NIH Panel Suggests More Research of Medical Marijuana
An 8-member panel of experts convened by the National Institutes of Health (NIH) said marijuana may have medical uses, and that further research is needed (Warren E. Leary, "U.S. Panel Urges Study of Medical Marijuana," New York Times, February 21, 1997, p. 27; Paul Recer, "Scientists tread lightly on notion that marijuana aid chronically ill," Star-Ledger (Newark), February 21, 1997, p. 5; David Brown, "NIH Panel Cautiously Favors Medical Marijuana Study," Washington Post, February 21, 1997, p. A2; "Citing marijuana's medical potential, panel urges further studies," Chicago Tribune, February 21, 1997, s. 1, p. 8; Marlene Cimons, "Study of Medical Uses of Marijuana Urged," Los Angeles Times, February 21, 1997, p. A10; Rebecca Voelker, "NIH Panel Says More Study Is Needed to Assess Marijuana's Medicinal Use," Journal of the American Medical Association, March 19, 1997, Vol. 277, No. 11, p. 867).
At a conference held on February 19-20, the panel listened to scientists review marijuana's possible therapeutic uses as an antiemetic, appetite stimulant, analgesic, and treatment for glaucoma and multiple sclerosis. The panel also heard testimony from patients and other speakers during a one-hour public comment period. The panel will write a report of recommendations for NIH director Harold E. Varmus, who requested the conference. The NIH effectively controls any marijuana research because the National Institute on Drug Abuse (NIDA), a branch of NIH, is the only legal source of the plant for use in medical research.
"There are at least some indications that are promising enough for there to be some new controlled studies," said panel chairman William T. Beaver, professor of pharmacology and anesthesia at Georgetown University School of Medicine. Although much research has been done into the therapeutic uses of marijuana, there have been few controlled studies comparing marijuana to other drugs or placebos. One difficulty in conducting marijuana studies is making a convincing placebo cigarette, especially with patients who have experience with the drug.
The expert panel concluded that further research should address whether marijuana's therapeutic benefits can be obtained without the intoxicating effects of smoking the plant. Tetrahydrocannabinol (THC), the primary active intoxicating ingredient in marijuana, is available in a synthetic form as a pill (Marinol®), but some patients report that the pill is difficult to swallow if they are suffering from nausea. Some also say that smoking marijuana allows them to better control the dosage. Some scientists noted that marijuana contains other potentially therapeutic substances not found in Marinol®.
Medical marijuana advocates, such as the Marijuana Policy Project (MPP) and ACT-UP, protested at the conference. They contend that NIDA has unnecessarily impeded marijuana research by refusing to provide marijuana to FDA-approved clinical trials by creating unique bureaucratic obstacles such as requiring the research protocol to be approved by n NIH peer review panel. Although they support further research, advocates say the conference was a "stalling tactic" by the government to delay a change in policy. "Drug Czar Barry McCaffrey ... knows that the current bureaucratic structure impedes research. Unless the present constraints are removed, depending on research alone would ensure that medicinal marijuana continues to be prohibited for decades," said MPP Director of Communications Chuck Thomas. Advocates also protested that NIDA Director Alan Leshner, who organized the conference for NIH, refused to include on the panel any of 28 physicians, suggested by MPP, who have clinical experience with or who have been supporters of medical marijuana, including New England Journal of Medicine editor Jerome Kassirer, M.D. (See "New England Journal of Medicine Endorses Medical Marijuana ... " NewsBriefs, February 1997.)