Cannabis Policy Reforms:
by Sunil Aggarwal on Sunday, November 21, 2010 at 1:09am
Greetings, Fellow Internet Users,
People have been asking what the ol’ doctors’ trade guild association, the AMA, have resolved about Cannabis and its use as a medicinal agent. Well, a few interesting things. First, a brief review from last year. The AMA filed a report written by their Council on Science and Public Health entitled “Use of Cannabis for Medicinal Purposes” on November 9, 2009, in which it was acknowledged that short-term clinical trials of smoked cannabis grown in Mississippi with federal tax dollars had demonstrated evidence of its ability to relieve neuropathic pain, stimulate appetite, and ease muscle spasms in humans. They furthermore adopted a policy recommendation from the report saying that “Our AMA urges marijuana’s status as a Schedule I drug be reviewed…” The report also said that rescheduling of marijuana could be supported if it aided in the development of cannabinoid medicines. Since last November, the report was kept on a website open only to AMA members and was to be published in a peer-reviewed journal, but this never occurred. Members of the press did get copies if requested, and human rights activist groups quickly shared it online, as did eventually the Board of Pharmacy of Oregon. Worldwide headlines took “reviewed” to mean “reconsidered”, which it essentially does in this context. It was also interpreted as saying the AMA calls on the Feds to stop classifying marijuana as dangerous. The phrase “AMA marijuana” has generated hundreds of google news alerts since that time. Earlier language that the Medical Student Section and several Pacific and Mountain state medical delegations had supported which called on “reclassification of marijuana’s status” to a more appropriate Schedule, did not make it.
Tthe AMA did disseminate its own news releases about their policy change. The AMA president was interviewed about the policy change on National NPR and said that the issue was brought forward in the AMA by the pain and palliative care doctors (sadly, it was not in fact). In the press since last year, AMA board members have made said stronger statements about cannabis. For example, in Dec. 09, AMA board member Dr. Edward Langston told CNN, with regards to Cannabis, “We believe it is time for rescheduling, consideration of that…” http://www.youtube.com/watch?v=zocYnuEuaSA At another time, an AMA spokesperson told the press that more medical societies should adopt the AMA policy if change is to be seen in federal law (I cannot find the link to the article that said this).
This year, the Hawaii delegation, led by Dr. Webb, introduced a resolution to call for Cannabis to be scheduled no higher than THC (which certain formulations of are found in III). In the process of considering this resolution (you can read it here: http://www.ama-assn.org/ama1/pub/upload/mm/2010i/hawaii1.pdf), a few things happened at the AMA meeting this year. First, they summarized what action they had taken from the previous year’s resolution:
“A copy of the Council report and AMA policy statement requesting federal review of the current scheduling status of cannabis was forwarded to the Drug Enforcement Administration immediately after the 2009 Interim Meeting.”
2. Next, when the AMA Council on Science and Public Health was writing briefing notes about their positions on the various resolutions before them, with regards to the aforementioned resolution from Hawai’i, they wrote:
“The Council on Science and Public Health studied the issue of cannabis scheduling in a report issued at the 2009 Interim Meeting. This report also discussed the current processes and barriers to conducting clinical trials with a substance that is contained in Schedule I of the Controlled Substances Act. Nothing substantial has changed since that report was written in terms of the established science base for medicinal use of cannabis except that more states are considering adopting statutes or regulation to facilitate medicinal use outside of the traditional prescription and over-the-counter classifications of pharmaceuticals. Current policy urges that the federal government consider removing cannabis from Schedule I to facilitate the conduct of clinical research but does not endorse state-run programs.”
3. Ultimately, this resolution did not pass. But the AMA House of Delegates took the opportunity to spruce up their current policy on this topic (pg 9 here: http://www.ama-assn.org/assets/meeting/2010i/i-10-annotated-k.pdf). For example, the title of their policy is no longer “Medical Marijuana” but “Cannabis for Medicinal Use” — nearly all instances where “marijuana” is mentioned in the policy have changed to “cannabis”. Finally, some new language saying that “a special schedule should be developed for Cannabis” was introduced at the last minute by American Society of Addiction Medicine representatives who have been hostile to the policy change at the AMA since the beginning. It probably means nothing, since no special schedules can be developed, except to make it seem like the AMA is not asking for Cannabis to move to a lower schedule, but a different and new one just for itself. It really is nonsensical, and will probably amount to nothing. However, the federal government might be able to have an easier time saying that it is acting in accordance with the wishes of the AMA when they keep Cannabis in Schedule I (which is clearly not true), which it seems they have every intention of doing for now. After this meeting, again, the AMA sent out a meeting recap to all its members. It said in the email: “The House weighed in on public health issues by extending support for universal influenza vaccination of health care workers to include seasonal and H1N1 influenza. It also urged that marijuana’s status as a federal Schedule I controlled substance be reviewed to facilitate clinical research and development of cannabinoid-based medicines.” (bold in original here).
Finally, the AMEDnews, the AMA’s official newspaper, wrote:
“Delegates also voted to ask the federal government to re-evaluate the Schedule 1 status of marijuana and related cannabinoids used for medical care to facilitate research. Much meaningful research is blocked by the current status, because researchers have to get special certification for studies involving Schedule 1 drugs, said Timothy McAvoy, MD, an internist from Waukesha, Wis., and a delegate for the Wisconsin Medical Society.”
So, in a nutshell,this month, we got a second AMA house of delegates to vote on marijuana liberalization and got the AMA to say a second time that marijuana’s schedule I status is suspect. I think the fact that it was on the agenda at the meeting again this year, that the meeting was held in San Diego a few days after the election, and that the policy was essentially re-endorsed in possibly more friendly language is why there was a flurry of interest in the AMA stories from last year on this issue.
Thank you for your interest and support,
Sunil Aggarwal, MD, PhD
AMA member in good standing
By the way, here is an interesting article to read again in light of what the DEA head nominee said at her recent Senate hearing: