Researchers Find Study of Medical Marijuana Discouraged

By GARDINER HARRIS

January 19, 2010

Despite the Obama administration’s tacit support of more liberal state
medical marijuana laws, the federal government still discourages research
into the medicinal uses of smoked marijuana. That may be one reason that —
even though some patients swear by it — there is no good scientific evidence
that legalizing marijuana’s use provides any benefits over current
therapies.

Lyle E. Craker, a professor of plant sciences at the University of
Massachusetts, has been trying to get permission from federal authorities
for nearly nine years to grow a supply of the plant that he could study and
provide to researchers for clinical trials.

But the Drug Enforcement Administration — more concerned about abuse than
potential benefits — has refused, even after the agency’s own administrative
law judge ruled in 2007 that Dr. Craker’s application should be approved,
and even after Attorney General Eric H. Holder Jr. in March ended the Bush
administration’s policy of raiding dispensers of medical marijuana that
comply with state laws.

“All I want to be able to do is grow it so that it can be tested,” Dr.
Craker said in comments echoed by other researchers.

Marijuana is the only major drug for which the federal government controls
the only legal research supply and for which the government requires a
special scientific review.

“The more it becomes clear to people that the federal government is blocking
these studies, the more people are willing to defect by using politics
instead of science to legalize medicinal uses at the state level,” said Rick
Doblin, executive director of a nonprofit group dedicated to researching
psychedelics for medical uses.

On Monday, his last full day in office, Gov. Jon S. Corzine of New Jersey
signed a measure passed by the Legislature last week that made the state the
14th in the nation to legalize the use of marijuana to help with chronic
illnesses.

The measure was pushed by a loose coalition of patients suffering from
chronic illnesses like Lou Gehrig’s disease and multiple sclerosis who said
marijuana eased their symptoms.

Studies have shown convincingly that marijuana can relieve nausea and
improve appetite among cancer patients undergoing chemotherapy. Studies also
prove that marijuana can alleviate the aching and numbness that patients
with H.I.V. and AIDS suffer.

There are strong hints that marijuana may ameliorate some of the
neurological problems associated with such degenerative diseases as multiple
sclerosis, said Dr. Igor Grant, director of the Center for Medicinal
Cannabis Research at the University of California, San Diego.

But there is no good evidence that legalizing the smoking of marijuana is
needed to provide these effects. The Food and Drug Administration in 1985
approved Marinol, a prescription pill of marijuana’s active ingredient,
T.H.C. Although a few small-scale studies done decades ago suggest that
smoked marijuana may prove effective when Marinol does not, no conclusive
research has confirmed this finding.

And Marinol is no panacea. There are at least three medicines that in most
patients provide better relief from nausea and vomiting than Marinol,
studies show.

Buddy Coolen, 31, of Warwick, R.I., said he tried or continued to use some
of those medicines. “Smoking for me is as good as any medicine I have,” he
said.

Eight years ago, Mr. Coolen contracted gastroparesis and cyclic vomiting
syndrome. He lost 50 pounds and, despite being 5 foot 11, weighed 120
pounds.

His doctors gave him myriad anti-emetics, many of which he still takes. They
also prescribed Marinol, but it did not work for him, Mr. Coolen said.

“My stepdad is old school and was really against marijuana, but then he saw
what it did for me and totally changed his way of thinking,” Mr. Coolen
said.

Some doctors and law enforcement officials say such anecdotes should not
drive public policy. Dr. Eric Braverman, medical director of a
multispecialty clinic in Manhattan, said legalizing marijuana was
unnecessary and dangerous since Marinol provided the medicinal effects of
the plant. “Our society will deteriorate,” he said.

Patients who call Dr. Braverman’s clinic are, when put on hold, told that
the clinic may prescribe supplements and other alternative treatments that
have even less scientific justification than marijuana. Dr. Braverman said
such alternatives rendered marijuana unnecessary, but his embrace of
alternatives is a reminder that medicine has long been driven by more than
science.

About 20 percent of drug prescriptions are written for uses that are not
approved by federal drug regulators; about half of the nation’s adults
regularly take supplements; herbal and homeopathic remedies are popular.

The nation’s growing embrace of medical marijuana has stemmed from these
alternative traditions.

The University of Mississippi has the nation’s only federally approved
marijuana plantation. If they wish to investigate marijuana, researchers
must apply to the National Institute on Drug Abuse to use the Mississippi
marijuana and must get approvals from a special Public Health Service panel,
the Drug Enforcement Administration and the Food and Drug Administration.

But federal officials have repeatedly failed to act on marijuana research
requests in a timely manner or have denied them, according to a 2007 ruling
by an administrative law judge at the Drug Enforcement Administration. While
refusing to approve a second marijuana producer, the government allowed the
University of Mississippi to supply Mallinckrodt, a drug maker, with enough
marijuana to eventually produce a generic version of Marinol.

“As the National Institute on Drug Abuse, our focus is primarily on the
negative consequences of marijuana use,” said Shirley Simson, a spokeswoman
for the drug abuse institute, known as NIDA. “We generally do not fund
research focused on the potential beneficial medical effects of marijuana.”

The Drug Enforcement Administration said it was just following NIDA’s lead.
“D.E.A. has never denied a research registration for marijuana and/or THC if
NIDA approved the protocols for that individual entity,” a supervisory
special agent, Gary Boggs, said by e-mail.

Researchers investigating LSD, Ecstasy and other illegal drugs can use any
of a number of suppliers licensed by the Drug Enforcement Administration,
Dr. Doblin said. And if a researcher wants to use a variety of marijuana
that the University of Mississippi does not grow — and there are many with
differing medicinal properties — they are out of luck, Dr. Doblin said.

Law enforcement tends to emphasize the abuse potential of medicines without
regard to their positive effects. Bureaucratic battles between the D.E.A.
and the F.D.A. over the availability of narcotics — highly effective but
addictive medicines — have gone on for decades.

So medical marijuana may never have good science underlying its use. But for
patients in desperate need, the ethics of providing access to the drug are
clear, said Dr. Richard Payne, a professor of medicine and divinity and
director of the Institute for Care on the End of Life at Duke Divinity
School.

“It’s not a great drug,” he said, “but what’s the harm?”

http://www.nytimes.com/2010/01/19/health/policy/19marijuana.html