cannabisnews.com: No Green Light Yet!





No Green Light Yet!
Posted by FoM on March 21, 1999 at 20:50:04 PT
By Claudia Kalb 
A long-awaited report supports medical marijuana. So now what? For Scott Imler, it was finally time to exhale. Six months ago, Imler feared his Los Angeles Cannabis Center would be shut down by federal authorities.
 Last week, after the Institute of Medicine released its findings on the medical merits of marijuana, Imler and his staffers were toasting the report with bottles of Chianti: "Sweet vindication," he said. Back at the Office of National Drug Control Policy in Washington, drug czar Gen. Barry McCaffrey had a very different reason to be relieved. Sources say that if the IOM had given blanket approval to marijuana as medicine, McCaffrey would have supported downgrading the drug from its current Schedule I status (high potential for abuse, no medicinal value) to Schedule II (which would allow doctors to prescribe it). Instead, the general politely thanked the report's investigators. "I think what we will aggressively support," he said, "is continued research." The IOM report, commissioned by McCaffrey in 1997 amid bitter clashes between state "medical marijuana" initiatives and a federal war on weed, had something for everyone. The study concluded that cannabinoids—marijuana's active components—can be useful in treating pain, nausea and appetite loss caused by advanced cancer and AIDS. For very ill patients with no other treatment options, investigators recommended short-term use of smoked marijuana under strict medical oversight. But the IOM in no way gave marijuana a clean bill of health: scientists said the drug's benefits were hampered by the toxicity of smoking. Marijuana's future lay not in the plant, investigators said, but in development of synthetic cannabinoids and in new, smokeless delivery systems—ideally an asthma-type inhaler. "We were asked, 'Is there a medical use for marijuana or cannabinoids?' " said Dr. Stanley Watson, a principal investigator. "Our answer comes out a reserved yes." While the report pleased many, some found the "yes" far too timid. Harvard doctor Lester Grinspoon, a longtime crusader for medical marijuana, called the findings a "political compromise." While praising the IOM for giving the drug legitimacy, Grinspoon says its emphasis on pharmaceutical research will delay treatment and may be wholly unrealistic. R&D for new drugs can cost $300 million—and only about one in five will make it to market. "Drug companies won't get involved," says Grinspoon, "unless they can be sure they'll make money." Stalwart anti-drug warriors, on the other hand, considered parts of the report reefer madness. IOM investigators said that they found no conclusive evidence that marijuana is a "gateway" drug, nor that recommending it medicinally would increase general use—both central tenets of the administration's opposition to legalizing medical marijuana. Rep. Bill McCollum, who last fall introduced a House resolution urging states not to pass marijuana referenda (it passed 310-93) says "nobody, but nobody, who uses heroin or cocaine didn't start out using marijuana." He and others worry that advocating smoking marijuana—even for very sick patients—is "a very, very bad thing." Once the smoke clears, what next? "I don't know," McCaffrey said last week. He says he intends to respect the IOM's report and will ask the National Institutes of Health to "sort it out." Marijuana advocates say they will use it to fuel state initiatives; anti-drug groups promise to continue their war. As for drug development, Unimed Pharmaceuticals—which manufactures the pill Marinol, the only legal cannabinoid synthetic—says it is devising an inhaler. Several other small companies are developing smokeless cigarettes, new pills and even a marijuana suppository. Still, all of that is years away. Patients like Greg Scott, who is battling AIDS, say marijuana helps keep them strong—"I'm living proof," says Scott, "that marijuana is good medicine." But the Feds will need more proof than that. With Pat Wingert and Debra Rosenberg in Washington, Anne Underwood in New York and Joshua Hammer in Los Angeles Special DeliveryThe study concluded that the future of medical marijuana is in its chemical compounds—not in the plant itself. The state of cannabinoid delivery: Smoking: Offers immediate delivery and patients can "titrate" dose as needed. But report deems fumes too dangerous—and smoking's illegal under federal law. Inhaler: Will eliminate toxicity of smoke while maintaining quick entry into the bloodstream. The study encourages development, but product approval is still years away. Pills: Legal and smokeless. But they can take over an hour to enter bloodstream. And some patients can't stomach concentrated dose. http://www.newsweek.com/nw-srv/printed/us/na/na0113_1.htmNewsweek, March 29, 1999 
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