Taken from the March 28 -- April # 1992 "The Economist" without permission. ----------------------------Beigin article----------------------------------- Medical marijuana The last smoke Medicines often produce side-effects. Sometimes they are physically unpleasant. Many doctors consider marijuana effective in relieving the nause of chemotherapy, treating glaucoma and helping AIDS patients gain weight. It too has discomforting side-effects, but these are not physical. They are political. On March 18th the Drug Enforcement Agency (DEA) rejected the pleas of medical marijuana advocates to reclassify the drug so that it could be prescribed by doctors. At present, marijuana is grouped with the most disapproved-of drugs such as LSD and heroin; cocaine and morphine, just as illegal, may be used medically. Two weeks earlier, the Public Health Service (PHS) had said it was curtailing a tiny "compassionate use" programme that supplies marijuana, despite the law, to 13 patients. They will go on getting their; no one else will. The decisions come after a year of to-ing and fro-ing. Last June the PHS hinted it might limit the compassionate-use programme because of a surge of applications from AIDS patients. After loud protests from AIDS activists, th PHS decided to review its policy. Pressure on the DEA came from elsewhere. In 1988 a federal administrative-law judge recommended that marijuana be re-classified. The DEA disagreed, saying the drug had no "currently accepted medical use". Last April a federal appeals court ordered the agency to think again. Now the government has in effect abandoned the "current acceptance" standard It had little choice. A recent study by two Harvard drug-policy researchers found that almost half of 1,035 oncologists surveyed said they would prescrib marijuana if it were legal. Indeed, 44% of them said they had advised patients to smoke pot despite the possibility of prosecution. The government's case against medical marijuana rests on an alleged lack of systematic studies of its safety and efficacy. Pot smoke contains carcinogens, says the PHS; it may harm the immune systems of AIDS patients; they may not like the "high". Besides, marijuana's main active ingredient, THC is already sold in pill form, as Marinol. According to the Harvard group study, however, 77% of those oncologists who had an opiniopn on the matter say smokeable marijuana is more effective than oral THC. Because puffs are easier for parients to measure than pills, it is also less likely to get them uncomfortably high. True, marijuana may be a carcinogen (though that has not been proved). But AZT, the most effective AIDS treatment, causes cancer in animals; and AIDS patients, in any case, are willing to risk anything. These concerns do not seem to bother the PHS or the DEA. They have other things on their minds. Last year a PHS spokesman admitted that for the government to say marijuana could ever be therapeutic would be and unwise signal to send during a "war on drugs". Recently James Masin, head of the PHS said he feared that AIDS patients, crazed on marijuana, would be more likely to practise unsafe sex. Some sick people who would benefit from marijuana will be deterred by the ban others, desperate, will smoke it anyway. So far, 35 states have endorsed medical marijuana. In San Francisco police have agreed to turn a blind eye t it. Unless the government does something similar, smoking marijuana to relieve intolerable discomfort will remain, incredibly, a crime.