Pubdate: Thu, 18 Mar 1999 Source: Centre Daily Times (PA) Copyright: 1999 Nittany Printing and Publishing Co., Inc. Contact: http://www.centredaily.com/ Forum: http://vh1615.infi.net/chat/world/html/index.html Author: Usha Lee McFarling, Knight Ridder Newspapers NATIONAL INSTITUTE URGES MEDICAL MARIJUANA USE WASHINGTON -- Entering the fractious debate over medical marijuana, the nation's Institute of Medicine recommended Wednes-day that marijuana cigarettes be made available for short periods to help cancer and AIDS patients who can find no other relief for their severe pain and nausea. Officials with the Department of Health and Human Services almost immediately responded by saying they would not dispense marijuana to individual patients until more clinical research showed it was safe. Still, the report was seen as a victory by many who advocate the use of marijuana as medicine. The response from drug-fighting groups was subdued. An explosion of recent scientific work, as well as patient anecdotes, shows that compounds in marijuana have potential to ease some of medicine's most intractable problems, the Institute of Medicine report said. But its authors warned that smoking marijuana carries its own health hazards -- including lung damage and low-birth-weight babies -- and should be used only as a last resort after standard therapies have failed. Addiction was seen as a relatively minor problem likely to affect only a few users. To avoid the smoke, they called for new delivery systems, like inhalers, and for the development of pharmaceutical drugs made from or modeled after the active ingredients in marijuana, chemicals known as cannabinoids. "Marijuana's future as a medicine does not involve smoking," said Dr. Stanley Watson, a neuroscientist and substance abuse expert from the University of Michigan who co-authored the report. "It involves exploiting the potential in cannabinoids." The endorsement pleased groups that have been working to make marijuana available to patients. Many were expecting a blander call for further research. "It's a discreet but clear call to make marijuana available," said Ethan A. Nadelman, dir-ector of the Lindesmith Center, a New York-based drug policy think tank. Other advocates, including the National Organization for the Re-form of Marijuana Laws and Harvard Medical School professor Lester Grinspoon, were more critical, calling the report "tepid" and "political." They said it ignored the fact that many patients have successfully used marijuana as medicine for years with few harmful effects. Battles over medical marijuana have raged across the nation since 1996, when California passed a ballot initiative that removed any state penalties from people who used marijuana for medicinal purposes. Since then, Arizona, Alaska, Oregon, Nevada and Washington state have passed laws permitting the use of medical marijuana. Many mainstream medical organizations, and the relatively conservative New England Journal of Medicine, have endorsed the use of medical marijuana. But last fall Congress overwhel-mingly passed a resolution condemning the medical use of marijuana and because federal law still outlaws marijuana use, many physicians are reluctant to prescribe it, even in states that have passed initiatives. "There are so many strictures on doctors, so much uncertainty on the part of licensing boards ... that nothing's happened," said Dr. John A. Benson Jr., a former dean of the Oregon Health Sciences University School of Medicine and the report's other co-author. Only eight patients in the United States have federal government permission to smoke marijuana for their conditions. They receive government-grown cigarettes under a "compassionate use" program no longer in existence. - --- MAP posted-by: Richard Lake