Smoke screen

The government has loosened its restrictions on the study of marijuana. Is this a step toward legalization -- or just a ploy?

by Jason Gay

WAY DOWN SOUTH, deep down in river country, your Uncle Sam is known to grow himself a little -- shhhhh -- pot. That's right: for years, the federal government has funded its own honest-to-goodness marijuana farm, located on the campus of the University of Mississippi at Oxford.

Mind you, this government pot isn't being used for dorm-room bong hits. Most of the marijuana harvested in Oxford is supplied to a tiny handful of scientific researchers working under the eye of the National Institutes of Health (NIH). And a small amount is sent to North Carolina, where it is rolled into cigarettes and supplied to the eight individuals who are allowed by the federal government to smoke marijuana for medical purposes.

But that's about it. The Ole Miss marijuana farm is an extremely restricted operation discussed on a need-to-know basis -- which is exactly how the government has wanted it. Historically, it's been easier to get a pair of courtside seats to the NBA finals than an ounce of pot from the feds.

That may change, however. Late last month, the US Department of Health and Human Services (HHS) announced that privately funded researchers may now buy the government's marijuana to use in their own independent studies. In the past, only researchers armed with NIH grants could tap into the Mississippi stash.

At first glance, this looks like a major breakthrough for proponents of marijuana, especially those who favor its legalization for medical use. For years, medical-marijuana supporters have chafed at the government's resistance to allowing comprehensive outside study.

But instead of celebrating, most marijuana activists are complaining. They argue that the government's loosening of research restrictions is more a ploy than a genuine change of position. They maintain that the feds are still more interested in stalling the medical-marijuana debate than in advancing it. And they express anger that the federal government refuses to back off its pledge to prosecute sick people who use marijuana and the physicians who recommend it.

"There's a misconception that the government is turning around on medical marijuana, as if these new guidelines are some sort of major step in the right direction. But in reality, they are a small step," says Chuck Thomas, the communications director of the Washington, DC-based Marijuana Policy Project. "And they could be a trap which could ultimately make things worse."

THE FORCE behind the government's movement on medical-marijuana research was the March report by the National Academy of Sciences' Institute of Medicine (IOM), which concluded that marijuana possesses "potential therapeutic value" for patients suffering from cancer, AIDS-related wasting, and other conditions (see "Up in Smoke," News, March 26). The report, which had been ordered by US drug czar Barry McCaffrey and cost nearly $900,000, was a colossal embarrassment to the feds, who had maintained that medical marijuana was junk science. (McCaffrey himself had referred to it as a "cruel hoax.")

The IOM report recommended that the government relax its restrictions on research of marijuana's potential medical benefits, allowing for private study. It also recommended that these researchers attempt to create "alternative delivery systems" to smoked marijuana that would replicate its medical properties while avoiding the health risks associated with smoking.

But though Health and Human Services officials followed up on the IOM report by deciding to allow private research, critics worry that the federal government's rules are still too restrictive. For starters, marijuana researchers have to jump through more hoops than a schnauzer at the Westminster Dog Show. There's a peer project review, a review by the National Institute of Drug Abuse, a review by the Drug Enforcement Agency, and, lastly, a review by the Food and Drug Administration.

Some review, of course, is necessary, but critics say that the government is holding medical-marijuana researchers to a far higher standard than other drug researchers. And not only are these reviews time-consuming, critics argue, but they're costly. "You've got people being forced to spend a gazillion dollars just to set up their research," says Michael Cutler, a Brookline attorney who coordinates the Voluntary Committee of Lawyers, a national organization of legal-trade drug-law reformers.

What really irks medical-marijuana proponents, however, is the government's stipulation that researchers study marijuana's ability to treat conditions for which there aren't any existing medications. "There are dozens of [medications] which treat the same symptoms, but they're holding marijuana to a different standard," says Chuck Thomas.

Thomas is pleased that the government is allowing private groups to buy its marijuana, but he worries that these continued restrictions and rigorous reviews may inhibit real research. That's exactly the idea, says Adam Smith, associate director of the Drug Reform Coordination Network in Washington, DC. "They [government officials] are trying to let a little steam out and also buy themselves more time," he says.

But a bigger hurdle than the feds may be the pharmaceutical industry itself. The government wants someone to develop a pharmaceutical alternative to smoked marijuana, but skeptics wonder how much incentive drug companies will have to try to replicate the properties of a drug that, despite its illegality, is relatively affordable, available, and effective. The IOM report theorized that the cost of developing an alternative delivery system to smoked marijuana may be somewhere between $200 million and $400 million. Does a corporation want to spent that kind of money to make a synthetic analogue of a drug that's already out there and being used?

Critics argue, too, that some patients who need marijuana aren't going to want to use alternative delivery systems, which are likely to be costly, require prescriptions, and, in all likelihood, relieve symptoms less effectively than the actual plant. "[If] you can get faster relief because you smoke something you can grow in your closet, are you going to be buying a pharmaceutical?" asks Lester Grinspoon, a Harvard Medical School professor of psychiatry who is the co-author of Marihuana, the Forbidden Medicine (Yale University Press).

And there's no indication that either the government or the pharmaceutical industry is interested in one safer delivery system that already exists: marijuana vaporizers, which allow users to inhale a puff of cannabis without the hazards of smoking. No one's jumping to patent them domestically, because vaporizers use whole-plant marijuana.

That's one of the reasons people like Lester Grinspoon contend that the medical-marijuana discussion will continue to be held back until marijuana itself is declared legal. After all, why put a vaporizer on the market if a patient can't use it legally? "If we are ever to realize the full potential of the medical potential of cannabis, we cannot do it in this setting of this prohibition," says Grinspoon.

The reluctance of pharmaceutical companies to embrace herbal medicine in general is another factor that could stall marijuana research. Herbal remedies are increasingly popular and are the source of much consternation in the industry. "This taps into a much broader debate between the pharmaceutical companies and alternative medicine, between pharmaceutical products and herbal products, and who regulates what," says Ethan Nadelmann, the director of the Lindesmith Center, a drug-policy-reform group in New York City. "Marijuana resides in the netherland between those two worlds."

PERHAPS WHAT concerns reformers most of all is that the federal government has yet to back off from its past promises to prosecute patients who currently use marijuana and the doctors who recommend it to them. Even though voters in seven states have approved the medical use of marijuana, proponents say that many patients and doctors in those states are scared to talk about it, much less use it, for fear of federal prosecution.

After the IOM report, there was hope that the government might expand its "compassionate use" program and allow patients to use marijuana as long as they were directly supervised by a physician who could regulate and record the results of the treatment. This practice, known as "single-patient IND," or "n-of-1," trials, was encouraged by the IOM report's authors, who wanted to make the drug available to sick people while alternatives are being developed.

But HHS declined to sanction single-patient trials, infuriating medical-marijuana proponents, who accuse the government of selectively picking and choosing from the IOM report's recommendations. "The federal government is using the calls for research as a delaying tactic to avoid making marijuana legally available to patients who need it today," says Ethan Nadelmann.

And that's tantamount to criminalizing the sick, says Chuck Thomas. "A patient has to act like a college student in a dorm-room party to make sure they don't get arrested," he says. "As long as there is one patient who says they prefer the plant [to the alternatives], I don't want that person to get arrested."

Jason Gay can be reached at jgay[a]phx.com.