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October 30, 1996

In light of next week's vote regarding a California ballot initiative to allow physicians to prescribe marijuana to seriously ill patients, NORML is forgoing its usual weekly news release to spotlight the following *special* report.

Making The Case For Medical Marijuana
by NORML Publications Director Paul Armentano

        Marijuana is medicine.  It has been used for thousands of years to treat a wide variety of ailments.  Marijuana was legal in the United States and prominent in the pharmacopoeia until 1937, when possession and use of marijuana was outlawed by the federal government.  Today, eight patients receive marijuana legally from the government; for all other Americans who could benefit from its therapeutic value, it remains a forbidden medicine.  The passage of Proposition 215 in California, the Medical Marijuana Initiative, would be a first step in amending this grievous and unnecessary crisis.

        Contrary to popular belief, there have been hundreds of studies on the medical uses of cannabis since its introduction to western medicine in the mid-nineteenth century.  The best established medical use of smoked marijuana is as an anti-nauseant for cancer chemotherapy.  During the 1980s, smoked marijuana was shown to be an effective anti-emetic in six different state-sponsored clinical studies involving nearly 1,000 patients.  For the majority of these patients, smoked marijuana proved more effective than both conventional prescription anti-nauseants and oral THC (marketed today as the synthetic pill, Marinol).  For example, in a 1988 study by Dr. Vincent Vinciguerra published in the New York State Journal of Medicine, 78 percent of patients who had shown no improvement with standard anti-emetics responded favorably to marijuana.  In addition, 29 percent of those patients who did not respond to oral THC did respond to smoked marijuana.  Vinciguerra concluded that the results of the pilot study "demonstrate that inhalation marijuana is an effective therapy for the treatment of nausea and vomiting due to cancer chemotherapy."[1]  Similar findings were noted in state-sponsored studies in New Mexico, Georgia, Tennessee, Michigan, and California.[2]  Currently, many oncologists are recommending marijuana to their patients despite its prohibition.[3]

        In addition to its usefulness as an anti-emetic, there exists evidence -- both scientific and anecdotal -- that marijuana is a valuable aid in reducing pain and suffering for patients with a variety of other serious ailments, and that it is less toxic and costly than the conventional medicines for which it may be substituted.  For example, marijuana alleviates the nausea, vomiting, and the loss of appetite caused by the AIDS wasting syndrome and by treatment with AZT and other drugs without accelerating the rate at which HIV positive individuals develop clinical AIDS or other illnesses.  Reportedly, 75 percent of the 12,000 members of the San Francisco Cannabis Buyers' Club were Patients With AIDS (PWAs) and a recent survey of HIV-positive patients in Australia found that one-quarter were using marijuana therapeutically.[4,5]

        It is generally accepted -- by the National Academy of Sciences (NAS) and others -- that marijuana reduces intraocular pressure (IOP) in patients suffering from glaucoma, the leading cause of blindness in the United States.  This was first shown in a series of experiments by Robert S. Hepler of UCLA, stemming from research aimed at finding out whether marijuana dilated pupils.  Hepler found a "statistically significant" drop in IOP in 429 subjects treated with marijuana or THC, 29 of which showed continued benefits during 94 days of treatment with no signs of tolerance.[6]  Currently, three of the eight patients who receive medicinal marijuana legally use it to treat glaucoma.

        There also exists historical evidence that marijuana is effective in treating a variety of spastic conditions such as multiple sclerosis, paraplegia, epilepsy, and quadriplegia.  In the book, Marijuana: The Forbidden Medicine, Dr. Lester Grinspoon of Harvard Medical School describes several case histories of patients suffering from multiple sclerosis and other disorders whose condition improved while they smoked marijuana and deteriorated after they stopped smoking.  In addition, a number of animal studies have supported marijuana's ability to suppress convulsions.  These studies specifically indicate cannabidiol, a non-psychoactive ingredient of marijuana unavailable in Marinol, to be a potent anti-convulsant.  This latter fact was recently reaffirmed by the government's premiere marijuana expert, Dr. Mahmoud ElSohly of the Marijuana Project at the University of Mississippi, who stated during an interview with the Journal of the International Hemp Association that, "CBD [cannabidiol] is famous for [its] anti-convulsant activity."  ElSohly concluded that, "There is no question about the use of cannabis for certain conditions.  It does have a history.  It does have utility."[7]

        Marijuana is also used to treat those who seek relief from chronic pain.  Historically, marijuana was used as an analgesic from ancient times through the nineteenth century.  This usage declined with the introduction of faster acting and more potent, yet sometimes addicting, opiates such as morphine.  However, anecdotal reports demonstrate that some patients currently receive their most effective pain relief from using marijuana.  Limited scientific studies on nearly 100 patients have shown marijuana to be a potent analgesic.[8]

        Evidence in support of marijuana's medical value has existed for centuries and has been validated by numerous studies, researchers, committees, health organizations, and even the Drug Enforcement Agency's Chief Administrative Law Judge, Francis L. Young, who in 1988 declared marijuana to be "one of the safest therapeutically active substances known to man."[9]  Unfortunately, patients who could benefit from marijuana's therapeutic value have been held hostage by a federal government that continues to treat the issue as a political football.  American medical patients deserve better and Proposition 215 is a genuine and encouraging step to address their needs.


  1. Vinciguerra, V., Moore T., Brennan, E. "Inhalation marijuana as an antiemetic for cancer chemotherapy," New York State Journal of Medicine: October 1988, pp. 525-527.
  2. Randall, R.C. Cancer Treatment & Marijuana Therapy, Galen Press: 1990, pp. 217-243.
  3. Doblin, R., Kleiman M. "Marihuana as Anti-emetic Medicine: A Survey of Oncologists' Attitudes and Experiences," Journal of Clinical Oncology: July 1991, pp. 1275-80.
  4. Personal communication with Dennis Peron, founder of the San Francisco Cannabis Buyers' Club.
  5. Prestage, Garrett et al. "Use of Treatments and Health Enhancement Behavior Among HIV-Positive Men in a Cohort of Homosexually Active Men," Eleventh International Conference on AIDS, Vancouver, B.C., Canada: July 1996.
  6. Hepler, R., Petrus, R. "Experiences with administration of marijuana to glaucoma patients." In M.C. Braude and S. Szara (eds) The Pharmacology of Marijuana. New York: Raven Press, pp. 63-94.
  7. Interview with Dr. Mahmoud A. ElSohly on December 19, 1995 as it appeared in The Journal of the International Hemp Association: Volume 3, No. 1, 1996.
  8. Gieringer, D. Review of Human Studies on Medical Use of Marijuana, NORML Reports, October 1996.
  9. In the Matter of Marihuana Rescheduling Petition, Docket 86-22, Opinion, Recommended Ruling, Findings of Fact, Conclusions of Law, and Decision of Administrative Law Judge, September 6, 1988. Washington, DC: Drug Enforcement Agency, 1988.