DATA SUPPORTS MEDICAL POT ARGUMENT

High-Level Report A 'Sane Step Forward'

A long-awaited report to be released today supports the contention of
medicinal marijuana advocates that the controversial drug may be an
effective pain reliever, nausea suppressant and appetite stimulant.

The Institute of Medicine came to that conclusion after spending more
than a year analyzing past studies and talking with patients,
prescribers and physicians on both sides of the medicinal marijuana
debate.

That debate could be reshaped after the institute's report lands on
the desks of legislators caught between a public that favors medicinal
marijuana and a federal government that continues to ban the drug.

The report deals only with scientific data, and does not make any
policy recommendations. But as the most thorough synthesis of data on
medicinal marijuana to date -- the institute last studied marijuana in
1982 -- the report tops the reading list for policy-makers such as the
Office of National Drug Control Policy, which sponsored the study.

In a prepared statement, the office promised to study the institute's
conclusions carefully and seek responses from the nation's health
officials. The Food and Drug Administration, which is doing its own
report on medicinal marijuana, would decide whether cannabis could be
used as a prescription drug. FDA officials could not be reached for
comment.

Still, advocates of medicinal marijuana cheered the new report, saying
it's a vindication of their position and a rejection of government
policies that list cannabis among drugs with no accepted medicinal use
and a high potential for abuse.

"I think the IOM report is going to be hailed as a sane step forward
when it comes to national policies for dealing with patients," said
Jeff Jones, director of the defunct Oakland Cannabis Buyers
Collective. "It's over. The federal government lost."

Cannabis researchers, while not as effusive as Jones, agreed the new
report could be helpful -- assuming it helps smooth the way for
additional research.

The report calls for further study of the physiological and
psychological effects of cannabinoids, the active components of
marijuana. It also calls for more research into possible dangers of
marijuana smoke -- including cancer and pregnancy complications -- and
recommends limiting tests in which marijuana is smoked to short-term
trials involving terminally ill patients who do not respond to other
medications.

"It's exactly what we're trying to do, is provide some more scientific
rigor to the potential benefits -- if there are any -- of smoking
marijuana," said Dr. Scott Morrow, public health officer for San Mateo
County, which has applied to the National Institute of Drug Abuse for
permission to conduct its own $500,000 study of marijuana's
effectiveness.

"Maybe it has no benefits. Maybe everything we hear is all anecdote
and it doesn't benefit people. Or maybe it does. We should answer that
question."

That perspective resonates on the other side of the fence, among
health professionals who have opposed the medicinal use of marijuana.

Dr. Eric A. Voth, director of the International Drug Strategy
Institute and co-author of one of the ballot arguments against
California's 1996 medicinal marijuana initiative, said he hopes the
new report will help separate cannabis science from the politics of
smoking pot.

But Voth also predicted the report could signal the beginning of a new
war, between those who feel marijuana should be broken down into its
individual components and reformulated as pills or sprays, and those
who insist the plant be made freely available for smoking --
regardless of the risks.

"I think that the proponents of marijuana will continue to push for
legalization," he said. "But what I really hope that this report does
is clearly paint in the mind of the public that (raw) pot is not
medicine. You don't smoke medicine."

SIDEBAR - Findings and recommendations included in the Institute of
Medicine report on marijuana and medicine:

CANNABINOID drugs may relieve pain, control nausea and vomiting, and
stimulate appetite. Other medications are usually more effective, but
cannabinoids may be better treatment for certain conditions, such as
nausea caused by chemotherapy and appetite loss in AIDS patients.

THE RISKS of regular marijuana smoking include respiratory tract
damage and increased exposure to cancer, lung damage and low fetal
birth weight.

SOME MARIJUANA smokers experience mild and short-lived withdrawal
symptoms, including restlessness, irritability, insomnia, nausea and
cramping. There is no conclusive evidence that marijuana leads to
other drug abuse.

THE GOAL OF of clinical trials should be to learn more about how its
cannabinoid ingredients work and how best to provide them to patients
without smoking. Because that could take several years, however,
clinical trials should be designed to last six months or less for
patients with debilitating symptoms who could get some relief from
smoking marijuana.