Pot Has Uses as Medicine, U.S. Panel Says

SAN FRANCISCO —  Marijuana eases pain and quells nausea in cancer patients and others, but research is needed to find alternatives to smoking it, an advisory panel to the federal government said Wednesday in a report that reignited the national debate over medical marijuana.

Contradicting administration policy that marijuana has no medical value and can lead to using harder drugs, a panel of experts found that marijuana is not addictive and said there is no clear evidence that smoking it leads to consumption of heroin, cocaine or other narcotics.

For patients “who suffer simultaneously from severe pain, nausea and appetite loss, cannabinoid drugs might offer broad-spectrum relief not found in any other single medication,” concluded the report, issued by the Institute of Medicine, a division of the National Academy of Sciences. Cannabinoids are the group of compounds related to THC, the main active ingredient in marijuana.

The panel of scientific experts in addiction, neurology, psychiatry and infectious diseases said clinical trials are needed, both to definitively determine marijuana’s medical benefits in easing the symptoms of some diseases, and to develop inhalers or other means of administering the drug. The authors said they were not calling for the legalization of medical marijuana.

Despite the caveats, medical marijuana advocates welcomed the findings.

“This report undercuts the government’s position on marijuana,” said Bill Zimmerman, director of Americans for Medical Rights, a medical marijuana lobbying organization. “In fact, it reveals that most of what the government has been telling us about marijuana is false.”

In February 1997, an advisory panel to the National Institutes of Health concluded that marijuana might have promising therapeutic uses and called for clinical trials of its effectiveness. But Wednesday’s report went further, recommending that some patients “with debilitating symptoms” be allowed to smoke marijuana under carefully controlled conditions for less than six months.

“Until a non-smoked, rapid-onset cannabinoid drug delivery system becomes available, we acknowledge that there is no clear alternative for people suffering from chronic conditions that might be relieved by smoking marijuana, such as pain or AIDS wasting,” the report said.

But it does not appear that the 290-page report will lead to a change any time soon in federal law, which classifies marijuana as a controlled substance illegal to possess or sell.

Nor will it have an immediate impact on California’s medical marijuana clubs, most of which were closed last year after a series of decisions in the state and federal courts that they were operating illegally.

Speaking to reporters in Los Angeles on Wednesday, retired Gen. Barry R. McCaffrey, head of the Office of National Drug Control Policy, focused on the report’s call for more research and concerns about the harmful effects smoking marijuana can have on the lungs.

“I think what they said is smoked marijuana is harmful, particularly for those with chronic conditions, that they could not tolerate any notion of people using it for any appreciable period of time,” McCaffrey said. “The central part of what they did was they said: ‘Look, go put it back in scientific medical research and go look at the potential of these other cannabinoids.’ ”

McCaffrey praised the report as “the most comprehensive summary and analysis of what’s known about the medical use of marijuana ever done,” but added, “Where do we go from here? I don’t know. First of all, I don’t want to be the one who decides that. I want the National Institutes of Health . . . to look very carefully and respectfully at the findings on this baseline study.”

Spokesmen for the U.S. Drug Enforcement Administration and the Food and Drug Administration declined to comment Wednesday.

The panel of 35 scientific experts who produced the report spent 18 months evaluating scientific studies on marijuana. They visited California marijuana clubs and took public testimony from dozens of patients and doctors.

It was McCaffrey who commissioned the study after Californians passed an initiative in November 1996 allowing patients to grow and use marijuana, with a doctor’s recommendation, to relieve symptoms of illnesses including AIDS, cancer, and spastic and degenerative muscle diseases. Since then, six states have passed medical marijuana initiatives.

In court battles over California’s law, the Clinton administration has argued that no state can legalize marijuana because federal law, which classifies the drug as illegal, supersedes state law. That position was upheld last year by a federal court in California that ordered six Northern California medical marijuana clubs to close.

Medical marijuana advocates said the report will boost their efforts to pass other state marijuana laws, and make it easier to implement the law in California, where state Atty. Gen. Bill Lockyer has asked a task force of law enforcement officials and medical marijuana advocates to find ways to make it work.

“In the past, we would go to members of Congress and to state legislators and say: ‘Medical marijuana works,’ and there was always resistance because of this myth that there was no medical value,” said Robert Kampia, executive director of the Marijuana Policy Project, a Washington-based advocacy group for legalizing marijuana.

“Now we can say, ‘Here is the science, it was commissioned by the bad guys, and it shows that marijuana is good medicine,’ ” Kampia said.

In California, state Sen. John Vasconcellos (D-Santa Clara), a strong advocate of medical marijuana, welcomed the report.

“With the institute report now in my hip pocket, I will aggressively pursue enactment of legislation this year to provide for a safe and affordable distribution system and to fund clinical research,” Vasconcellos said in a statement.

And Lockyer added, in a statement of his own: “The Institute of Medicine report takes an important step toward answering questions about the medical benefits of marijuana. . . . We look forward to the federal government building on this report’s findings so that we can wisely implement Proposition 215.”

In their news conference, the doctors who wrote the report stressed that they did not believe marijuana should be licensed as a drug. Instead, said Dr. John A. Benson Jr., dean of Oregon Health Sciences University School of Medicine in Portland, clinical trials “should be done in parallel with the development of new, safe delivery systems of drugs related to the compounds found in marijuana.”

Benson issued a stern warning that smoking marijuana could increase a user’s chance of developing cancer, of damaging the lungs or of harming fetuses.

“While we see a future in the development of chemically defined cannabinoid drugs, we see little future in smoked marijuana as a medicine,” he said. “That said, we concluded that there are some limited circumstances in which we recommend smoking marijuana for medical uses.” Such circumstances include the terminally ill, Benson said, “where the long-term risks are not of great concern.”

In Washington, AIDS patient Greg Scott came away from the news conference jubilant. “I feel vindicated after years of risking arrest, property forfeiture, fines, imprisonment,” said Scott, a Florida man who said he has smoked marijuana daily for seven years to ease his symptoms.

“This report demonstrates there is sufficient scientific evidence to merit an exemption from the marijuana prohibition laws for people who need this medicine,” Scott said.

But Scott Imler, director of the Los Angeles Marijuana Resource Center, sounded a cautious note. Imler said he was disappointed that the report seemed to rule out federal reclassification of marijuana as a drug that could be prescribed by physicians and dispensed by pharmacies.

Medical marijuana opponents, including U.S. Rep. Bill McCollum, a Florida Republican who chairs the House Subcommittee on Crime, issued statements pointing out that there is one pill now available that contains THC. The report, he said, gives no reason to use anything other than that medicine, which sells under the brand name Marinol.

“When smoking a dangerous and highly addictive drug is labeled ‘therapeutic,’ we are sending the wrong message to our youth,” McCollum said.

But Dr. Stanley Watson, co-director and research scientist at the University of Michigan’s Mental Health Research Institute and a panel member, said Marinol works slowly “and its results are variable.”

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Times staff writer Marlene Cimons contributed to this report.