CLOUDING THE ISSUE

Relief for medical marijuana patients was snatched away last week. In
Gonzales v. Raich, the Supreme Court ruled that such patients will be
subject to federal prosecution even if their own state's laws permit
use of marijuana.

Now, short of Congress legalizing medical marijuana, the only way that
its users can avoid stiff financial penalties or jail is if it is
turned into a prescription medicine approved by the Food and Drug
Administration. Justice Stephen G. Breyer said as much during oral
arguments last November with his comment that "medicine by regulation
is better than medicine by referendum."

Fair enough. The problem is that the very agencies integral to
facilitating the research and development of medical marijuana have
actually been impeding progress.

The first obstacle is ideological. The Drug Enforcement Administration
has fought marijuana's use as a medicine, maintaining that it has no
therapeutic value. (It hasn't helped that activists have tried to use
medical marijuana as a wedge to liberalize drug laws.)

But scientific consensus says otherwise. Surveying a range of
findings, a federally commissioned Institute of Medicine report issued
in 1999 noted that the active ingredients in marijuana, cannabinoids,
can relieve chemotherapy-induced nausea, stimulate appetite and
suppress pain in patients who have failed to get relief from
conventional treatments.

Other countries have embraced such findings. In April, for example,
regulators in Canada approved a marijuana extract delivered in an oral
spray for relief of symptoms of nerve pain associated with multiple
sclerosis.

A more imposing obstacle to developing medicine in the United States
is that there is only one legal source of research marijuana: a farm
in Mississippi run by the National Institute on Drug Abuse, part of
the National Institutes of Health.

As gatekeeper of the supply, the drug abuse institute must review and
approve all proposed marijuana research projects, a hurdle for
researchers that is both onerous and redundant: They already must
undergo at least three other oversight evaluations (from the FDA, the
DEA and their own institutions) before they can enroll their first
subject.

One scientific team has been trying for two years to get a mere 10
grams of marijuana from the drug abuse institute for its effort to
develop a device that heats marijuana but doesn't burn it, thereby
providing nontoxic and immediate relief to patients.

Since the drug abuse institute's mission does not include the
development of marijuana into a commercial prescription medicine, any
expanded studies with the marijuana plant must be privately financed.
But, in a Catch-22, private resources are out of reach as long as only
federal marijuana -- which is notoriously weak and poorly manicured --
can be used.

After all, a pharmaceutical development team must have a stable source
of raw material with adequate purity. Researchers need to be able to
control the ratio of active to inert compounds in the plant by
manipulating growing conditions. Unless a pharmaceutical company could
be sure of producing a drug or device for commercial sale, it won't
invest millions of dollars in clinical trials.

One solution is to get the National Institute on Drug Abuse out of the
marijuana supply business. Let researchers get marijuana directly from
the government-approved Mississippi farm or from overseas sources like
the Dutch Office of Medicinal Cannabis.

Better yet, permit a privately financed DEA-approved farm, like the
kind that Lyle Craker, a medicinal plants expert at the University of
Massachusetts, has been hoping to create for the last three years. In
addition to producing higher-potency, cleaner marijuana, such a farm
could offer strains with varying levels of cannabinoids that may
contribute to marijuana's therapeutic effects.

Developing cannabis into an approved and effective prescription
medication can be a goal within reach. But it will take a federal
government that is truly open to the research that it claims to value.