Cannabis Catch-22

In response to initiatives in California and Arizona approving the medical use of marijuana, drug czar Barry McCaffrey at first claimed "there is not a shred of scientific evidence" that cannabis has therapeutic applications. Yet in January, McCaffrey announced that his Office of National Drug Control Policy would give the National Academy of Sciences $1 million to review the evidence of marijuana's medical utility.

Nearly a decade ago, the Drug Enforcement Administration's own administrative law judge, after two years of testimony, called marijuana "one of the safest therapeutically active substances known to man" and said it should be available by prescription. Since then, the federal government has blocked research on medical uses of marijuana, even while insisting that more is needed.

In 1994, after two years of effort, Dr. Donald Abrams, a researcher at the University of California at San Francisco, won approval from the Food and Drug Administration for a pilot study of marijuana as a treatment for AIDS wasting syndrome. But Abrams has been unable to obtain a legal supply of the drug. The DEA would not let him import it from the Netherlands, and the National Institute on Drug Abuse, which manages the only legal source of research marijuana in the United States, has refused to part with any.

In an April 1995 letter, NIDA Director Alan Leshner cited problems with Abrams's research protocol, which had been approved not only by the FDA but also by U.C.-San Francisco's Institutional Review Board, the Scientific Advisory Board of the San Francisco Community Consortium, and the California Research Advisory Panel. A few months later, Leshner said NIDA would provide the marijuana if the project received the blessing of a National Institutes of Health peer review panel. The only way to get that approval was to submit a grant application to the NIH, so Abrams revised his research plan, transforming what had been a relatively straightforward, privately funded out-patient study into a complex in-patient study requiring $300,000 in government support. The NIH rejected his grant application last August.

Meanwhile, researchers in Washington state hope to obtain FDA approval for studies of marijuana's effectiveness in relieving symptoms or treatment side effects in patients suffering from cancer, glaucoma, AIDS, multiple sclerosis, and other serious illnesses. The Washington legislature allocated money for the project, which is being managed by the Department of Health and the Board of Pharmacy, last year. If the project is approved and NIDA won't provide marijuana, the state might use cannabis seized by law enforcement. The Massachusetts Department of Health, which in January announced a certification program for some medical uses of marijuana, will also seek FDA clearance for research.

At an NIH-sponsored conference in February, an FDA official said marijuana would be made legally available only if research showed that it was superior to current treatments–a standard higher than the one usually applied to new drugs. The NIH appointed a panel of physicians to consider the future of medical marijuana research and make recommendations within a month.