NIH STUDY HELPS THE CASE FOR
MEDICAL MARIJUANA

SACRAMENTO BEE The Bee disagrees that a recent
National Institutes of Health report ''validates marijuana as a
medicine,'' as our group indirectly suggested in reaction to the news
(editorial, ''Marijuana agenda,'' Aug. 19). At the least, however,
the report has crippled arguments that marijuana has no role at all
in medicine.

No one claims that the NIH report represents a definitive study
of marijuana's therapeutic uses. Indeed, the advisory panel was
scrupulous in writing each line of the report to avoid making any
statements that were overly supportive or dismissive of claims of
marijuana's medical potential. The point of the report is mainly to
advise NIH and future researchers on the most promising directions
for new clinical trials of marijuana's medical uses. The panel
suggests that NIH fund new studies of the use of marijuana to treat
nausea and vomiting (mainly due to cancer and AIDS treatment);
appetite stimulation; glaucoma; neurological and movement disorders
(including epilepsy and multiple sclerosis); and general analgesia.

Simply to have this NIH panel take the position that the
existing evidence published clinical studies and patient reports
is sufficient to support further and more definitive studies is a
tremendously positive step, one that effectively refutes many
diehard opponents of medical marijuana. U.S. drug czar Barry
McCaffrey, for example, has repeatedly claimed that there is no
evidence that marijuana has any medical value, at one point famously
saying, ''there is not a shred of scientific evidence that shows that
smoked marijuana is useful or needed. . . . This is a cruel hoax.''

Thanks in large part to the new NIH report, such rhetoric,
suggesting that medical claims for marijuana have been pulled from
thin air, is rightly disappearing from the debate.

The NIH panelists undercut other antimedical arguments as well.
Both at their public meeting in February and in their report, the
panelists admitted that the pill form of marijuana's chief
ingredient, THC, is inadequate for many patients, and that smoking
marijuana may be a reasonable way to get THC's benefits. This refutes
claims that the existence of the pill, called Marinol, makes
marijuana unnecessary.

While the panelists were not eager to endorse the smoking of
marijuana, in their final report, they called for development of a
''smokefree inhaled delivery system'' for whole marijuana or THC.
One panelist, UC San Francisco Professor Avram Goldstein, said during
the panel's public meeting, ''It would be perfectly safe medically to
let the patient determine their own dose [of marijuana] by the
smoking route.'' Clearly, when patients claim that smoking marijuana
helps them more than other available drugs, their claims deserve a
measure of respect they have not consistently received.

Of course, more research will help answer scientific questions to
the satisfaction of doctors who must know how, or whether, to use
marijuana. And such research could contribute to reclassifying the
drug under federal law. That is why in California, after Prop. 215 we
have participated in a broad coalition, including many prominent
opponents of the initiative, to try to pass a bill, SB 535, to create
new medical marijuana studies at the University of California. Having
passed the Senate with a twothirds vote, that important bill awaits
action in the Assembly and by the governor.

In California, patients now have an explicit right to use
marijuana in medical treatment if approved by their physicians. In
most other states and under federal law, however, there is no
exemption even for doctorapproved, experimental use of marijuana,
and the research that would force such legal changes is surely years
from completion. In advocating and facilitating more studies of
marijuana, let us not forget the reallife risks taken by thousands
of patients outside California who find that marijuana works for
them. Their fate is in the balance as science ponders its next move.

Dave Fratello is communications director for Americans for Medical
Rights, based in Sacramento and Santa Monica, one of the sponsors of
Proposition 215.

[Copyright 1997, Dialog]