In June 1991, the U.S. Public Health Service ordered a study of the issue of medical marijuana by the nation's top scientists at the National Institutes of Health. In March 1992, at the completion of their long thorough review, the NIH scientists issued a report stating that there were better, safer drugs available than marijuana cigarettes. The report contained specific fact sheets concerning cancer chemotherapy, the AIDS wasting syndrome, multiple sclerosis, pain, and glaucoma.
These fact sheets stated that "Marijuana cigarette smoke contains a complex mixture of over 400 compounds including polyareomatic hydrocarbons which are carcinogenic. This would be a concern for anyone, but especially for patients with chronic disorders and/or impaired immune systems".
The National Eye Institute fact sheet on the Therapeutic Use of Marijuana for Glaucoma states that the NEI did research on marijuana from 1978 to 1988, and "none of the studies demonstrated that marijuana or any of its components could safely and effectively lower intraocular pressure enough to prevent optic nerve damage from glaucoma". Undesirable side effects were produced by smoking marijuana, such as elevated blood pressure and dry eye. It was noted that these patients would also be at risk for respiratory damage. Furthermore, marijuana smoking is not an optimal drug delivery system, lacking a standardized product and method of assuring the bioavailability of its active ingredients. There are 24 FDA approved drugs for the treatment of glaucoma. In conclusion, "there is no scientifically verifiable evidence that marijuana or its derivatives are safe and effective in the treatment of glaucoma".
The National Cancer Institute fact sheet noted that the FDA has approved synthetic THC (Marinol) and a related synthetic drug, Cesamet, for use in chemotherapy patients who have failed to respond to other anti-nausea agents. However the NCI scientists believe that marijuana-related compounds probably are not as effective as certain other antiemetics or combinations of emetics in controlling nausea and vomiting. Moreover, inhaling marijuana smoke is a health hazard. Other antiemetic agents such as ondansetron, metoclopramine, droperidol, etc. have been shown to be more useful than marijuana-related compounds as first line therapy.
The National Institute of Neurological Disorders and Stroke fact sheet stated that there is no evidence that marijuana is effective in modifying the course of multiple sclerosis and that only anecdotal reports of benefit have been reported. The report mentioned that a suppository formulation of THC is being tested on human beings and that this promises better bioavailability than the oral form.
The National Institute of Dental Research fact sheet reported that no controlled studies of the effects of marijuana on acute or chronic pain exist, thus there is insufficient evidence to recommend marijuana as treatment for pain.
The National Institute on Allergy and Infectious Diseases fact sheet reports that studies of the effect of oral THC on the HIV-wasting syndrome are underway. Also the suppository THC is being tested in normal volunteers. Again it is mentioned that marijuana cigarette smoke would be a concern for patients with compromised immune systems.