OFFICIAL U.S. REPORT BACKS MEDICAL USE OF MARIJUANA

WASHINGTON, March 17 (Reuters) - A U.S.-commissioned report released on
Wednesday strongly backed the medical use of marijuana, declaring that for
some people with serious diseases such as AIDS it may be one of the most
effective treatments available.

The widely-anticipated report by the Institute of Medicine (IOM) was
commissioned by the White House Office of National Drug Control Policy and
looked likely to prompt a thorough review of U.S. efforts to ban almost all
marijuana use as dangerous drug abuse.

IOM investigators declared that marijuana was not particularly addictive
and did not appear to be a "gateway" to the use of harder drugs such as
heroin. They also said there was no evidence to indicate that approved
medical use of marijuana would increase public abuse of the drug.

The IOM report, the product of more than 18 months of research, highlighted
continued concerns over marijuana, noting that the common practice of
smoking the drug was medically dangerous and asking for more studies on how
the drug really works on the human body.

But on almost every front the independent medical review of scientific
research and patient experience found "substantial consensus" to indicate
that, for some people, the potential medical benefits of marijuana outweigh
its risks.

"Smoked marijuana should not generally be recommended for long-term medical
use," the report said.

"Nonetheless, for certain patients such as the terminally ill or those with
debilitating symptoms, the long-term risks are not of great concern."

The focus of the report was on "cannabinoid" drugs such as THC, the main
active element in marijuana.

Research over the last 16 years has provided new insight into how these
drugs work on both the brain and the body, where they can help to modulate
pain, and alleviate other symptoms of serious illness such as anxiety, lack
of appetite, and nausea.

The report said one focus of new medical and pharmaceutical research should
be to design a "non-smoked, rapid onset" delivery system for the drug which
could mimic the speedy action of a smoked marijuana cigarette.

But the report's authors also noted that some desperately ill patients may
not want to wait.

"We acknowledge that there is no clear alternative for people suffering
from chronic conditions that might be relieved by smoking marijuana such as
pain or AIDS wasting," they said.

To help these patients, the report suggested that doctors be allowed to
launch one-by-one clinical studies of marijuana, informing each test
subject of the potential risks and rewards of smoking the drug.

The IOM report lands amid an increasingly bitter U.S. debate over medical
marijuana, launched in 1996 when California became the first state to pass
a local initiative aimed at allowing patients with AIDS, cancer, and other
serious diseases to use the drug.

While federal authorities have used their power to block implementation of
the California measure, voters in six more states passed similar
initiatives in 1998 -- boosting pressure on the Clinton Administration to
consider removing marijuana from the "Schedule I" list of dangerous narcotics.

Barry McCaffrey, Clinton's anti-drug "czar" and long an outspoken opponent
of relaxing anti-marijuana law, ordered the IOM report in 1997 to give a
scientific basis to the discussion, and his office Wednesday responded to
the IOM findings with a call for more research.

"We will carefully study the recommendations and conclusions contained in
this report," the Office of National Drug Control Policy said in a statement.

"We look forward to the considered responses from our nation's public
health officials to the interim solutions recommended by the report."

Supporters of the medical marijuana movement declared the IOM report an
unequivocal victory.

Bill Zimmerman, director of Americans for Medical Rights, the sponsor of
six 1998 state marijuana initiatives, said the IOM's findings would
radically rework the public image of what has long been one of the United
States' most demonised drugs.

"They are in effect saying that most of what the government has told us
about marijuana is false ... it's not addictive, it's not a gateway to
heroin and cocaine, it has legitimate medical use, and its not as dangerous
as common drugs like Prozac and Viagra," he said.

"This is about as positive as you can get."