Laws and medicine clash over medicinal marijuana use.
"Marijuana's future as a medicine does not involve smoking," says Stanley Watson, a neuroscientist and substance-abuse expert from the University of Michigan who cowrote the report. "It involves exploiting the potential in cannabinoids" (chemical compounds that are the active ingredients in marijuana).
The best-known substance, THC, is already legally available as an oral prescription drug sold under the trade name Marinol -- a fact that those staunchly against medical marijuana use are quick to emphasize. "We already have good medicines out there for every ailment that marijuana is reported to help relieve the symptoms for, including cancer and AIDS," says Robert Maginnis, a senior director at the Family Research Council in Washington, DC. Maginnis and other opponents say legalizing marijuana for medical use sends the public the message that the drug is safe -- a sure prescription for increased illegal use by teenagers.
Still, the Institute of Medicine report acknowledged problems with some legal drugs. Both oral THC and megestrol acetate, a synthetic derivative of progesterone sold as Megace, can stimulate appetite in AIDS patients, but they can also cause dizziness, lethargy, and other more serious side effects. In addition, some patients say inhaling marijuana smoke gives them more control over the effects than a pill containing THC. Yet, even if researchers eventually do develop safer forms of the drug such as inhalers, the authors observed, terminally ill patients currently in severe pain "will find little comfort in a promise of a better drug ten years from now."
On that last point many Americans would seem to agree: In a nationwide Gallup poll conducted after the report was issued, 73% of respondents favored making it legal for doctors to prescribe marijuana to suffering patients. The issue has also been cropping up repeatedly on the campaign trail. In an October debate in Hanover, NH, Republican presidential contender John McCain was asked how he reconciles society's tolerance for alcohol with the obstacles to medicinal marijuana. "That is an excellent question," said McCain. "Which I'd prefer to duck." GOP front-runner George W. Bush has said that while he personally does not support medical marijuana use, states should have the right to allow it.