AMA Reverses Stance on Medical Marijuana

By Kristina Fiore, Staff Writer, MedPage Today Published: November 13, 2009

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."