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Study of Medical Uses of Marijuana Urged

LA Times
Marlene Cimons
February 21, 1997

Health: Federal panel sees drug's potential value in treating cancer and AIDS patients. But experts stop short of calling for doctors to prescribe it.

WASHINGTON--A federal advisory panel, thrusting itself into the center of a standoff between federal drug authorities and advocates of marijuana use for medicinal purposes, said Thursday that the drug may have promising therapeutic results and called for clinical trials of its medical effectiveness.

Following a two-day workshop at the National Institutes of Health, members of the panel said they believe that marijuana could have some value in treating nausea among cancer patients receiving chemotherapy, wasting syndrome among AIDS patients and glaucoma.

"There are at least some indications that are promising enough for there to be some new controlled studies," said panel chairman William T. Beaver, professor of pharmacology and anesthesia at Georgetown University School of Medicine in Washington.

The call for research stopped well short of advocating that doctors be allowed to prescribe marijuana but neither did the specialists dismiss anecdotal evidence indicating that the drug has helped certain patients.

The advisory panel, made up of outside medical experts, shied away from discussing the politics of the issue, which escalated into a national debate after voters in California and Arizona approved initiatives allowing doctors to prescribe it for medical purposes--and the Clinton administration responded by announcing that it would prosecute any doctors who did.

"You can argue policy and politics all you want but if you haven't got the data, the political thing is irrelevant--because you cannot say this is an effective medication," Beaver said.

California's Proposition 215, approved by 56% of the voters, removes criminal penalties for possession of marijuana by patients and care-givers if the drug was recommended by a physician. Arizona's Proposition 200 goes one step further by allowing sick people to use stronger drugs, including heroin or LSD, if approved by two licensed physicians.

Federal drug officials responded with stern warnings that the propositions were in conflict with U.S. drug laws and that physicians who prescribed marijuana would be criminally prosecuted. But those authorities have suggested that they do favor more scientific research into marijuana.

Barry R. McCaffrey, director of the White House Office of National Drug Control Policy, has indicated that he would support studies examining the medical value of marijuana. Last December, his office asked the Institute of Medicine, part of the National Academy of Sciences, to review what is known about the health effects and potential medicinal uses of smoked marijuana.

Immediately after the panel's announcement Thursday, the director of the National Institute on Drug Abuse, which is part of the NIH, urged researchers to seek federal funding for marijuana studies.

Director Alan I. Leshner stressed the "openness and willingness" of the federal biomedical research agency to review such grant proposals and, if they are approved, to "provide the product," in other words, the drug.

While research exists showing the benefits of taking delta-9 tetrahydrocannabinol (THC)--the active ingredient of marijuana--in pill form, studies conducted on smoked marijuana have been rare, Beaver said.

Such research poses problems, he said, because it is difficult to conduct marijuana studies that are "blinded," a term referring to a standard research technique in which neither participants nor researchers know who is receiving the drug and who is receiving a medically worthless placebo. With marijuana, the side effects would become instantly apparent, Beaver said.

During the panel's news conference, which was disrupted several times by demonstrators from ACT UP (the AIDS Coalition to Unleash Power), Dr. Paul Palmberg, professor of ophthalmology at the Bascom-Palmer Eye Institute, part of the University of Miami School of Medicine, said that several of his glaucoma patients have succeeded in lowering pressure on their eyes by smoking marijuana.

Despite the need to administer the drug frequently because it wears off after several hours, the patients "function quite well and don't appear to be inebriated," he said. "But I don't know about the impact on their lungs, their immune systems--the long-term effects."

THC is legally available in capsules but the plant form is illegal and has no approved medical applications. Some experts believe that THC in oral form is slower-acting and less predictable in its effects than inhalation. However, there are potential risks of inhalation, since marijuana smoke contains many of the same toxic chemicals found in tobacco smoke.

Times staff writer Faye Fiore contributed to this story.