Pubdate: Sun, 01 Apr 2001
Source: Dallas Morning News (TX)
Copyright: 2001 The Dallas Morning News
Contact:  http://www.dallasnews.com/
Details: http://www.mapinc.org/media/117
Author: Laura Beil, The Dallas Morning News

SCIENCE'S VERDICT ON MEDICAL MARIJUANA STILL OUT

Patients' Reported Success Is Driving Bill

Texas is considering allowing people to smoke pot under doctor's orders, 
but the science behind medical marijuana remains full of weeds.

Advocates say it might ease the relentless nausea of chemotherapy, the 
wasting syndromes of the chronically ill or excruciating pain. Or it might 
have little use beyond illegal recreation.

"There's really not enough data to support any claim," said Dr. Stanley 
Watson, a neuroscientist at the University of Michigan in Ann Arbor.

Nor is there enough data to refute one. While some individual reports of 
medicinal benefits are intriguing, he said, "we need good studies."

Even without the kind of research doctors would like, voters in eight 
states -- Alaska, Arizona, California, Colorado, Maine, Nevada, Oregon and 
Washington -- have approved the use of the drug by certain patients. And in 
Hawaii last year, the state Legislature passed a bill allowing medicinal 
use of marijuana.

Other states' lawmakers may not be far behind. This year, besides in Texas, 
legislators have introduced bills in Maryland, Massachusetts, New Mexico 
and Vermont. Texas will vote on its bill, authored by Rep. Terry Keel, 
R-Austin, in the next few weeks, and Mr. Keel said he feels good about its 
chances in the House. No sponsor has stepped forward to shepherd the 
measure through the Senate.

Lacking solid clinical studies, the movement toward medical marijuana is 
largely driven by the anecdotal reports of patients themselves. Research in 
animals has also hinted at medical benefits from marijuana's active 
ingredients. But no one can say scientifically whether marijuana alleviates 
symptoms in people, which patients it will help most, how to take the drug, 
or what dose works best.

The fact that marijuana is illegal is just one obstacle to medical research 
in people. Another is its common method of delivery: smoking crushed 
leaves. The amount of drug varies from plant to plant and from person to 
person, depending on how deeply one inhales. For sound experiments, 
researchers need to give each person the same dose.

Some doctors also are hesitant to recommend a smoked drug, which may 
introduce a whole new set of health problems, Dr. Watson said. Studies 
suggest that marijuana smoke is bad for the lungs, just as tobacco smoke is.

"We don't think studies should be done on the smoked material," Dr. Watson 
said, but on other possible routes such as pills or inhalers.

He and others had hoped to generate more scientific interest in marijuana 
research. In 1999, Dr. Watson and Dr. John Benson, from Oregon Health 
Sciences University, were the principal authors of a government report on 
medicinal marijuana. After reviewing data, along with meeting scientists, 
marijuana smokers, and even opponents of marijuana use, the report's 
authors concluded that marijuana has potential as a medicine. However, Dr. 
Benson said at the time of the report's release, "there is far less 
convincing data about actual medical benefits."

Existing drugs

Drugs already exist for conditions that marijuana might help. For most 
patients, Dr. Benson said, "there are better medications in every case than 
marijuana." Because major drug companies don't see a large potential 
market, they aren't rushing to develop marijuana-based drugs, he said.

Many patients nevertheless believe strongly that marijuana is the only 
means to relieve their nausea or pain, or to maintain appetite when weight 
melts off their bodies from AIDS or chemotherapy.

"If you ask a bunch of AIDS patients, they'll say, 'We don't need any 
research, we know that it works.' It's the anecdotal [evidence] that's very 
prevalent," Dr. Benson said.

And in many cases, patients may be right, Dr. Benson acknowledges. As with 
any medication, not all drugs work as well, or the same, in every patient.

"Standard therapy, which is approved and generally better, doesn't always 
work," he said. That's the reason he believes that marijuana research 
should continue.

But Dr. Benson's report, commissioned by the White House Office of National 
Drug Control Policy, didn't light up much interest among scientists.

What's needed, he and others say, is a federal law that will make it easier 
for researchers to do their jobs.

"There are many, many obstacles that dissuade them from this area of 
study," said Dr. Andrew Mattison of the University of California, San 
Diego, who is co-director of the Center for Medicinal Cannabis Research. 
For example, he said, a scientist could be easily overwhelmed by the 
paperwork involved in obtaining marijuana for a laboratory.The California 
center, established by the state government last year, won't focus on 
ailments like glaucoma that already have good treatment alternatives, Dr. 
Mattison said. Although marijuana has been found to relieve the eye 
pressure caused by glaucoma, conventional medicines already exist.

Safer methods

Dr. Mattison and his colleagues are also looking for safer ways to deliver 
marijuana's active ingredients.

"There are clearly scientific data indicating the deleterious effects of 
smoking," he said. "We are taking that charge seriously."

One drug now on the market does offer marijuana in pill form for people 
with AIDS or undergoing chemotherapy. But many patients don't like it, Dr. 
Mattison said. The medicine dumps the drug into the body all at once, while 
patients might prefer to gradually take only as much as they need. An 
inhaler, patch or under-the-tongue spray might be a better method.

Until there is a federal standard for marijuana's medicinal use, however, 
states will pursue laws on their own. Each law might make it possible for 
people to take the drug, Dr. Benson said, but beyond establishing specific 
centers like the one in California, "I don't think the state bills have any 
direct effect on research."

The federal government ultimately controls drug enforcement, Dr. Benson 
said. At the same time, it also is the largest single sponsor of medical 
research.

"The states can write in stuff that has to do with encouraging research," 
Dr. Benson said, "but it may not matter very much if the grants that come 
and the substance they're going to test has to come through federal agencies
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