Pubdate: Sat, 20 Mar 1999 Source: Economist, The (UK) Copyright: 1999. The Economist Newspaper Limited. Contact: http://www.economist.com/ MEDICAL MARIJUANA: THE SMOKE CLEARS SO FAR, seven American states have voted in favour of it. In Britain, clinical trials are about to begin, and in Canada they have just been authorised. Now, the Institute of Medicine, in Washington, DC, has issued its report on the matter. It concludes, to nobody's great surprise--though in the most timid possible terms--that marijuana is a legitimate medical drug. It recommends further research, which is reasonable. But it cannot quite steel itself to concede that, in the face of the evidence that it presents, American doctors ought now to be given the right to prescribe the stuff as freely as they would any other medicine. The report, which was commissioned in January 1997 by the White House Office of National Drug Control Policy, looked at the effects of smoked marijuana on all the diseases for which some consensus exists that it might be beneficial. In cases of chemotherapy-induced nausea and vomiting in cancer patients, and the wasting that accompanies AIDS, the authors--John Benson of Oregon Health Sciences University and Stanley Watson of the University of Michigan--agreed that the drug was effective, and might sometimes be better than existing treatments. That was also true for its use in treating the muscle spasms that are associated with multiple sclerosis. The authors disagreed, however, with the notion that it helped glaucoma patients. The relief of pressure on the eyeball that marijuana brings was thought too short-term to be useful. There was also little comfort for those who had hoped that marijuana would help with Parkinson's disease and Huntington's chorea. As to the risks associated with marijuana use, the only one thought to be outside the bounds of those normally acceptable in a medicine was the deleterious effect of the smoke itself (it is like tobacco smoke). So Dr Benson and Dr Watson recommended developing other ways of delivering marijuana's active ingredients, while accepting that drug companies might not necessarily think it worth their while doing this. Moving beyond strictly therapeutic matters, the report also noted that there was no evidence to suggest marijuana was a "gateway" to other, more dangerous recreational drugs. Most hard-drug users had, indeed, tried it before they moved on to other substances. But they had experimented with legal drugs--ie, tobacco and alcohol--before that (though usually at illegal ages). If any drugs are gateways, therefore, it is these. Try selling that idea to the distillers and cigarette companies. - --- MAP posted-by: Richard Lake