THE SMOKE CLEARS: MARIJUANA CAN BE MEDICINAL, BUT THE SMOKE IS NOT

A new report on marijuana by the Institutes of Medicine offers a rational
approach to one of the nation's most controversial substances. In the most
comprehensive review to date by a panel of distinguished medical experts,
the IOM has concluded that certain chemicals inside marijuana known as THC
and cannabinoids are, indeed, medicine. The medical challenge now is to
isolate all of marijuana's helpful ingredients from the harmful ones in some
new form, such as a pill or vapor that is inhaled. The political challenge
is how to handle marijuana in the coming years (and they may be many) before
a real alternative to the joint is on the market.

The IOM's first conclusion undoubtedly will please the marijuana advocates:
"Scientific data indicate the potential therapeutic value of cannabinoid
drugs, primarily THC, for pain relief, control of nausea and vomiting and
appetite stimulation." This caveat, however, will please marijuana's foes:
"Smoked marijuana, however, is a crude THC delivery system that also
delivers harmful substances."

Neither conclusion is shocking nor unexpected. What is important is that it
comes from the nation's medical establishment, which for years avoided the
marijuana controversy until voters in California, Arizona, Colorado, Nevada,
Oregon and Washington sought to make the drug available for certain medical
conditions.

The report doesn't resolve the ongoing legal deadlock. Although a growing
number of states seek to legalize the drug for certain patients, federal law
bans the drug and designates marijuana as one of the nation's most
controlled substances. The IOM does, however, provide considerable
ammunition for relaxing federal law to allow states, which now regulate the
practice of medicine, to decide medicinal uses of marijuana as well.

The IOM, for example, found "no conclusive evidence that the drug effects of
marijuana are causally linked to the subsequent use of other illicit drugs."
Neither did it buy the argument that medicinal use of marijuana would
increase its use in the general population.

It remains unclear whether the government is willing to fund studies to
isolate marijuana's medicinal components. Even if the government did, would
a drug company be willing to gamble on investing in a product that might
prove less popular than the joint? Under the most optimistic of
circumstances, this process will take years.

In the meantime, the case becomes more compelling for Congress to let states
experiment with various ways to regulate marijuana while researchers work on
finding a better, safer and less controversial alternative.