Physicians (AMA) Change Tune on Marijuana

By chillinwill · Nov 11, 2009 · ·
  1. chillinwill
    The AMA Wants More Research on Cannabis Medicines and a Lesser Drug Classification.

    The American Medical Assn. on Tuesday urged the federal government to reconsider its classification of marijuana as a dangerous drug with no accepted medical use, a significant shift that puts the prestigious group behind calls for more research.

    The nation's largest physicians organization, with about 250,000 member doctors, the AMA has maintained since 1997 that marijuana should remain a Schedule I controlled substance, the most restrictive category, which also includes heroin and LSD.

    In changing its policy, the group said its goal was to clear the way to conduct clinical research, develop cannabis-based medicines and devise alternative ways to deliver the drug.

    "Despite more than 30 years of clinical research, only a small number of randomized, controlled trials have been conducted on smoked cannabis," said Dr. Edward Langston, an AMA board member, noting that the limited number of studies was "insufficient to satisfy the current standards for a prescription drug product."

    The decision by the organization's delegates at a meeting in Houston marks another step in the evolving view of marijuana, which an AMA report notes was once linked by the federal government to homicidal mania. Since California voters approved the use of medical marijuana in 1996, marijuana has moved steadily into the cultural mainstream spurred by the growing awareness that it can have beneficial effects for some chronically ill people.

    This year, the Obama administration sped up that drift when it ordered federal narcotics agents not to arrest medical marijuana users and providers who follow state laws. Polls show broadening support for marijuana legalization.

    Thirteen states allow the use of medical marijuana, and about a dozen more have considered it this year.

    The AMA, however, also adopted as part of its new policy a sentence that admonishes: "This should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana, or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription drug product."

    The association also rejected a proposal to issue a more forceful call for marijuana to be rescheduled.

    Nevertheless, marijuana advocates welcomed the development. "They're clearly taking an open-minded stance and acknowledging that the evidence warrants a review. That is very big," said Bruce Mirken, a spokesman for the Marijuana Policy Project. "It's not surprising that they are moving cautiously and one step at a time, but this is still a very significant change."

    Advocates also noted that the AMA rejected an amendment that they said would have undercut the medical marijuana movement. The measure would have made it AMA's policy that "smoking is an inherently unsafe delivery method for any therapeutic agent, and therefore smoked marijuana should not be recommended for medical use."

    Dr. Michael M. Miller, a psychiatrist who practices addiction medicine, proposed the amendment. "Smoking is a bad delivery system because you're combusting something and inhaling it," he said.

    Reaction from the federal government was muted.

    Dawn Dearden with the Drug Enforcement Administration said: "At this point, it's still a Schedule I drug, and we're going to treat it as such." The Food and Drug Administration declined to comment.

    In a statement, the office of the White House drug czar reiterated the administration's opposition to legalization and said that it would defer to "the FDA's judgment that the raw marijuana plant cannot meet the standards for identity, strength, quality, purity, packaging and labeling required of medicine."

    The DEA classifies drugs into five schedules, with the fifth being the least-restrictive. Schedule II drugs, such as cocaine and morphine, are considered to have a high potential for abuse, but also to have accepted medical uses.

    Several petitions have been filed to reschedule marijuana. The first, filed in 1972, bounced back and forth between the DEA and the courts until it died in 1994. A petition filed in 2002 is under consideration.

    Kris Hermes, a spokesman for Americans for Safe Access, said that advocates hoped the petition would receive more attention. "Given the change of heart by the AMA, there is every opportunity for the Obama administration to do just that," he said.

    In a report released with its new policy, the AMA notes that the organization was "virtually alone" in opposing the first federal restrictions on marijuana, which were adopted in 1937. Cannabis had been used in various medicinal products for years, but fell into disuse in the early 20th century.

    Sunil Aggarwal, a medical student at the University of Washington, helped spark the AMA's reconsideration after he researched marijuana's effect on 186 chronically ill patients. "I had reason to believe that there was medical good that could come from these products, and I wanted to see AMA policy reflect that," he said.

    The AMA is not the only major doctors organization to rethink marijuana. Last year, the American College of Physicians, the second-largest physician group, called for "rigorous scientific evaluation of the potential therapeutic benefits of medical marijuana" and an "evidence-based review of marijuana's status as a Schedule I controlled substance."

