As of 3/29/99 there are 3 files in this special section.

I: Marijuana and medicine:Assessing the Science Base

II: M&M:The News Conference

III: M&M WHITE HOUSE DRUG POLICY OFFICE ISSUES STATEMENT .

This is Section III: The White House Response

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FOR IMMEDIATE RELEASE
Contact: Bob Weiner or Steve Panton: (202) 395-6618
March 17, 1999

WHITE HOUSE DRUG POLICY OFFICE ISSUES STATEMENT ON INSTITUTE OF MEDICINE'S REPORT ON MARIJUANA AND MEDICINE

(Washington, D.C.) -- The White House Office of National Drug Policy (ONDCP) issued the following statement today following the release of the Institute of Medicine's report, Marijuana and Medicine: Assessing the Science Base:

We are delighted that science is the basis of the discussion of this issue, as it must be. In January 1997, ONDCP asked the Institute of Medicine to conduct a review of the scientific evidence for assessing the potential health benefits and risks of marijuana and its constituent cannabinoids. ONDCP believed that an objective and independent evaluation of research regarding the use of marijuana for medicinal purposes was appropriate given the ongoing debate about cannabis and its health effects.

The report released today by the Institute of Medicine represents the most thorough analysis to date of the relevant scientific literature. It summarizes recent advances in molecular and behavioral neuroscience, in particular newly elaborated systems of transmitters, receptors, and antagonists -- all illuminating the physiological effects of cannabinoids. The Institute of Medicine has addressed all issues that ONDCP requested be examined, including: the science base and gaps in scientific knowledge regarding use of marijuana for medicinal purposes; scientific information about marijuana's mechanism of action; peer-reviewed literature on the uses of marijuana; and costs associated with various forms of the component chemical compounds in marijuana and other pharmacotherapies for special medical conditions. We thank the principal investigators, members of the advisory panel, biomedical and social scientists, patients, advocates, report reviewers, and all who supported the Institute of Medicine in developing this comprehensive report.

The report contains six specific recommendations that address:

1. Continued research into the physiological effects of cannabinoids.
2. Clinical trials of cannabinoid drugs for symptom management.
3. Evaluation of psychological effects of cannabinoids in clinical trials.
4. Studies of individual health risks in smoking marijuana.
5. Clinical trials of marijuana use under limited circumstances for medical purposes.
6. Short-term use of smoked marijuana under strict conditions for patients with debilitating symptoms.

These recommendations are supported by the following observations:

• Scientific data indicate the potential therapeutic value of cannabinoids for pain relief, control of nausea and vomiting, and appetite stimulation. This value would be enhanced by a rapid onset of drug effect.
• The psychological effects of cannabinoids are probably important determinants of their potential therapeutic value. They can influence symptoms indirectly, which could create false impressions of the drug effect or be beneficial as a form of adjunctive therapy.
• Numerous studies suggest that marijuana smoke is an important risk factor in the development of respiratory diseases, but the data that could conclusively establish or refute this suspected link have not been collected.
• Because marijuana is a crude THC delivery system that also delivers harmful substances, smoked marijuana generally should not be recommended for medical use. Nonetheless, marijuana is widely used by certain patient groups, which raises both safety and efficacy issues.
• If there is any future for marijuana as medicine, it lies in its isolated components -- the cannabinoids and their synthetic derivatives. Isolated cannabinoids will provide more reliable effects than crude plant mixtures. Therefore, the purpose of clinical trials of smoked marijuana would not be to develop marijuana as a licensed drug, but such trials could be a first step towards the development of rapid-onset, nonsmoked cannabinoid delivery systems.

The Office of National Drug Control Policy appreciates the contributions made by the Institute of Medicine to the debate on the medical efficacy and safety of cannabinoids. We will carefully study the recommendations and conclusions contained in this report. We will continue to rely on the professional judgement of the Secretary of Health and Human Services, the Director of the National Institutes of Health, and the Surgeon General on all issues related to the medical value of marijuana and its constituent cannabinoids. We note in the report's conclusion that "the future of cannabinoid drugs lies not in smoked marijuana, but in chemically-defined drugs that act on the cannabinoid systems that are a natural component of human physiology." We look forward to the considered responses from our nation's public health officials to the interim solutions recommended by the report.

The full text of the report is available from I.O.M. on line at http://www.nas.edu or call 1-800-624-6242.