STUDY SEES LIMITED MEDICINAL-MARIJUANA ROLE

WASHINGTON -- Stepping into the fractious debate about medicinal marijuana,
a federal panel of independent scientists recommended Wednesday that
marijuana cigarettes be made available for short periods to help cancer and
AIDS patients who can find no other relief for their severe pain and nausea.

But the $900,000 report, commissioned by White House drug czar Barry
McCaffrey and issued by the Institute of Medicine, does little to
immediately resolve the legal gridlock that has kept the medicinal-pot
movement on the run in California since voters approved Proposition 215 in
1996.

``There needs to be more evidence for it to have any influence on law
enforcement policy,'' said Brian Steel, an official of the U.S. Justice
Department, which shut down six Northern California marijuana clubs, saying
federal drugs laws took precedence over the California initiative.

An explosion of new scientific research, as well as patient anecdotes, shows
that compounds in marijuana have potential to ease some of medicine's most
intractable problems, the report said.

A warning on smoking

But its authors warned that smoking marijuana carries its own health
hazards -- including potential lung damage and low-birth-weight babies --
and that marijuana cigarettes should be used only as a last resort after
standard therapies have failed.

Psychological dependency was seen as a relatively minor problem, likely to
affect only a few users. The scientists also concluded that there is no
biochemical basis for the belief that marijuana leads to subsequent abuse of
other illicit drugs.

To avoid the harmful effects of smoke, they called for new delivery systems,
like inhalers, and for the development of pharmaceutical drugs made from or
modeled after the active ingredients in marijuana, chemicals known as
cannabinoids.

``Marijuana's future as a medicine does not involve smoking,'' said Dr.
Stanley Watson, a neuroscientist and substance-abuse expert from the
University of Michigan who co-wrote the report. ``It involves exploiting the
potential in cannabinoids.''

McCaffrey, a foe of medicinal pot, ordered the study by a branch of the
National Academy of Sciences after calls for a new federal policy on the
drug. The findings were seen as a victory by many who advocate the use of
marijuana as medicine.

``It's a discreet but clear call to make marijuana available,'' said Ethan
A. Nadelman, who directs the Lindesmith Center, a New York-based drug-policy
think tank.

AIDS patient John Petersen of Scotts Valley welcomed the report, saying it
confirmed his experience with pot. ``My legs feel like when you step into a
hot tub, burning really bad. But there's something in the (marijuana)
chemical that releases the pain. I am so grateful for it.''

Battles over medicinal marijuana have intensified over the past three years.
Proposition 215 removed any state penalties for people who used marijuana
for medicinal purposes. Since then, Arizona, Alaska, Oregon, Nevada and
Washington state have passed laws permitting use of medicinal marijuana.

California's new Attorney General Bill Lockyer -- unlike his predecessor --
has urged local law enforcement officials to make Proposition 215 work. He
is scheduled to go to Washington, D.C., later this month with attorneys
general from other states with similar laws to press for changes in federal
policy.

Clarification needed

The report may also give the state Legislature reason to clarify Proposition
215. The proposition, officials say, never offered guidance on how patients
could get medicinal pot without breaking the law.

``It's going to make it easier for the Legislature to move forward,'' said
Bill Zimmerman, executive director of the Santa Monica-based Americans for
Medical Rights, which has helped organize medicinal-marijuana ballot
initiatives around the country.

Whatever happens in Sacramento, however, will have limited impact on
patients' ability to find legitimate distributors of medicinal pot if the
Justice Department and the U.S. Drug Enforcement Administration do not step
aside.

``State law does not and will not pre-empt federal law,'' U.S. Justice
Department official Steel repeated Wednesday.

In a lawsuit filed by the Justice Department, a San Francisco federal judge
last year concluded that six Northern California marijuana clubs had to
close because federal drug laws trumped their ability to operate under
Proposition 215. That ruling is scheduled to be reviewed next month by a
federal appeals court.

Few operations around the state have survived law enforcement crackdowns on
medicinal-marijuana clubs. Gone are clubs such as Proposition 215 author
Dennis Peron's Market Street operation in San Francisco, which served 9,000
clients.

In Santa Clara County, the local cannabis club, originally supported by
local officials, has been closed for a year while its former director, Peter
Baez, faces pot-distribution charges filed by the district attorney's
office.

The town of Arcata continues to run a system for distributing medicinal pot
under the supervision of the local police chief. The Oakland club no longer
dispenses marijuana, but is helping patients find the drug.

Senator wants action

State Sen. John Vasconcellos, D-San Jose, said the study should influence
that debate.

``The federal government, which has relied on ignorance to justify its
opposition to medicinal marijuana, has no excuse now to block expeditious
efforts to get this medicine into the hands of our citizens,'' said
Vasconcellos, a strong supporter of Proposition 215.

Many mainstream medical organizations, and the relatively conservative New
England Journal of Medicine, have endorsed the use of medicinal marijuana.

But last fall, Congress overwhelmingly passed a resolution condemning it.
And many physicians are reluctant to prescribe it, even in states that have
passed initiatives.

``There are so many strictures on doctors, so much uncertainty on the part
of licensing boards . . . that nothing's happened,'' said Dr. John A. Benson
Jr., the report's other co-author.

In campaigning against pot initiatives, McCaffrey said that there was no
proof marijuana had medical benefits; that it was a gateway drug that led to
abuse of drugs like heroin; and that allowing marijuana to be used as
medicine would increase illicit recreational marijuana use.

The study addressed McCaffrey's arguments directly. Its authors found no
evidence that marijuana use led people to progress to harder drugs or that
medicinal use brought increases in recreational use.

In a statement, McCaffrey said he would study the report's conclusions. He
emphasized that there is some evidence that marijuana is addictive and can
lead to further drug use. He left it to the nation's health agencies to
judge whether more patients should be provided with marijuana cigarettes.