AMA Goes Pro-Pot!

Medical marijuana gets a boost from major doctors group

The American Medical Assn. changes its policy to promote clinical
research and development of cannabis-based medicines and alternative
delivery methods.

By John Hoeffel
November 11, 2009

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@ latimes.com

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