But these future prospects offer little comfort to people with chronic pain that defies conventional treatments. Accordingly, the IOM researchers recommended the creation of an individual clinical trial program that would allow such patients to smoke marijuana under carefully controlled conditions for a limited period of time. Note that this is not the same as reopening the marijuana Compassionate Use Program that was closed in 1991 (see Chapter 11). As described in the IOM report, individual trials would be used to gather information to help develop alternative delivery methods for cannabinoid medications. Participants, who would be fully informed of their status as experimental subjects and the harms inherent in using smoking as a delivery system, would have their condition documented while they continued using marijuana. By analyzing the results of such trials, medical scientists could significantly increase their knowledge of both the positive and the negative effects of medical marijuana use.


1. Institute of Medicine. 1999. Marijuana and Medicine: Assessing the Science Base. Washington, DC: National Academy Press, p. 141.

2. Raft D, Gregg J, Ghia J, Harris L. 1977. “Effects of intravenous tetrahydrocannabinol on experimental and surgical pain: Psychological correlates of the analgesic response.” Clinical Pharmacology and Therapeutics 21:26-33.

3. Ibid.

4. Jain AK, Ryan JR, McMahon FG, Smith G. 1981. “Evaluation of intramuscular levonantradol and placebo in acute postoperative pain.” Journal of Clinical Pharmacology 21:320S-326S.

5. Noyes R Jr, Brunk SF, Baram DA, Canter A. 1975a. “Analgesic effect of delta-9-tetracannabinol.” Journal of Clinical Pharmacology 15:139-143.

6. Noyes R Jr, Brunk SF, Baram DA, Canter A. 1975b. “Analgesic effect of delta-9-tetracannabinol and codeine.” Clinical Pharmacology and Therapeutics 18:84-89.

7. Staquet M, Gantt C, Machin D. 1978. “Effect of a nitrogen analog of tetrahydrocannabinol on cancer pain. ” Clinical Pharmacology and Therapeutics 23:397-401.

8. Consroe P, Musty R, Rein J, Tillery W, Pertwee RG. 1997. “The perceived effects of smoked cannabis on patients with multiple sclerosis.” European Neurology 38:44-48.

9. Dunn M and Davis R. 1974. “The perceived effects of marijuana on spinal cord injured males.” Paraplegia 12:175.

10. El-Mallakh RS. 1987. “Marijuana and migraine.” Headache 27:442-443.

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