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AlterNet.org
03 Apr, 2008
Dr. Jocelyn Elders

Former Surgeon General: Mainstream Medicine Has Endorsed Medical Marijuana

A historic document from the 124,000-member American College of Physicians certifies the medical value of marijuana

One of America’s largest and most important groups of physicians has moved to cut through the clutter of political controversies over medical use of marijuana. Lawmakers and the public alike would do well to pay attention. The American College of Physicians is the largest medical specialty organization and the second largest physician group in the United States. Its 124,000 members are doctors specializing in internal medicine and related subspecialties, including cardiology, neurology, pulmonary disease, oncology and infectious diseases. The College publishes Annals of Internal Medicine, the most widely cited medical specialty journal in the world.


In a landmark position paper released in February, these distinguished physicians are saying what many of us have been arguing for years: Most of our laws have gotten it wrong when it comes to medical marijuana, and it’s time for public policy to get in step with science.

Right now, the laws of 38 states and the federal government bar use of marijuana as a medicine. Federal law classifies marijuana as a Schedule I drug, defined as having no accepted medical use and being unsafe for use even under medical supervision. ACP’s position paper urges ‘reclassification into a more appropriate schedule, given the scientific evidence regarding marijuana’s safety and efficacy in some clinical conditions. The document goes on to call for protection of physicians’ right to ‘prescribe or dispense medical marijuana in accordance with state law and ‘strongly urges protection from civil or criminal penalties for patients who use medical marijuana as permitted under state laws.’

ACP supports its position with 10 pages of scientific documentation and references. They cite data showing relief of the nausea, vomiting and wasting that can worsen the misery of cancer, AIDS and other diseases; of the pain and tremors associated with multiple sclerosis; and for relief of pain caused by a variety of other conditions. They note that marijuana in combination with some pharmaceuticals may produce more benefit than either drug alone.

ACP calls for more research, but then adds a critical point: In some areas, the efficacy of medical marijuana has already been established, and it’s time for studies designed to determine the best dose and route of delivery.

The ACP position paper demolishes several myths, starting with the notion still proclaimed by some politicians that marijuana is unsafe for medical use. The College notes that the most serious objection to medical marijuana – potential harm to the lungs from smoking – has largely been solved by a technology called vaporization, already proven in scientific studies.

The ACP position paper also explains that there is no reason to believe that protecting medical marijuana patients leads to increased drug abuse. ‘Marijuana has not been proven to be the cause or even the most significant predictor of serious drug abuse,’ the doctors write. ‘Opiates are highly addictive, yet medically effective ‘ There is no evidence to suggest that medical use of opiates has increased perception that their illicit use is safe or acceptable.’

This is an historic document. Large medical associations are by their nature slow, cautious creatures that move only when the evidence is overwhelming. The evidence is indeed overwhelming that, as ACP put it, there is ‘a clear discord’ between what research tells us and what our laws say about medical marijuana. It appears that voters and lawmakers in a number of states will consider medical marijuana proposals this year, and Congress will again be asked to stop federal attempts to interfere with the 12 state medical marijuana laws already in place. It’s time to end that ‘clear discord’ and put science ahead of politics.

Read the Report in PDF: Supporting Research into the Therapeutic Role of Marijuana



Large physician group calls for lifting ban on medical use, research

Published in the Baltimore Sun
February 15, 2008
By Eric Baily

SACRAMENTO, Calif. – A large and respected association of physicians is calling on the federal government to ease its strict ban on marijuana as medicine and hasten research into the drug’s therapeutic uses.

The American College of Physicians, a 124,000-member group that is the nation’s largest for doctors of internal medicine, contends that the long and rancorous debate over marijuana legalization has obscured good science demonstrating the benefits and medicinal promise of cannabis.

In a 13-page paper approved by the college’s governing board and posted yesterday on the group’s Web site, the ACP calls on the government to drop marijuana from Schedule I, a classification it shares with illegal drugs such as heroin and LSD that are considered to have no medicinal value and a high likelihood of abuse.

The declaration could put new pressure on lawmakers and government regulators, who for decades have rejected attempts to reclassify marijuana. Bush administration officials have aggressively rebuffed all attempts in Congress, the courts and among law enforcement organizations to legitimize medical marijuana.

Clinical researchers say the federal government has resisted full study of the potential medical benefits of cannabis, instead pouring money into looking at its negative effects.

A dozen states have legalized medical marijuana, but the federal prohibition has led to an enforcement tug of war.

Given the conflicts, most mainstream doctors have steered clear of medical marijuana.

The ACP position paper calls for protection of both doctors and patients from criminal and civil penalties in states that have adopted medical-marijuana laws.

“We felt the time had come to speak up about this,” said Dr. David Dale, the ACP’s president. “We’d like to clear up the uncertainty and anxiety of patients and physicians over this drug.”

Bruce Mirken, a San Francisco spokesman for the Marijuana Policy Project, said the ACP position is “an earthquake that’s going to rattle the whole medical marijuana debate.” The ACP, he said, “pulverized the government’s two favorite myths about medical marijuana – that it’s not supported by the medical community and that science hasn’t shown marijuana to have medical value.”

But officials at the White House Office of National Drug Control Policy said calls for legalizing medical marijuana are misguided.

“What this would do is drag us back to 14th-century medicine,” said Bertha Madras, the drug czar’s deputy director for demand reduction. “It’s so arcane.”

She said guidance on marijuana as medicine ought to come from the U.S. Food and Drug Administration, which is unlikely ever to approve leafy cannabis as a prescription drug. Two oral derivatives of marijuana’s psychoactive ingredient, THC, have won FDA approval, and the agency is also in the early stages of considering a marijuana spray.

An FDA spokeswoman declined to comment on the ACP’s position and referred inquiries to a 2006 news advisory noting that the agency has never approved of smoked marijuana as a medical treatment.

In the 12 years since California votes approved the nation’s first-ever medical marijuana law, several medical organizations – including the American Nurses Association and the American Public Health Association – have urged Congress to make cannabis a legal medicine.

But the ACP is second in size only to the American Medical Association, which has about 240,000 members.

Eric Baily writes for the Los Angeles Times.