REPORT ON MEDICAL USE OF MARIJUANA BRINGS NEW FIGHT ON ZERO TOLERANCE

Te long-awaited Government-commissioned report on marijuana that was issued
on Wednesday may have concerned the drug's medicinal uses, but it has also
opened a debate into marijuana's longstanding role as linchpin of a national
policy of zero tolerance toward illicit drugs.

In addressing issues like whether marijuana was a gateway to the use of
harder drugs (the researchers found no convincing evidence that it was), the
report used language calculated not to overstep the bounds of scientific
inquiry into the arena of political argument.

But the very nature of the report was contrary to the Government's usual
inclination against acknowledging any merit at all in marijuana use, and
advocates on both sides of the issue seized on it.

The authors -- 11 independent experts at the Institute of Medicine, a branch
of the National Academy of Sciences -- found that marijuana smoke was even
more toxic than tobacco smoke and could cause cancer, lung damage and
pregnancy complications. As a result, they said, marijuana should be smoked
only by those patients in whom long-term effects are not of great concern,
like the terminally ill, and even then under tight control.

Nonetheless, they said, marijuana's active ingredients appear to be
effective for treating pain, nausea and the severe weight loss associated
with AIDS.

The White House Office of National Drug Control Policy, which ordered and
financed the two-year study after voters in California and Arizona endorsed
medicinal use of marijuana in 1996 referendums, has had little comment on
the report beyond endorsing its call for further research, saying science
alone should determine what is safe and effective medicine.

But other marijuana opponents have been more outspoken.

"The only issue from a policy point of view is whether smoked marijuana is a
viable medicine for the treatment for anything, and the report virtually
says no, which is very important," said Dr. Robert DuPont, clinical
professor of psychiatry at Georgetown University Medical School. "People
don't go to their pharmacy and get a prescription for burning leaves."

On the other hand, advocates of a more liberal approach to drugs see the
report as a catalyst to force the Government to rethink its zero-tolerance
policy.

"The release of this report is the beginning of a process, not the end,"
said Bill Zimmerman, executive director of Americans for Medical Rights,
which has sponsored medicinal-marijuana initiatives in a dozen states. "It
will provoke all kinds of activity across the country."

The Government's longtime position -- that marijuana is a dangerous drug
that cannot be tolerated any more than cocaine or heroin -- has not been
helped by the fact that as many as 60 million Americans, including Bill
Clinton, have tried it, most with no significant aftereffect. Further, the
Government's policy has been predicated on the assumption that smoking
marijuana can lead nowhere but to the abuse of harder drugs, an outlook that
the authors contradicted.

Medical marijuana was chosen as a wedge issue several years ago by people
who wanted to move drug policy in a softer direction, said Mark A. R.
Kleiman, professor of public policy at the University of California at Los
Angeles.

Government officials could have neutralized the issue, Professor Kleiman
said, by agreeing to strictly medical use of the drug, but instead "they had
to be against marijuana for any use, and as a result they handed a wonderful
issue to their opponents."

In fact, the Government's opposition to medicinal use "is one of the most
readily comprehensible excesses of the war on drugs," said Ethan Nadelmann,
director of the Lindesmith Center, which promotes liberalized alternatives
to current drug policy. "It's one that most Americans understand: that
arresting patients is not right."

Others, though, see a freewheeling public debate about medicinal marijuana
as a slippery slope that can only lead to acceptance of the drug's
recreational use.

"Anything that is going to make marijuana use by adolescents a more likely
event is going to be a terrible blow to the efforts we are making to remedy
the problem of raising children in America," said Dr. Mitchell Rosenthal,
president of Phoenix House, the nationwide network of drug treatment
centers.

Dr. Herbert D. Kleber, one of 13 experts who reviewed the report for the
Institute of Medicine before its release, said it set high standards for
justifying the medicinal use of marijuana. But Dr. Kleber, medical director
of the National Center on Addiction and Substance Abuse at Columbia
University, also called the report "that kind of thing where people can take
sound bites to bolster whatever position they want."