The following article appeared in the July 6th 1991
issue of "The Economist."
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Medical marijuana

C R O S S - E Y E D   A N D   P A I N L E S S

Cambridge, Massachusetts


Drugs can be medicinal or recreational: marijuana is both.  For nearly
20 years advocates of its medical use--to relieve the nausea of
chemotherapy, to treat glaucoma and to help AIDS patients gain weight--
have fought in the American courts to have the drug reclassified so that
doctors can prescribe it.  Currently marijuana is grouped with the most
disapproved of drugs, such as LSD and heroin.  The government argues it
must remain so because it has no "currently accepted medical use in
treatment".  A new study by researchers at Harvard refutes this.

Mainly because of its effectiveness in treating the vomiting common
among cancer patients during chemotherapy, tetrahydrocannabinol (THC),
the main psychoactive ingredient in marijuana, was approved for medical
use in America in 1985.  A synthetic form of THC is sold in pill form
under the trade name Marinol;  last year almost 100,000 doses were
prescribed.  Smokable marijuana, however, is available to just 34 people
through a "compassionate use" programme.  To the confusion of many a
police officer, these patients are given a supply of marijuana
cigarettes rolled by government hands at a research farm in Mississippi.

Proponents claim that smoking marijuana works better than taking oral
THC.  In 1988 Francis Young, a judge who examines administrative issues
for the Drug Enforcement Agency, recommended that marijuana be
reclassified on the ground that "current Acceptance" of a drug is
present if a "respectable minority" of doctors endorse it.  The
administration disagreed, claiming that the vast majority of doctors
believe oral THC is as reliable and effective as smokable marijuana and
produces fewer side-effects.

Enter Rick Doblin and Mark Kleiman, two drug-policy researchers at
Harvard's Kennedy School of Government.  To test the administration's
thesis, they conducted a random survey of members of the American
Society of Clinical Oncology.  Some 1,035 responded, about 10% of
America's oncologists.  The results, published in the July 1st issue of
the "Journal of Clinical Oncology", surprised even Mr. Doblin and Mr.
Kleiman: nearly half of the respondents said they would prescribe
smokable marijuana if it were legal.  Indeed 44% of them said they had,
in effect, done so already by recommending it to one or more of their
patients, despite the possibility of prosecution.

Nearly two-thirds of the oncologists agreed that marijuana was an
effective antiemetic, while 77% of the 157 who expressed a preference
said that smokable marijuana is more effective than oral THC.  A
majority said that marijuana was no worse than Marinol in terms of
producing bad side-effects.

Predictably, such numbers have the Bush administration's drug-policy
office all out of sorts.  Not long ago it chided Mr. Young by suggesting
that only one in 200 doctors would support medical use of marijuana, and
that this was not a "respectable minority".  When some of Mr. Doblin and
Mr. Kleiman's results were published recently as a letter in the "Annals
of Internal Medicine", the adverse publicity led Herbert Kleber, number
two in the drug-policy office, to declare that anyone who really needed
medical marijuana could get it through the compassionate-use programme
within 30 days.

But last week the administration admitted it was planning to limit that
already tiny programme.  Now, under strong pressure from AIDS
activists--marijuana has proved especially helpful to people taking AZT
to fight the AIDS virus--Mr. Kleber has said he will soon call an
inter-agency meeting top decide what to do.  Meanwhile a federal appeals
court has rejected the government's response to Mr. Young's recommendation
that marijuana be reclassified.  The court said the government's
interpretation of "current acceptance" was impossible to meet.

Despite all this, the administration is unlikely to yield.  There are
other, non-medical, issues at stake.  One official agreed that to admit
that marijuana might ever be "safe and effective" would make a mockery
of the government's stringent anti-drugs campaign.  In some ways the
research by Mr. Doblin and Mr. Kleiman already has.

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