Pubdate: Wed, 08 Jun 2005
Source: New York Times (NY)
Copyright: 2005 The New York Times Company
Author: Sally Satel
Note: Sally Satel, a psychiatrist and resident scholar at the American 
Enterprise Institute, is the co-author of "One Nation Under Therapy: How 
the Helping Culture Is Eroding Self-Reliance."
Cited: Gonzales v. Raich ( )
Cited: The Institute of Medicine report
Bookmark: (Opinion)
Bookmark: (Cannabis - Medicinal)
Bookmark: (Angel Raich)


Washington -- RELIEF for medical marijuana patients was snatched away this 
week. In Gonzales v. Raich, the Supreme Court ruled that such patients will 
be subject to federal prosecution even if their own state's laws permit use 
of marijuana. Now, short of Congress legalizing medical marijuana, the only 
way that its users can avoid stiff financial penalties or jail is if it is 
turned into a prescription medicine approved by the Food and Drug 
Administration. Justice Stephen G. Breyer said as much during oral 
arguments last November with his comment that "medicine by regulation is 
better than medicine by referendum."

Fair enough. The problem is that the very agencies integral to facilitating 
the research and development of medical marijuana have actually been 
impeding progress.

The first obstacle is ideological. The Drug Enforcement Administration has 
fought marijuana's use as a medicine, maintaining that it has no 
therapeutic value. (It hasn't helped that activists have tried to use 
medical marijuana as a wedge to liberalize drug laws.)

But scientific consensus says otherwise. Surveying a range of findings, a 
federally commissioned Institute of Medicine report issued in 1999 noted 
the active ingredients in marijuana, cannabinoids, can relieve 
chemotherapy-induced nausea, stimulate appetite and suppress pain in 
patients who have failed to get relief from conventional treatments. Other 
countries have embraced such findings. Last April, for example, regulators 
in Canada approved a marijuana extract delivered in an oral spray for 
relief of symptoms of nerve pain associated with multiple sclerosis.

A more imposing obstacle to developing medicine in the United States is 
that there is only one legal source of research marijuana: a farm in 
Mississippi run by the National Institute on Drug Abuse, part of the 
National Institutes of Health. As gatekeeper of the supply, the drug abuse 
institute must review and approve all proposed marijuana research projects, 
a hurdle for researchers that is both onerous and redundant: they already 
must undergo at least three other oversight evaluations (from the Food and 
Drug Administration, the D.E.A. and their own institutions) before they can 
enroll their first subject.

One scientific team has been trying for two years to get a mere 10 grams of 
marijuana from the drug abuse institute for its effort to develop a device 
that heats marijuana but doesn't burn it, thereby providing nontoxic and 
immediate relief to patients.

Since the drug abuse institute's mission does not include the development 
of marijuana into a commercial prescription medicine, any expanded studies 
with the marijuana plant must be privately financed. But, in a Catch-22, 
private resources are out of reach as long as only federal marijuana - 
which is notoriously weak and poorly manicured - can be used.

After all, a pharmaceutical development team must have a stable source of 
raw material with adequate purity. Researchers need to be able to control 
the ratio of active to inert compounds in the plant by manipulating growing 
conditions. Unless a pharmaceutical company could be sure of producing a 
drug or device for commercial sale, it won't invest millions of dollars in 
clinical trials.

One solution is to get the National Institute on Drug Abuse out of the 
marijuana supply business. Let researchers get marijuana directly from the 
government-approved Mississippi farm or from overseas sources like the 
Dutch Office of Medicinal Cannabis. Better yet, permit a privately financed 
D.E.A.-approved farm, like the kind that Lyle Craker, a medicinal plants 
expert at the University of Massachusetts, has been hoping to create for 
the last three years. In addition to producing higher-potency, cleaner 
marijuana, such a farm could offer strains with varying levels of 
cannabinoids that may contribute to marijuana's therapeutic effects.

Developing cannabis into an approved and effective prescription medication 
can be a goal within reach. But it will take a federal government that is 
truly open to the research that it claims to value.
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MAP posted-by: Richard Lake