Pubdate: Wed, 17 May 2000 Source: New York Times (NY) Copyright: 2000 The New York Times Company Contact: 229 West 43rd Street, New York, NY 10036 Fax: (212) 556-3622 Website: http://www.nytimes.com/ Forum: http://www10.nytimes.com/comment/ Author: Katharine Q. Seelye THE EVOLUTION OF A POSITION Gore Retreats From Earlier Stand Supporting The Medical Use Of Marijuana WASHINGTON - As anyone who has watched Al Gore over the years knows, some of his positions on various topics have a way of evolving. As the vice president himself has acknowledged, this has been true on abortion and gun control. There now seems to be another example: medical marijuana. Back in December, at a town meeting in Derry, N.H., Mr. Gore indicated that he would favor allowing marijuana to be prescribed for medical purposes. He referred to a strikingly personal experience. His sister, Nancy Gore Hunger, died of lung cancer in 1984 after painful chemotherapy. She was being treated in Tennessee, where medical marijuana was legal at the time, and her doctor -- "one of the very best in the entire world," Mr. Gore said -- had prescribed marijuana. She tried it. "She decided against it because she didn't like it and it didn't produce the desired results for her," Mr. Gore told his audience that night. "But the doctor said, 'Look, this is an option she ought to have available, very carefully monitored and controlled.' And if it had worked for her, I think she should have had the option." This answer, while heartfelt, deviated sharply from the Clinton administration's policy against medical marijuana. And Mr. Gore's aides quickly called a news conference so that the vice president could clarify his views. "Look, look, let me just say that I'm opposed to anything that opens the door to legalization of marijuana," he told reporters. He said that the use of marijuana should be determined by science rather than emotion but that, under certain limited circumstances and if the research validated that choice, it should be allowed. Then he added, "We are not at that point." Despite what he said at the news conference, there was an unmistakable perception -- on both sides of the issue -- that Mr. Gore had signaled his support for the practice. Doug Bandow, a senior fellow at the Cato Institute, a libertarian policy organization, hailed the vice president for his "compassionate and sensible position." Opponents, like the American Society of Addiction Medicine, complained. In a letter on Dec. 29 to Mr. Gore, James F. Callahan, executive vice president of the group, wrote that Mr. Gore's comments "seem to be an unmistakable statement that physicians ought to have the option of using marijuana to alleviate pain." The letter added, "Though it was reported that in a subsequent meeting with reporters you emphasized that you opposed legalizing marijuana and believe more research is needed to determine whether medicinal marijuana works, these were not the views that were stated publicly for the American people's consumption." Mr. Gore still gets the occasional question on this subject, as he did last week in California, where voters approved the medicinal use of marijuana. But now, five months after his initial indication that doctors should have the "flexibility" to prescribe marijuana, Mr. Gore appears to have become firmer in his opposition, even though there has been no new research in the intervening months to indicate that marijuana works better or worse than anyone thought in December. "Right now the science does not show me, or the experts whose judgment I trust, that it is the proper medication for pain and that there are not better alternatives available in every situation," Mr. Gore said in response to a student's question last Thursday at the Elizabeth Learning Center in Cudahy, Calif. The latest medical opinions suggest otherwise. In 1997 the National Academy of Sciences asked the Institute of Medicine, its medical arm, to evaluate all research on the subject, since more states were passing initiatives to allow the medicinal use of marijuana and public opinion was divided. (By now, voters in a half-dozen states and the District of Columbia have approved the medicinal use of marijuana, and Hawaii is on the verge of becoming the first state to pass it into law, rather than decreeing it by ballot initiative.) After two years of research and interviews with three dozen experts, including those representing government agencies, the institute's panel concluded in March 1999 that "Marijuana's active components are potentially effective in treating pain, nausea, the anorexia of AIDS wasting and other symptoms, and should be tested rigorously in clinical trials," the institute said in a news release. The panel said that smoking marijuana could cause other health problems like cancer, lung damage and low birth-weight for babies born to women who smoke it. For that reason, the panel said, smoking marijuana should only be recommended for terminally ill patients or those with debilitating symptoms that do not respond to approved medicines. It also said that no one should smoke it for more than six months. Dr. John A. Benson Jr., the co-principal investigator of the institute's report who is the dean of the Oregon Health Sciences University School of Medicine in Portland, said in an interview that no new information had emerged over the last year to alter the panel's views. He said there had been some experimentation with a patch system in an effort to find an alternative to inhalation because "smoking is a poor way of delivering medicine." And he said synthetic versions with components of marijuana were effective for 75 percent to 90 percent of patients. But he added that "there are some patients that don't respond to these better drugs," and that smoking marijuana can ease their discomfort, particularly in cases of nausea, when patients cannot take pills. Mr. Gore's aides insisted that the vice president's position as articulated last week in California was no different from what he had said at his news conference after the New Hampshire town meeting. But Mr. Bandow of Cato, who had heard encouragement in Mr. Gore's remarks in December, said he detected a difference now. "I think quite clearly he's retreated," Mr. Bandow said in an interview. "It was an opportunity to move out there and take some new ground and indicate some greater sophistication, and voters appreciate that." - --- MAP posted-by: Derek Rea