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Pot as Herbal Medicine?

WASHINGTON, D.C.--Marijuana today received the imprimatur of U.S. science's most august body: The drug and its active ingredients can relieve severe pain, the nausea and vomiting associated with chemotherapy, and the anorexia of AIDS wasting syndrome, according to a report issued by the National Academy of Sciences' Institute of Medicine (IOM). The report, released at a news conference here today, also calls for more clinical trials of marijuana and efforts to develop new, synthetic drugs that mimic pot's active ingredients. For now, smoking marijuana for medical use is recommended only in rare circumstances, such as for terminally ill patients.

Since 1996, voters in seven states have approved ballot initiatives that permit the medical use of marijuana. In response to the often heated debate, the White House Office of National Drug Control Policy about 2 years ago commissioned the IOM to review the scientific literature on marijuana's health effects and potential medical benefits. According to Stanley Watson, co-director of the Mental Health Research Institute at the University of Michigan, Ann Arbor, and a report author, the panel found no evidence that medical use of marijuana leads to abuse of other illicit drugs. Beyond the harm due to smoking, marijuana has side effects no worse than for any other approved medication, the panel found. Because the majority of evidence suggests that marijuana is effective at relieving pain, stimulating appetite, and suppressing nausea and vomiting, the report advocates what Watson calls a "compassionate use of marijuana."

That verdict pleases many patient advocacy groups. "This report clearly shows that there is scientific evidence for bona fide medical benefits for some patients," says Chuck Thomas, spokesperson for the Marijuana Policy Project. But others criticize the report for limiting the recommendations to severe cases and not recommending ways for patients to take the drug without smoking. "There are ways around smoking marijuana, yet the report makes no mention of them," says psychiatrist Lester Grinspoon of Harvard Medical School in Boston, who was one of 13 outside experts reviewing the report before completion. For instance, as to fast-acting delivery to the lungs, Grinspoon says vaporizers already exist that selectively extract cannabinoid vapors without burning the plant material. Adds Thomas, "Many patients eat marijuana; it's no more dangerous than eating Valium."