Monday, December 6, 2010

AMA Reverses Stance on Medical Marijuana

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

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