CLEARANCE FOR MARIJUANA?

Few people who have informed themselves will be surprised that the
federal government's Institute of Medicine's report on medical uses of
marijuana concluded that there is solid evidence that the plant can be
therapeutic for certain conditions and that more research should be
done to refine medical knowledge. After all, the same institute issued
a report in 1982 - before much was known about cannabinoids and
cannabinoid receptors in human brains - that came to much the same
conclusion.

Now it's up to the federal government to redesign drug policy so it
fits what is known scientifically rather than being based on myths,
fears and out-right falsehoods.

The conclusions probably weren't the ones desired by "Drug Czar" Barry
McCaffery, who commissioned this report two years ago, after
California and Arizona passed initiatives to authorize the use of
marijuana by patients with recommendations from licensed physicians.
He said at the time he was doing so not to delay implementation, but
so that decisions about drug policy could be based on science rather
than popular opinion influenced by political contributions.

Now he has his report. Among other things, it concludes: "the
combination of cannabinoid drug effects (anxiety reduction, appetite
stimulation, nausea reduction and pain relief) suggests that
cannabinoids would be moderately well-suited for certain conditions
such as chemotherapy-induced nausea and vomiting and AIDS wasting" and
more clinical trials should be conducted. It concludes that the risks
associated with marijuana use are modest, though more research about
the risks of long-term use is needed. It concludes that the risk of
developing dependence is slight.

The report also concludes that there is no evidence whatsoever that
marijuana is a "gateway" drug whose use leads inevitably to the use of
harder and more dangerous drugs. In fact, it says that "because
underage smoking and alcohol use typically precede marijuana use,
marijuana is not the most common, and is rarely the first, 'gateway'
to illicit drug use. There is no conclusive evidence that the drug
effects of marijuana are causally linked to the subsequent abuse of
other illicit drugs."

So a policy that takes science into account would have to abandon the
hoary "gateway drug" myth so often used by drug warriors.

Also important, public sentiment is shifting on the issue. Initiatives
similar to California's Prop. 215 passed in Alaska, Nevada, Oregon and
Washington last year.

The most significant policy implication of this report is that
marijuana does not belong on Schedule I of the Controlled Substances
Act, which by law is reserved for substances with a high potential for
abuse and with no currently accepted medical use. Others in the
category are heroin, LSD and PCP. The Institute of Medicine makes it
clear that marijuana does not fit these criteria. The designation is
key because it would by virtually impossible to conduct the scientific
research the report recommends if the substance were kept on Schedule
I.

We talked to John Gettman in Virginia, who filed a petition to have
marijuana rescheduled in 1995. It was referred to the Department of
Health and Human Services in December 1997. The Drug Enforcement
Administration is required by law to accept HHS determinations on
medical and pharmacological issues. This study should give HHS the
firepower it needs to rule favorably on this petition - and soon.

In California, Attorney General Bill Lockyer, who ran as an advocate
of the medical use of marijuana, was cautious in his response to the
study and what it might mean for Prop. 215. "Current federal law
prohibits doctors from prescribing marijuana and has made medical
research difficult," Lockyer said in a statement. "We look forward to
the federal government building on this report's findings so that we
can wisely implement Prop. 215."

Mr. Lockyer should be bolder in representing the wishes of
Californians - and his own stated position - and place his support
behind the petition to reschedule the drug and open the way for
research and use by patients who need it.

We would also recommend that no politician or political candidate
utter a word on drug policy until reading the report in its entirety.

The report can be read online at (www.nap.edu/readingroom/books/marimed)