THE SMOKE CLEARS

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 chemicals in
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 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 or 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 casually 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 such a
product that may prove less popular than the joint?

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.