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Marijuana Medically Useful but Issue Still Hazy, NIH Says

By David Brown
Washington Post Staff Writer
Page A06 The Washington Post

A panel of experts convened by the National Institutes of Health reported
yesterday there is some evidence that smoking marijuana may be a useful
treatment for many medical conditions, but said there is no proof that it
is better than available legal medications.

The evidence for marijuana's usefulness to date comes mostly from patient
testimony and small clinical studies that, in general, are not up to the
standards required of new drugs, the group of nine scientists wrote.
Nevertheless, medicine should not write off smoked marijuana's "medical
utility," they said.

"It was difficult to compare marijuana with products that had received
regulatory approval under more rigorous experimental conditions. This does
not mean, however, that the issue should be foreclosed. It simply means
that in order to evaluate various hypotheses . . . more and better studies
would be needed," the group wrote.

The panel heard two days of "testimony" by scientists, patients, marijuana
advocates and marijuana opponents in February. The report is informational
and advisory, and NIH officials do not have to respond to it in a formal way.

The major but not the only active ingredient of marijuana smoke is
delta9tetrahydrocannabinol (THC). In pill form, THC is legally prescribed
for two purposes the suppression of nausea in cancer patients, and the
stimulation of appetite in AIDS patients. Many people believe, however,
that smoked marijuana offers advantages the pills don't.

Two welldesigned studies have shown that smoked marijuana helps control
pain in some cancer patients. Both marijuana and THC pills are better than
some older antinausea medicines, although neither has been tested against
newer, betterperforming drugs. There are clinical studies proving that THC
stimulates appetite, and a universe of anecdotes that smoked marijuana does
the same thing.

Marijuana lowers the pressure of fluid inside the eyeball, which if high
enough leads to the eye disease known as glaucoma. For a few patients who
haven't responded adequately to existing medicines, marijuana has been
visionsaving. There is also weak evidence marijuana may be useful in
multiple sclerosis and some other neurological illnesses.

The panel made several observations it believes researchers should keep in
mind.

For one, marijuana is a mild suppressor of the immune system, and may be
unsuitable for longterm use by people, such as AIDS patients, whose
immunity is already damaged. The panel also recommended that a method which
allows a person to inhale marijuana resins without smoking the leaf should
be devised. (A steamdistilling device might do this, it noted.) The panel
also said that even if marijuana doesn't turn out to be the best treatment
for anything, it may still be useful for people who don't get the expected
benefits from more conventional medicines.

"We're very enthusiastic about it," Don Maple, spokesman for retired Gen.
Barry R. McCaffrey, director for the White House Drug Policy Office, said
of the marijuana report. "We have said from the start that this is an issue
for the medical and scientific community, and not for politics." Similarly
enthusiastic was Steve Michael, head of ACTUP Washington, the AIDS
activism organization which sponsors Initiative 57, a ballot initiative
that would legalize marijuana for medical use in the District of Columbia.

"I think this is wonderful news. We clearly support further studies. This
is going to make our signature gathering infinitely easier," Michael said.

However, Chuck Thomas, a spokesman for the Marijuana Policy Project, said
he was disappointed the panel didn't address the issue of what should
happen to people currently using marijuana for medical purposes at the
risk of being arrested and sent to jail.

The government allows citizens to use numerous plants whose therapeutic
utility has never been scientifically proven, Thomas said. However,
marijuana is the only one in which those people face criminal charges, he
said.

© Copyright 1997 The Washington Post Company