becoming blind. The federal government then looked for a way to provide other such patients with marijuana.

A solution to this dilemma, the Compassionate Use Program, was launched in 1976. It was administered as part of an existing program to provide seriously ill patients with promising medicines prior to their approval by the FDA. Thirteen patients were accepted into this program between 1976 and 1991. They received government-grown marijuana to treat a variety of symptoms and were later joined by hundreds of patients in state-run experimental treatment programs. To obtain this legal marijuana, a patient's physician—or the physician in charge of the state program —submitted a lengthy application to the FDA, after which the DEA conducted inspections to assure that the drug would not be diverted from its intended use. Then, as now, the National Institute on Drug Abuse (NIDA)—an arm of the National Institutes of Health—oversaw the cultivation and distribution of all marijuana provided by the U.S. government.6

In 1991 the Public Health Service closed the Compassionate Use program for smoked marijuana after a National Institutes of Health review concluded that marijuana was not the best treatment for any of the patients who were receiving it. Increasing numbers of AIDS patients were applying to the program, and its administrators worried that smoking marijuana would be harmful to people with compromised immune systems. At the time the program closed, 28 people had been approved for treatment, but only the 13 who were already receiving marijuana continued to have it provided to them. Since then five of those original patients have died of AIDS. Most state-sponsored clinical research programs folded in the 1980s due to lack of patient interest and after 1986 due to their inability to obtain research-grade marijuana from the federal government.

Upon reconsidering the Compassionate Use suspension in 1994, the Clinton administration decided to keep the program closed. However, with the recent release of the IOM report to the White House's Office of National Drug Control Policy, the subject of government-sponsored marijuana use has again come under federal scrutiny.

Rather than argue for the resurrection of the suspended program, the IOM team advocated support for research that could



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