US MEDICAL REPORT BACKS MARIJUANA USE

A US-commissioned report released yesterday strongly backed certain medical
uses of marijuana, declaring that for some people with serious diseases such
as AIDS and cancer, it may be one of the most effective treatments
available.

The widely anticipated report by the independent Institute of Medicine (IOM)
was commissioned by the White House Office of National Drug Control Policy
and could spark a reassessment of the decades-long US drive to ban almost
all marijuana use.

But US officials said the drug would continue to be classified as illegal
and that there were "complicated scientific issues" that had to be assessed.

Dr John Benson, one of the principal investigators for the report, told a
news conference, "We uncovered an explosion of new scientific knowledge
about how the active components in marijuana affect the body and in how they
might be used in a medical context."

The IOM study, the product of more than 18 months of research, highlighted
continued concerns over marijuana, noting that the common practice of
smoking the drug was medically dangerous.

But it also said marijuana clearly controlled some forms of pain, was not
particularly addictive and did not appear to be a "gateway" to harder drugs
such as heroin.

For some patients with severe AIDS or cancer symptoms such as nausea, severe
weight loss and lack of appetite, marijuana AD even in its smoked form AD
appears to have benefits that outweigh its risks, the investigators said.

"Smoked marijuana should not generally be recommended for long-term medical
use," the report said. "Nonetheless, for certain patients such as the
terminally ill or those with debilitating symptoms, the long-term risks are
not of great concern."

Authors of the report sought to sidestep the political issue of medical
marijuana, noting repeatedly that their brief was simply to assess the
effectiveness of "cannabinoid" drugs such as THC, marijuana's main active
element.

The White House anti-drugs "tsar", Barry McCaffrey, who commissioned the
report in 1997, welcomed its scientific findings but said smokable marijuana
was not the answer and the government would continue to classify it as
illegal.

"Everyone is looking for a cure these days and pain is seen as a sort of
blurry background," Mr McCaffrey, who has long opposed relaxing marijuana
laws, told a news conference in Los Angeles, adding that the government
would support more research in this area.

The IOM report stressed that the new research should aim to design a
"non-smoked, rapid onset" delivery system that could mimic the speedy action
of a smoked marijuana cigarette. "I think the main take-home message from
this report is that we prefer to move away from the plant," said another
principal investigator, Dr Stanley Watson. "From the point of view of safety
we are quite concerned about it."

But the report's authors also noted that some desperately ill patients may
not want to wait the years it would take to develop a safe alternative such
as a cannabinoid inhaler.

To help these patients, the report suggested that doctors be allowed to
launch clinical studies of marijuana, telling each test subject the risks
and rewards of smoking the drug.

The IOM report landed amid an increasingly bitter US debate over medical
marijuana, sparked in 1996 when California became the first state to pass a
local initiative aimed at allowing patients with AIDS, cancer, and other
serious diseases to use the drug.

While federal authorities have used their power to block implementation of
the California measure, voters in six more states passed similar bills in
1998 AD boosting pressure on the Food and Drug Administration to consider
removing marijuana from the "Schedule I" list of the most dangerous
narcotics.

The White House spokesman, Joe Lockhart, told a news conference that the
report's main message was the need for further scientific study, and that
there should be no rush to subject important issues like drug approvals to
popular votes.

"I think this is a scientific issue and I'd hate to see there be a
referendum on the latest technology in air traffic control and I'd hate to
see there be a referendum on FDA review process," Mr Lockhart said.

"These are complicated scientific issues and they ought to be debated on a
scientific basis."

Supporters of the medical marijuana movement declared the IOM report a
victory, however, and urged the government to couple its research efforts
with a new push to get marijuana to sick people who need it.

Bill Zimmerman, director of Americans for Medical Rights, the sponsor of six
1998 state marijuana initiatives, said the IOM's findings would radically
rework the public image of what has long been one of the United States' most
demonised drugs.

"They are in effect saying that most of what the government has told us
about marijuana is false ... it's not addictive, it's not a gateway to
heroin and cocaine, it has legitimate medical use, and it's not as dangerous
as common drugs like Prozac and Viagra," he said. "This is about as positive
as you can get."