MARIJUANA HOAX

"Some dismiss medical marijuana as a hoax that exploits our natural
compassion for the sick.," notes a new report from the Institute of Medicine
that details the therapeutic potential of cannabis. The IOM's experts
discreetly refrain from adding that it's an opinion shared by the man who
commissioned the report.

"There is not a shred of scientific evidence that shows that smoked
marijuana is useful or needed," Barry McCaffrey, director of the Office of
National Drug Control Policy, told the San Francisco Chronicle in August
1996. "This is not medicine. This is a cruel hoax."

McCaffrey was campaigning against ballot initiatives aimed at allowing
patients to use marijuana without fear of prosecution. After voters in
California and Arizona approved these measures, he and other federal
officials threatened to punish physicians who recommended marijuana to their
patients.

At a December 1996 press conference, McCaffrey was asked whether there was
"any evidence...that marijuana is useful in a medical situation." His reply
was unequivocal: "No, none at all."

A week later, however, McCaffrey asked the IOM, a branch of the National
Academy of Sciences, to review the evidence of marijuana's medical
utility--evidence he had repeatedly claimed did not exist. The result was
this month's report, which confirms that McCaffrey is guilty either of
appalling ignorance or of bald-faced mendacity.

"The accumulated data indicate a potential therapeutic value for cannabinoid
drugs [marijuana's active ingredients], particularly for symptoms such as
pain relief, control of nausea and vomiting, and
appetite stimulation," says the report (available at www.nap.edu).
"Cannabinoids would be moderately well suited for certain conditions, such
as chemotherapy-induced nausea and vomiting and AIDS wasting."

The authors add that marijuana's tendency to reduce anxiety would probably
be welcomed by many seriously ill patients. They also note evidence that
marijuana helps control the muscle spasms associated with multiple sclerosis.

Looking at the drug's risks, the report says "few marijuana users develop
dependence," while any withdrawal syndrome is "mild and short-lived." The
authors find "there is no conclusive evidence that the drug effects of
marijuana are causally linked to the subsequent abuse of other drugs"--a
theory favored by prohibitionists such as McCaffrey. As for the idea that
"sanctioning the medical use of marijuana might increase its use in the
general population"--another of McCaffrey's favorite bugaboos--"there are no
convincing data to support this concern."

The report finds that "the adverse effects of marijuana use are within the
range of effects tolerated for other medications," with one exception:
Smoking it introduces toxins that may lead to respiratory illness over the
long term. For this reason, the authors conclude that the future of medical
marijuana lies not in smoking the whole plant but in absorbing its active
components through inhalers or other clean delivery systems.

The report concedes that developing and marketing such products will take
years, and it acknowledges that some patients get better relief from
marijuana than they do from the currently available alternatives. It
recommends that such patients be permitted to use marijuana under strict
rules and close supervision while research continues.

Harvard psychiatrist Lester Grinspoon, co-author of Marihuana, Forbidden
Medicine and one of 13 experts who reviewed the IOM report before
publication, said it should have discussed marijuana vaporizers, which
release cannabinoids from the plant without burning it. He said these
devices, which address the IOM's main concern about marijuana's side
effects, are already available.

Given the needless suffering of patients who could get relief with
marijuana, the attempt to make the drug more acceptable to the medical
establishment is understandable. But leaving aside the cultural baggage this
particular drug carries, most doctors view the medicinal use of raw plant
matter as hopelessly primitive in an age of purified pharmaceuticals.

Furthermore, as Grinspoon has observed, a prescription system for marijuana
would have to filter out the people seeking simply to get high, and "the
doctors are not going to want to be gatekeepers." Indeed, Grinspoon has
argued that full legalization is the only way to make marijuana available to
every patient who could benefit from it.

It is this prospect, of course, that scares the drug warriors who decry
medical marijuana as a "hoax." But if, as the IOM report indicates,
marijuana's benefits are genuine and its hazards have been greatly
exaggerated, the real hoax is the one that men like Barry McCaffrey have
perpetrated on the American public for more than half a
century.