NATIONAL ACADEMY OF SCIENCES

2 10 1 CONS-I`ITUTlON AVENUE

WASHINGTON, D. C. 20418

INSTITUTE OF MEDICINE

July 19, 1982

C. Everett Koop, M.D.
Surgeon General, U.S. Public

Health Service

Deputy Assistant Secretary for Health
Department of Health and Human Service
200 Independence Avenue, S.W.
Washington, D.C.  20201

Dear Dr. Koop:

  Dr. Robbins has asked me to respond to your draft Surgeon
General's advisory on marijuana, which I think is very good as it
stands and much needed.  The suggestions that follow are not major but
may be useful to strengthen your case.

  First of all, many people brush aside the acute effects of
marijuana demanding evidence of chronic effects before they can be
convinced of the drug's harm.  The committee felt that the acute
effects of the drug were substantial.  In addition to affecting
perception and motor skills, there is good evidence that marijuana
impairs short term memory and slows learning. Since surveys show
marijuana is primarily used during school hours (rather than on
weekends or at night), a student's ability to perform in school will
be lessened.

  In persons with underlying mental illness, use of marijuana
appears to worsen mental symptoms.  Even in those without mental
illness, a surprising number report reactions such as panic or anxiety
that they regard as unpleasant.

  Under your list of known or suspected chronic effects of marijuana
I would add to the last point w . ..the by-products of marijuana remain
in body fat for several weeks with unknown consequences. The storage
of these by-products increases the possibilities for chronic effects
as well as residual effects on performance even after the effects of
the drug have worn off."


C. Everett Koop, M.D.
July 19, 1982
Page 2

  If I can be helpful in any way don't hesitate to call
(202)334-2383.

Sincerely,

Queta Bond, Ph.D.
Director, Divisions of Health
Sciences Policy and Health
Promotion and Disease Prevention