AMA House of Delegates

AMA meeting: Delegates support review of marijuana's schedule I status

A change could make it easier for researchers to test potential medical uses and develop a drug delivery form safer than smoking.

By Kevin B. O’Reilly — Posted Nov. 23, 2009

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It is time to re-examine whether marijuana should be legally categorized as a schedule I drug, the AMA House of Delegates said at its Interim Meeting.

The goal of such a review is to facilitate "the conduct of clinical research and development of cannabinoid-based medicines and alternate delivery methods," says the newly adopted house policy.

The current scheduling "limits the access to cannabinols for even research -- it is very difficult," said AMA Board of Trustees member Edward L. Langston, MD, a Lafayette, Ind., family physician. "We believe there should be a scientific review of cannabinols in the treatment of pain and other issues. ... We support research on the use of cannabinols for medical use."

Scientists researching marijuana's medical properties must get the Drug Enforcement Administration's approval every step of the way, and the sole legal national source of cannabis for scientific purposes is the National Institute on Drug Abuse. A number of bureaucratic hurdles apply to cannabis research that do not impede other drug investigations, said a report from the AMA Council on Science and Public Health.

Previously, the AMA called for more medical research on marijuana but balked at questioning its placement in the DEA schedule. The science council originally recommended retaining marijuana's schedule I status, but delegates objected in reference committee testimony.

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"Cannabinoids are useful drugs," says Melvyn Sterling, MD, a California palliative care physician.

"Schedule I is very appropriate for heroin and other noxious substances that have no place in medicine, but cannabinoids are useful drugs," said Melvyn Sterling, MD, a palliative care doctor and California Medical Assn. delegate who spoke on his own behalf. "There is compelling research that cannabinoids are helpful in treating the spasticity associated with multiple sclerosis and in persistent nausea associated with chemotherapy, and they may have other uses yet undiscovered. Why are they undiscovered? Because it's a schedule I drug."

Though delegates called for reviewing whether marijuana fits into schedule I, the house's new policy said the recommendation "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."

Last year, the American College of Physicians adopted policy supporting a review of marijuana's schedule I classification. By this article's deadline, the DEA had not responded to American Medical News inquiries on the AMA's action. The Food and Drug Administration cited an interagency memo reflecting policy of the DEA, the Office of National Drug Control Policy and the FDA stating that the agencies "do not support the use of smoked marijuana for medical purposes."

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ADDITIONAL INFORMATION

Meeting notes: Public health

Issue: The growing popularity of computed tomography and other imaging tests is exposing patients to increasing cumulative amounts of ionizing radiation, with unclear effects on lifetime cancer risk.

Proposed action: Work with specialty societies to devise a common format to track individual patients' cumulative radiation exposure and develop related physician performance measures. [Adopted]

Issue: Physicians too often fail to spot cases of child abuse and neglect.

Proposed action: Develop a comprehensive strategy to help educate doctors about how to detect, report and treat the mistreatment of children while reducing conflicts with child protective services. [Adopted]

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