THE MEDICINAL MARIJUANA DEBATE POT PROPONENTS GAIN A VICTORY

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.

Mercury News Staff Writer Lisa M. Krieger contributed to this
report.