PANEL SEES VALUE IN MEDICAL MARIJUANA

WASHINGTON -- The active ingredients in marijuana appear to be useful
for treating pain, nausea and the severe weight loss associated with
AIDS, according to a new study commissioned by the government.

The report, the most comprehensive analysis to date of the medical
literature about marijuana, said there was no evidence that giving the
drug to sick people would increase illicit use in the general population.

Nor is marijuana a ``gateway drug'' that prompts patients to use
harder drugs like cocaine and heroin, the study said.

The study's authors, a panel of 11 independent experts at the
Institute of Medicine, a branch of the National Academy of Sciences,
cautioned that the benefits of smoking marijuana were limited because
the smoke was so toxic.

Yet at the same time, they recommended that the drug be given, on a
short-term basis under close supervision, to patients who did not
respond to other therapies.

The release of the delicately worded report, at a news conference,
prompted a flurry of political maneuvering.

Proponents of state initiatives to legalize marijuana for medical
purposes seized upon the findings as long-awaited evidence that it had
therapeutic value.

They called on the Clinton administration, and in particular Gen.
Barry McCaffrey, director of the Office of National Drug Control
Policy, to ease its opposition to the initiatives. McCaffrey's office
requested the study.

``This report has proved McCaffrey wrong,'' said Chuck Thomas, a
spokesman for the Marijuana Policy Project, a nonprofit organization
in Washington that lobbies for the legalization of medical marijuana.
``We never said marijuana was a panacea and a be all or end all. What
we have said is there are some patients who don't respond to existing
medications, and this report confirms that.''

But the study is unlikely to change the administration's position. The
Department of Health and Human Services, which is already financing
some research involving medical marijuana, issued a written statement
noting simply that it would continue to fund the work.

And McCaffrey, in Los Angeles, said, ``This study seems to suggest
that there is little future in smoked marijuana.''

McCaffrey praised the analysis and said he would take the
recommendations under advisement. But he said there was ``enormous
confusion in law enforcement'' about how to handle the issue, adding,
``We've got people with mischievous agendas at work.''

While the study's authors said they had been surprised to discover
``an explosion of new scientific knowledge about how the active
components of marijuana affect the body,'' they added pointedly that
the future of marijuana as a medicine does not lie in smoking it. The
smoke, they said, is even more toxic than tobacco smoke, and can cause
cancer, lung damage and complications during pregnancy.

The true benefits of marijuana, the experts said, would only be
realized when alternative methods, like capsules, patches and
bronchial inhalers, were developed to deliver its active components,
called cannabinoids, without the harmful effects of smoke.

So far, there is only one cannabinoid-based drug on the market,
Marinol. It comes in pill form and was approved in May 1985 by the
Food and Drug Administration for nausea and vomiting associated with
chemotherapy, as well as for anorexia and weight loss associated with
AIDS. Some patients have complained that Marinol is more expensive
than marijuana and it doesn't work as quickly.

The researchers recommended that the government pay for research that
would speed up the development of more cannabinoid drugs, and were
particularly keen on the promise of inhalers. But, recognizing that
such methods might take years to perfect, they also recommended that
people who did not respond to other therapy be permitted to smoke
marijuana in the interim.