Pubdate: Wed, 17 Mar 1999 Source: Oakland Tribune (CA) Page: 1 Copyright: 1999 MediaNews Group, Inc. and ANG Newspapers Contact: 66 Jack London Sq., Oakland, CA 94607 Website: http://www.newschoice.com/newspapers/alameda/tribune/ Author: Matthew B. Stannard DATA SUPPORTS MEDICAL POT ARGUMENT High-Level Report A 'Sane Step Forward' A long-awaited report to be released today supports the contention of medicinal marijuana advocates that the controversial drug may be an effective pain reliever, nausea suppressant and appetite stimulant. The Institute of Medicine came to that conclusion after spending more than a year analyzing past studies and talking with patients, prescribers and physicians on both sides of the medicinal marijuana debate. That debate could be reshaped after the institute's report lands on the desks of legislators caught between a public that favors medicinal marijuana and a federal government that continues to ban the drug. The report deals only with scientific data, and does not make any policy recommendations. But as the most thorough synthesis of data on medicinal marijuana to date -- the institute last studied marijuana in 1982 -- the report tops the reading list for policy-makers such as the Office of National Drug Control Policy, which sponsored the study. In a prepared statement, the office promised to study the institute's conclusions carefully and seek responses from the nation's health officials. The Food and Drug Administration, which is doing its own report on medicinal marijuana, would decide whether cannabis could be used as a prescription drug. FDA officials could not be reached for comment. Still, advocates of medicinal marijuana cheered the new report, saying it's a vindication of their position and a rejection of government policies that list cannabis among drugs with no accepted medicinal use and a high potential for abuse. "I think the IOM report is going to be hailed as a sane step forward when it comes to national policies for dealing with patients," said Jeff Jones, director of the defunct Oakland Cannabis Buyers Collective. "It's over. The federal government lost." Cannabis researchers, while not as effusive as Jones, agreed the new report could be helpful -- assuming it helps smooth the way for additional research. The report calls for further study of the physiological and psychological effects of cannabinoids, the active components of marijuana. It also calls for more research into possible dangers of marijuana smoke -- including cancer and pregnancy complications -- and recommends limiting tests in which marijuana is smoked to short-term trials involving terminally ill patients who do not respond to other medications. "It's exactly what we're trying to do, is provide some more scientific rigor to the potential benefits -- if there are any -- of smoking marijuana," said Dr. Scott Morrow, public health officer for San Mateo County, which has applied to the National Institute of Drug Abuse for permission to conduct its own $500,000 study of marijuana's effectiveness. "Maybe it has no benefits. Maybe everything we hear is all anecdote and it doesn't benefit people. Or maybe it does. We should answer that question." That perspective resonates on the other side of the fence, among health professionals who have opposed the medicinal use of marijuana. Dr. Eric A. Voth, director of the International Drug Strategy Institute and co-author of one of the ballot arguments against California's 1996 medicinal marijuana initiative, said he hopes the new report will help separate cannabis science from the politics of smoking pot. But Voth also predicted the report could signal the beginning of a new war, between those who feel marijuana should be broken down into its individual components and reformulated as pills or sprays, and those who insist the plant be made freely available for smoking -- regardless of the risks. "I think that the proponents of marijuana will continue to push for legalization," he said. "But what I really hope that this report does is clearly paint in the mind of the public that (raw) pot is not medicine. You don't smoke medicine." SIDEBAR - Findings and recommendations included in the Institute of Medicine report on marijuana and medicine: CANNABINOID drugs may relieve pain, control nausea and vomiting, and stimulate appetite. Other medications are usually more effective, but cannabinoids may be better treatment for certain conditions, such as nausea caused by chemotherapy and appetite loss in AIDS patients. THE RISKS of regular marijuana smoking include respiratory tract damage and increased exposure to cancer, lung damage and low fetal birth weight. SOME MARIJUANA smokers experience mild and short-lived withdrawal symptoms, including restlessness, irritability, insomnia, nausea and cramping. There is no conclusive evidence that marijuana leads to other drug abuse. THE GOAL OF of clinical trials should be to learn more about how its cannabinoid ingredients work and how best to provide them to patients without smoking. Because that could take several years, however, clinical trials should be designed to last six months or less for patients with debilitating symptoms who could get some relief from smoking marijuana. - --- MAP posted-by: Patrick Henry