administration.

Some review, of course, is necessary, but critics say that the government
is holding medical-marijuana researchers to a far higher standard than
other drug researchers. And not only are these reviews time-consuming,
critics argue, but they're costly. "You've got people being forced to spend
a gazillion dollars just to set up their research," says Michael Cutler, a
Brookline attorney who coordinates the Voluntary Committee of Lawyers, a
national organization of legal-trade drug-law reformers.

What really irks medical-marijuana proponents, however, is the government's
stipulation that researchers study marijuana's ability to treat conditions
for which there aren't any existing medications. "There are dozens of
[medications] which treat the same symptoms, but they're holding marijuana
to a different standard," says Chuck Thomas.

Thomas is pleased that the government is allowing private groups to buy its
marijuana, but he worries that these continued restrictions and rigorous
reviews may inhibit real research. That's exactly the idea, says Adam
Smith, associate director of the Drug Reform Coordination Network in
Washington, DC. "They [government officials] are trying to let a little
steam out and also buy themselves more time," he says.

But a bigger hurdle than the feds may be the pharmaceutical industry
itself. The government wants someone to develop a pharmaceutical
alternative to smoked marijuana, but skeptics wonder how much incentive
drug companies will have to try to replicate the properties of a drug that,
despite its illegality, is relatively affordable, available, and effective.
The IOM report theorized that the cost of developing an alternative
delivery system to smoked marijuana may be somewhere between $200 million
and $400 million. Does a corporation want to spent that kind of money to
make a synthetic analogue of a drug that's already out there and being used?

Critics argue, too, that some patients who need marijuana aren't going to
want to use alternative delivery systems, which are likely to be costly,
require prescriptions, and, in all likelihood, relieve symptoms less
effectively than the actual plant. "[If] you can get faster relief because
you smoke something you can grow in your closet, are you going to be buying
a pharmaceutical?" asks Lester Grinspoon, a Harvard Medical School
professor of psychiatry who is the co-author of Marihuana, the Forbidden
Medicine (Yale University Press).

And there's no indication that either the government or the pharmaceutical
industry is interested in one safer delivery system that already exists:
marijuana vaporizers, which allow users to inhale a puff of cannabis
without the hazards of smoking. No one's jumping to patent them
domestically, because vaporizers use whole-plant marijuana.

That's one of the reasons people like Lester Grinspoon contend that the
medical-marijuana discussion will continue to be held back until marijuana
itself is declared legal. After all, why put a vaporizer on the market if a
patient can't use it legally? "If we are ever to realize the full potential
of the medical potential of cannabis, we cannot do it in this setting of
this prohibition," says Grinspoon.

The reluctance of pharmaceutical companies to embrace herbal medicine in
general is another factor that could stall marijuana research. Herbal
remedies are increasingly popular and are the source of much consternation
in the industry. "This taps into a much broader debate between the
pharmaceutical companies and alternative medicine, between pharmaceutical
products and herbal products, and who regulates what," says Ethan
Nadelmann, the director of the Lindesmith Center, a drug-policy-reform
group in New York City. "Marijuana resides in the netherland between those
two worlds."

PERHAPS WHAT concerns reformers most of all is that the federal government
has yet to back off from its past promises to prosecute patients who
currently use marijuana and the doctors who recommend it to them. Even
though voters in seven states have approved the medical use of marijuana,
proponents say that many patients and doctors in those states are scared to
talk about it, much less use it, for fear of federal prosecution.

After the IOM report, there was hope that the government might expand its
"compassionate use" program and allow patients to use marijuana as long as
they were directly supervised by a physician who could regulate and record
the results of the treatment. This practice, known as "single-patient IND,"
or "n-of-1," trials, was encouraged by the IOM report's authors, who wanted
to make the drug available to sick people while alternatives are being
developed.

But HHS declined to sanction single-patient trials, infuriating
medical-marijuana proponents, who accuse the government of selectively
picking and choosing from the IOM report's recommendations. "The federal
government is using the calls for research as a delaying tactic to avoid
making marijuana legally available to patients who need it today," says
Ethan Nadelmann.

And that's tantamount to criminalizing the sick, says Chuck Thomas. "A
patient has to act like a college student in a dorm-room party to make sure
they don't get arrested," he says. "As long as there is one patient who
says they prefer the plant [to the alternatives], I don't want that person
to get arrested."