Responding to public opposition over the Clinton administration's proposal to arrest physicians who recommend or prescribe marijuana as a medicine in accordance with state law, the Office of National Drug Control Policy (ONDCP) has committed $995,639 to fund a comprehensive review by the National Academy of Sciences' Institute of Medicine (IOM) of the efficacy of the therapeutic use of marijuana for specific medical conditions such as glaucoma, cancer chemotherapy, multiple sclerosis, and AIDS wasting syndrome. NORML Deputy Director Allen St. Pierre announced that he was encouraged by administration's decision to review existing medical marijuana research, but criticized the plan for failing to authorize contemporary studies such as Dr. Donald Abrams' FDA-approved protocol to examine the effects of marijuana on the AIDS wasting syndrome.
"Nothing in the administration's announcement addresses granting the marijuana necessary to complete Dr. Abrams FDA-approved study in San Francisco or the 1996 state-sponsored study at Washington State University to evaluate marijuana's therapeutic value in the treatment of cancer chemotherapy. It is solely a backward-looking proposal," said St. Pierre. "We believe that a comprehensive review of the existing scientific evidence regarding the use of marijuana as a therapeutic agent by the Institute of Medicine will demonstrate that marijuana has legitimate value as a medicine, just like the Australian government's National Task Force on Cannabis concluded in 1994 and the IOM itself determined in 1982."
The following excerpts are taken from the summary conclusions of those committees:
"Cannabis and its derivatives have shown promise in the treatment of a variety of disorders. [Emphasis added. --ed.]The evidence is most impressive in glaucoma, where their mechanism of action appears to be different from the standard drugs; in asthma, where they approach isoproterenol in effectiveness; and in the nausea and vomiting of cancer chemotherapy, where they have compared favorably with phenothiazines. Smaller trials have suggested cannabis might also be useful in seizures, spasticity, and other nervous system disorders.
"... Although marijuana has not been shown unequivocally superior to any existing therapy for any of these conditions, several important aspects of its therapeutic potential should be appreciated. First, its mechanisms of action and its toxicity in several diseases are different from those of drugs now being used to treat those conditions; thus, combined with use of other drugs might allow greater therapeutic efficacy without cumulative toxicity. Second, the differences in action suggest new approaches to understanding both the disease and the drugs used to treat them. Last, there may be an opportunity to synthesize derivatives of marijuana that offer better therapeutic ratios than marijuana itself.
"The committee believes that the therapeutic potential of cannabis and its derivatives and synthetic analogues warrants further research... ."
-- Marijuana and Health, page 150
-- Institute of Medicine, 1982
-- National Academy of Sciences
"First, there is good evidence that THC is an effective anti-emetic agent [for patients undergoing cancer chemotherapy.] ... Second, there is reasonable evidence for the potential efficacy of THC and marijuana in the treatment of glaucoma, especially in cases which have proved resistant to existing anti-glaucoma agents. Further research is clearly required, but this should not prevent its use under medical supervision in poorly controlled cases. [Emphasis added. --ed.] ... Third, there is sufficient suggestive evidence of the potential usefulness of various cannabinoids as analgesic, anti-asthmatic, anti-spasmodic, and anti-convulsant agents to warrant further basic pharmacological and experimental investigation, and perhaps clinical research into their effectiveness.
... Despite the positive appraisal of the therapeutic potential of cannabinoids ..., they have not been widely used. ... Part of the reason for this is that research on the therapeutic use of these compounds has become a casualty of the debate in the United States about the legal status of cannabis. ... As a community we do not allow this type of thinking to deny the use of opiates for analgesia. Nor should it be used to deny access to any therapeutic uses of cannabinoid derivatives that may be revealed by pharmacological research."
-- The health and psychological consequences of cannabis use, pages 198-199
-- National Task Force on Cannabis
-- Australian Government Publishing Service, 1994
NORML's report: "Review Of Human Studies On The Medical Use Of Marijuana" by Dale Gieringer, Ph.D. cites well over 100 research articles on marijuana's pharmacological effects. NORML possesses many of these articles and scientific studies "in-house" and will provide them to both the ONDCP and the IOM committee when it convenes this spring.
" ... There is no question about the use of cannabis for certain [medical] conditions," said government marijuana researcher Dr. Mahmoud ElSohly in a recent interview conducted by the Journal of the International Hemp Association (JIHA). ElSohly is the current director of the National Institute on Drug Abuse's (NIDA's) Marijuana Project at the University of Mississippi and one of the federal government's premiere marijuana experts. "It does have a history. It does have the utility and so on," he concluded.
NORML Executive Director R. Keith Stroup said he hopes the administration's announcement will encourage McCaffrey to finally meet with NORML to discuss the subject of medical marijuana. In the past, McCaffrey has publicly stated that he "welcomes" NORML's participation in the national debate on drug policy, but has denied repeated requests for meetings. "If the General genuinely wants to explore the issue of medical marijuana, then NORML will gladly supply his office with scientific studies, expert physicians, and patients," said Stroup.
"In a 1990 survey, 44 percent of oncologists said they had suggested that a patient smoke marihuana (sic) for relief of the nausea induced by chemotherapy," wrote Dr. Lester Grinspoon of Harvard Medical School in the June 21, 1995 issue of the Journal of the American Medical Association (JAMA). "If marihuana (sic) were actually unsafe for use even under medical supervision, as its Schedule I status explicitly affirms, this recommendation would be unthinkable. It is time for physicians to acknowledge more openly that the present classification is scientifically, legally, and morally wrong."
For more information, please contact Allen St. Pierre or Paul Armentano of NORML. Copies of the summary conclusions of the Institute of Medicine's or the National Task Force on Cannabis' report, as well as additional scientific studies demonstrating marijuana's therapeutic value are available upon request from NORML.