Pubdate: Thu, 18 Mar 1999 Source: Boston Globe (MA) Copyright: 1999 Globe Newspaper Company. Contact: http://www.boston.com/globe/ Page: A01 Author: Dolores Kong, Globe Staff MEDICINAL MARIJUANA USES SEEN Scientific study commissioned by President Clinton's antidrug policy adviser has found that marijuana can be useful in treating people with AIDS, cancer, and other diseases, adding fire to the already politically charged issue of whether to legalize the drug for medicinal purposes. The Institute of Medicine report, released yesterday, also found no evidence to support the theory that marijuana is a ''gateway'' to harder drugs of abuse, and urged further study of marijuana's active ingredients in treating pain, nausea, and other ailments. The $896,000 study was commissioned in 1997 by retired Army General Barry R. McCaffrey after he and other US officials criticized state ballot measures legalizing medical marijuana, calling them `hoax initiatives,'' and dismissed reports on the drug's benefits as a ''Cheech & Chong show,'' referring to a pair of actor-comedians who have glamorized drug use. The Institute of Medicine is a private nonprofit organization that provides health policy advice under a congressional charter. Its report concludes that the future of the drug's medicinal use lies not in lighting up joints, since smoking can lead to lung damage and low-birthweight babies, but in the development of pharmaceuticals or other drug delivery systems, like a vaporizer, that would be based on marijuana's active ingredients. In the meantime, the report did support interim solutions for some sick and dying patients who do not benefit from approved painkillers and anti-nausea drugs. ''There are limited circumstances in which we see recommending smoked marijuana for medical uses,'' said Dr. John A. Benson Jr., former dean of Oregon Health Sciences Unversity and one of the two principal investigators for the report. But he said this would be only in the context of a carefully controlled study in which patients are told of the potential harmful effects. Thousands of patients with nausea and vomiting from chemotherapy, for example, could be among those who could benefit from smoked marijuana in carefully controlled trials, Benson said during a news conference. McCaffrey told the Washington Post he endorsed the report ''thoroughly,'' and called it a ''significant contribution to discussing the issue from a scientific and medical viewpoint.'' He said he wouldn't oppose studies of smoked marijuana until a less harmful way of inhaling the substance's active ingredients is found. ''I would note, however, that the report says `smoked marijuana has little future as an approved medication,''' McCaffrey said. ''You should not expect to go into an ICU (intensive care unit) in 15 years and find someone with prostate cancer with a `blunt' stuck in his face as a pain-management tool.'' The report did not find evidence to support the use of marijuana to reduce some of the eye pressure that comes with glaucoma, however, even though people have reported it to be helpful. One scientist asked by the institute to review the report, Dr. Lester Grinspoon of Harvard Medical School and author of ''Marihuana: The Forbidden Medicine,'' said he found fault with the glaucoma finding and other conclusions, but overall backed the report because ''it does say unequivocally that marijuana has medicinal capacities.'' Yesterday, other supporters of the legal use of marijuana for medical purposes also welcomed the report. And AIDS groups used the report to demand that federal officials immediately allow experimental access to medical marijuana. ''I think this report is General McCaffrey's worst nightmare,'' said Bill Zimmerman, executive director of the California-based Americans for Medical Rights, which has sponsored successful medical marijuana initiatives in seven states, mostly out West, and has put one on Maine's ballot for November. ''Most of what the government has been telling us is false ... It's not a gateway to heroin and cocaine. It has proven medical value,'' said Zimmerman. ''I think from both a scientific and moral standpoint, government has no choice but to make it available for patients who need it,'' he said. Antidrug activists generally called the report an objective evaluation, but continued to oppose the state initiatives as political ploys by people seeking to have all marijuana use legalized. ''General McCaffrey has been wonderfully responsible and responsive to fund this report and to get the medical community injected into this issue,'' said Steve Dnistrian, executive vice president for the Partnership for a Drug-Free America, a private nonprofit organization known for its national antidrug advertising campaigns. ''The best thing is to have this issue pulled out of the political arena, and put into the scientific arena.'' But Dnistrian said the report's findings could send the wrong message about marijuana to children. Imagine a situation in which a parent discusses marijuana with a son and discovers that the teenager ''has just been offered a joint at school, and a friend tells him, `It can't be so bad, sick people use it.''' `It's going to be inherently more difficult for that parent to talk to that kid persuasively about marijuana,'' Dnistrian said. ''It's not impossible to deal with, it just makes it all the more complicated.'' He also disputed the conclusion that marijuana does not play a role in teenagers progressing to harder drugs. While the Institute of Medicine report supports limited use of smoked marijuana for some patients, federal agencies, including the White House Office of National Drug Control Policy that McCaffrey heads up, remained silent on whether they would expand experimental access to the drug outside of some small federally approved programs. ''We will carefully study the recommendations and conclusions contained in this report,'' said McCaffrey, who then deferred to the US Department of Health and Human Services. Health and Human Services, in its own statement, said the National Institutes of Health, which it oversees, ''will continue to consider any grant applications it receives on the medical utility of marijuana and its constituents, and is prepared to fund those applications that meet the accepted standards of scientific design and are found, on the basis of peer review, to be competitive with other applications that qualify for funding.'' Globe correspondent Louise D. Palmer contributed to this report, which also includes material from the Associated Press. - --- MAP posted-by: Derek Rea