The Pew Charitable Trusts

WASHINGTON - Voters who supported medical marijuana initiatives in six Western states can now take comfort in the fact that science stands behind their vote, based on a government-ordered report on the effectiveness of pot in easing the unpleasant side-effects of certain illnesses.

The study, conducted at the request and financed by the White House Office of National Drug Control Policy, was released today by the National Academy of Science's Institute of Medicine. It says a review of all relevant scientific evidence found that marijuana's active components (cannabinoids) are potentially effective in treating pain, nausea, the anorexia of AIDS wasting, and other symptoms, and should be tested rigorously in clinical trials.

The report says trials should be carried out along with the development of a new delivery mechanism for the drug, other than smoking it, which can potentially increase a person's risk of cancer and lung damage.

"For patients, such as those with AIDS or undergoing chemotherapy, who suffer simultaneously from severe pain, nausea, and appetite loss, cannabinoid drugs might offer broad spectrum relief not found in any other single medication," the report said.

"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," said the report's principal investigators, Dr. Stanley Watson, co-director and research scientist at the Mental Health Research Institute at the University of Michigan, Ann Arbor, and Dr. John Benson Jr, dean and professor of medicine emeritus at Oregon Health Sciences University School of Medicine in Portland.

The report said there was no evidence that approving the medical use of marijuana would increase its use among the general population, particularly if marijuana were regulated as closely as other medications with the potential to be abused.

In last November's election, voters approved referenda authorizing medical marijuana use in Alaska, Arizona, Nevada, Oregon and Washington. California passed the first such initiative in 1996.

The ballot drives were funded by three tycoons: New York financier George Soros, Cleveland insurance executive Peter B. Lewis and Phoenix entrepreneur John Sperling.

Although these state laws now exempt patients who use the drug under a physician's supervision from prosecution for illegal drug use, the federal government has not approved the Schedule I drug for any medical use and it is against federal law for physicians to prescribe it.

"We are very pleased with the Institute of Medicine report, it strongly supports the medical use of marijuana. For the government to continue withholding marijuana from patients would be cruel and illogical based on the findings of the report," said Bill Zimmerman, director of Americans for Medical Rights, the group that coordinated the ballot drives in every state but Arizona.

A statement released by the White House Drug Policy Office in response to the report gave no hint of a change in federal policy as a result of the findings.

"We are delighted that science is the basis of discussion of this issue, as it must be...(we) believed that an objective and independent evaluation of research regarding the use of marijuana for medicinal purposes was appropriate given the ongoing debate about cannabis and its health effects," it said.

"We will carefully study the recommendations and conclusions in this report. We will continue to rely on the professional judgment of the Secretary of Health and Human Services, the Director of the National Institutes of Health, and the Surgeon General on all issues related to the medical value of marijuana and its constituent cannabinoids," the White House statement added.

Maine, one of the few states that permits an off-year initiative, will have a medical marijuana initiative on the ballot this year. Colorado will have an initiative in 2000, and although Nevada voters approved the use of medical marijuana in 1998, the use of it depends on a second "yes" vote in 2000.

Sam Bagenas, the director of Arizonans for Drug Policy Reform, the chief petitioner for the state's ballot initiative, said that the new report "confirms what voters across the country voted on: marijuana is medicine."

Josh Burner, a resident of Mesa, Ariz., has been using marijuana since October 1995 after he was diagnosed with cancer of the tongue. Burner, a grandfather of three and a former deputy sheriff in Montana, said marijuana controls his pain and increases his appetite and decreases his nausea, which are exacerbated by his radiation treatments.

"It works wonderfully for me. My last surgery I had over 100 stitches in my mouth and I went straight from morphine to marijuana with no other medication," he said.

Burner often ingests marijuana in food such as meatloaf, brownies, cookies or in a shake he calls a "Banglassee," a blended drink that consists of a cup of yogurt, a tablespoon of honey, a banana, two tablespoons of finely ground marijuana and ice cubes.