REPORT FINDS MEDICAL VALUE IN MARIJUANA SMOKING

Not Endorsed By U.S. Institute

The active component of marijuana may effectively counteract pain,
nausea and weight loss for people suffering cancer and AIDS and a
number of other ailments, according to a report issued Wednesday by a
panel of medical experts.

Voters in California and five other Western states approved ballot
measures allowing medical use of marijuana but it is still prohibited
by federal law.

The findings by the national Institute of Medicine reflect a near
consensus of scientific opinion, but the issue is certain to remain
delicate politically.

"It seems to be a positive step," said Marvin Lehrman, co-founder of
the 200- member Cannabis Buyers Club in Ukiah.

Sonoma County District Attorney Mike Mullins, who was recently
appointed to a state task force on medical marijuana, said he hopes
the study will lead to federal approval for physicians to prescribe
pot.

But the sponsor of a congressional resolution condemning the medical
use of marijuana said he's afraid the report will encourage pot
smoking and the White House drug czar predicted limited interest from
pharmaceutical companies.

And the report itself included several caveats.

Among other things, it found little value as a treatment for two of
the maladies most commonly cited by advocates of medical marijuana:
migraines and glaucoma.

The report also warned that smoking creates its own risks and
recommended research to isolate compounds in marijuana that eventually
could be given to patients via inhalers or other fastacting delivery
systems.

"We see little future in smoked marijuana as a medicine," said John A.
Benson Jr., a co-author of the Institute of Medicine study and the
former dean of Oregon Health Sciences University School of Medicine.

While that conclusion drew criticism from medical marijuana advocates
in Northern California, the report's recommendation that marijuana
cigarettes be made available to some patients for short periods and
its endorsement of rigorous clinical trials to test its effectiveness
were received as a victory for their cause.

"It's opened the door at least to proving it," said Lynette Shaw of
the Marin Alliance for Medical Marijuana. "There are hundreds of us
who need no convincing."

Some of that work already is under way at the National Institutes of
Health, which has approved studies of marijuana safety for AIDS
patients, of its use by patients of health maintenance organizations
and of its effectiveness in reducing nausea.

A fourth study, involving marijuana as a pain killer, is expected to
be approved soon.

But officials at the Food and Drug Administration warned that
individual patients aren't likely to receive marijuana until it is
proven to be safe.

The federal government provides marijuana to eight people who
participated in a medical testing program more than a decade ago. And
voters in California, Alaska, Washington, Oregon, Arizona and Nevada
have passed laws since 1996 permitting medical use.

Those laws have created conflicts with the Drug Enforcement
Administration and federal prosecutors, who don't recognize the state
law. They have used federal courts to shut down cannabis clubs in San
Francisco and Oakland, and threatened sanctions against physicians
who recommend marijuana to their patients.

It also has proven problematic for local police and prosecutors, who
have been left to sort out who is and is not a legitimate medical user.

A variety of systems are in place across the state, ranging from
identity cards issued by the Arcata Police Department to a panel of
doctors in Sonoma County that reviews cases to determine if someone is
eligible for medical use.

Attorney General Bill Lockyer recently appointed a 20-member task
force to recommend ways to ensure that marijuana is only used by
legitimate medical patients. He also is lobbying for changes in
federal law.

Mullins, who serves on Lockyer's task force, said he believes Congress
should reclassify marijuana from a strictly prohibited drug to one
that can be prescribed by doctors. "That makes it easy," he said. "You
can draw a nice bright line for law enforcement."

The $900,000 federal report was produced at the request of Gen. Barry
McCaffrey, the director of the White House Office of National Drug
Control Policy and a leading critic of marijuana use. He issued a
statement promising to study its results.

For patients, the report underscored their belief that marijuana is a
palliative.

"Everybody and anybody can be stricken with anything," said Ed Learn,
a Santa Rosa man with AIDS who grows his own marijuana. "If marijuana
is the one thing that can make you feel better, it's worth it."

In its report, the Institute of Medicine concluded that
"cannabinoids," the active compound in marijuana, holds the most
potential for easing pain and nausea caused by AIDS, chemotherapy and
nerve damage and is most likely to benefit people who do not respond
to standard drugs, which work in a majority of cases.

The institute, an affiliate of the National Academy of Sciences, also
warned that the risks of cancer and low birth-weight babies associated
with tobacco smoking also are present when smoking marijuana. It
conceded that Marinol, a pill form of marijuana's active ingredient,
isn't effective for some patients.

It suggested research into an alternative form of delivery, most
likely an inhaler.