    Last month, the California Medical Assn. passed resolutions that declared the criminalization of marijuana "a failed public health policy" and called on the organization to take part in the debate on changing current policy.

    John Hoeffel
    November 11, 2009
    LA Times,0,3003312.story

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  1. chillinwill
    Dr. Cannabis? American Medical Association urges review of marijuana prohibition

    The American Medical Association recently made an unprecedented call for America to rethink marijuana prohibition laws, urging a "review" of the drug's status as a Schedule I drug.

    Meeting in Houston, the AMA's House of Delegates approved a new policy calling for "marijuana's status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines, and alternate delivery methods."

    That does not mean the AMA is supporting full legalization or decriminalization of cannabis for responsible adults. Such a bold move that would advocate that cannabis be considered on par with alcohol and tobacco is likely a long ways off.

    Schedule I drugs are considered by the Government to have no medical use and to be harmful under any circumstances. This means the federal government puts marijuana, which is much less dangerous than tobacco or alcohol, in a class with drugs like heroin and LSD.

    Meanwhile, drugs like cocaine and methamphetamines are listed as Schedule II substances, which are approved for certain medical applications. The AMA's stance may result in the marijuana being rescheduled as Schedule II substance, which has some medical benefits. This would likely broaden the number of doctors willing to prescribe cannabis for their patients.

    Aaron Houston, director of government relations for the Marijuana Policy Project, says that the AMA's action is certainly "historic," as the organizations traditionally regarded as "America's most cautious and conservative major medical organization."

    Jefferson Adams
    November 10, 2009
    The Examiner
  2. chillinwill
    AMA Reverses Stance on Medical Marijuana

    The American Medical Association has changed its policy on medical marijuana, urging the federal government to review the drug's status as a top-tier controlled dangerous substance.
    The new policy, adopted Tuesday at its semiannual House of Delegates meeting in Houston, also calls for further studies of marijuana "and related cannabinoids in patients who have serious conditions for which preclinical, anecdotal, or controlled evidence suggests possible efficacy" of the drug.

    The agency adopted the policy to "help facilitate scientific research and the development of cannabinoid-based medicines," Edward Langston, MD, an AMA board member, said in a statement.

    "Despite more than 30 years of clinical research, only a small number of randomized, controlled trials have been conducted on smoked cannabis."

    But the organization emphasized that the policy change "should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana, or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription drug product."

    The policy also calls for the National Institutes of Health to facilitate grant applications for well-designed trials of medical marijuana. It asks the agency to make funding available and confirm that the National Institute on Drug Abuse will supply the drug to researchers via the Drug Enforcement Agency.

    In a blog on National Public Radio, AMA President James Rohack, MD, said the Drug Enforcement Agency's current drug classification system makes it difficult to study marijuana's potential effects in medical conditions.

    Other schedule I substances include heroin and LSD and have "no currently accepted medical use." The Drug Enforcement Agency groups drugs in five schedules, the fifth being the least restrictive.

    But researchers say that even if marijuana is rescheduled, it couldn't become medically available for general prescription use unless it is reviewed and approved by the FDA under the Food, Drug, and Cosmetic Act.

    The AMA is not the only physicians' organization to reconsider its stand on medical marijuana. In 2008, the American College of Physicians issued a position statement supporting research into the therapeutic role of the drug.

    The paper states that while the use of marijuana for some conditions such as HIV wasting and chemotherapy have been well documented, "less information is available about other potential medical uses."

    "Additional research is needed to clarify marijuana's therapeutic properties and determine standard and optimal doses and routes of delivery," the papers authors' state.

    "Unfortunately, research expansion has been hindered by a complicated federal approval process, limited availability of research-grade marijuana, and the debate over legalization."

    Some researchers have pointed out that the AMA has broadened its social agenda, particularly after it endorsed the House of Representatives' bill for healthcare reform.

    In the NPR blog, Rohack said in the past the AMA may have been painted as "an organization of No," but is now focusing on changing social issues and governmental regulations that "have not allowed us to provide better care for patients."

    By Kristina Fiore
    November 13, 2009
    Med Page Today
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