The New England Journal of Medicine endorsed the medical use of marijuana this week, thus increasing the pressure on the Clinton Administration to accelerate a fair and reasoned re-examination of the drug's medical properties. When a leading medical journal finds therapeutic value in marijuana, it may be hard for drug officials to continue blocking medical uses pending conclusive clinical studies showing marijuana to be beneficial.

The journal acknowledges that marijuana use may cause long-term adverse effects and lead to serious addiction. But it argues that these distant risks are not relevant issues when the drug is prescribed to combat intractable nausea and pain in seriously ill patients with AIDS, cancer and other diseases. It does not make sense to prohibit physicians from prescribing marijuana when they are allowed to prescribe morphine and meperidine, wrong dosages of which may hasten death, when there is no risk of immediate death with marijuana. While a synthetic form of a key ingredient of marijuana is available by prescription, the journal said, smoking marijuana provides rapid and more effective relief.

Although top drug officials are calling for rigorous clinical trials, The journal notes that nausea and pain are extremely difficult to quantify in controlled clinical tests, and that what counts for a therapy in these circumstances is whether patients feel relief. Thousands of patients report relief from smoking marijuana, it noted.

The journal's voice is a welcome addition to the widening national debate over marijuana as medicine. It is rooted in compassion for the seriously ill who may be suffering needlessly because of broader concerns about society's drug problem.

Copyright 1997 The New York Times Company