November 17, 2009 | 35
The Obama administration announced last month that people who buy or sell medical marijuana in the growing number of states that have decriminalized its therapeutic usage should not be targeted for arrest or prosecution by federal authorities. Now, the American Medical Association (AMA) has called for the federal government to go one step further in easing restrictions, the Los Angeles Times reported last week.
Although the new AMA policy is far from outright support of medically sanctioned pot smoking, delegates of the organization recommended at an interim meeting in Houston last week that marijuana be removed from the U.S. Drug Enforcement Administration’s Schedule I category of drugs, which includes heroin and LSD. Drugs in this category are deemed unsafe with no currently acceptable medical use. With its recommendation, the AMA hopes to facilitate research on the clinical effects of smoking marijuana, as well as other delivery methods for the drug.
Part of the impetus behind the AMA’s change of heart, according to the Times, was work done by Sunil Aggarwal, a medical student at the University of Washington. Aggarwal initially drummed up support in the AMA’s medical student section, of which he is a member, for marijuana’s removal from its Schedule I category. Then, at the AMA’s 2008 meeting, Aggarwal convinced the organization to begin a one-year review of the effectiveness of medical marijuana. In his own research, Aggarwal has studied 139 patients with chronic pain and found that medical marijuana relieved a range of their symptoms, including nerve damage and back pain.
Although the U.S. Food and Drug Administration has approved a capsule form of medical marijuana called Marinol for chemotherapy-induced nausea and vomiting and for AIDS-related wasting, some doctors argue that swallowing a pill does not offer the same analgesic benefits as smoking pot. Marinol, which contains a synthetic version of marijuana’s active compound delta-9-THC, must be swallowed whole and cannot be chewed, therefore it could present problems to patients taking it for nausea or vomiting, wrote Peter J. Cohen, a physician and lawyer at the Georgetown University Law Center, in an article published in the Journal of Pain & Palliative Care Pharmacotherapy in 2009. Cohen argued that Marinol takes longer to have an effect than smoking a joint, which could also pose a problem for patients with nausea or vomiting who need rapid relief.
More studies, in particular randomized, controlled trials, need to be carried out on smoked cannabis, Dr. Edward Langston, an AMA board member, told the Times. The small number of that have been conducted in the past 30 years have been "insufficient to satisfy the current standards for a prescription drug product," Langston said.
Part of the reason for the paucity of studies on therapeutic pot is strict federal regulations for studying the substance. Researchers working with marijuana must use a research crop, which could be less potent and thus less effective, than pot that is trafficked. In spite of these restrictions, scientists have managed to publish studies in the past two years that demonstrate the effectiveness and safety of smoking pot to relieve HIV-associated neuropathy and nausea caused by the therapies used to treat hepatitis C infection.
With its recommendation, the AMA joins the American College of Physicians in encouraging studies of the medical benefits of marijuana. The AMA noted in the report on its new policy that it had actually opposed the first federal restrictions on citizen access to marijuana in 1937. But, since 1997, it has joined the federal government in proclaiming marijuana as medically useless.
In response to the AMA report, the U.S. Office of National Drug Control Policy echoed the U.S. Food and Drug Administration’s position that "raw marijuana plant cannot meet the standards for identity, strength, quality, purity…required of medicine." But advocates of medical marijuana hope that the AMA’s new position will spur a change of heart in the Obama administration.
The states that have decriminalized the use of medical marijuana are Alaska, California, Colorado, Hawaii, Maine, Maryland, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington.