The 2002 Petition to Reschedule Cannabis (Marijuana)

Accepted Medical Use: Medical Professionals


Cannabis's accepted medical use in the United States is increasingly recognized by health care professionals and the medical community, including the Institute of Medicine. Numerous medical organizations support legal access to cannabis for medicinal purposes. A new medical journal released in 2001 focuses on the medicinal use of cannabis and cannabinoids. National clinical conferences on the medicinal use of cannabis have been held in the United States in 2000 and 2002 and are scheduled to continue on a biennial basis. Most importantly, data on the number of physicians currently recommending therapeutic marijuana use to their patients demonstrate its acceptance by the medical community in the United States.

The most significant evidence of marijuana’s acceptance by the medical community in the United States consists of data on the number of physicians currently recommending marijuana medical use by their patients:

"By any reasonable definition, marijuana has "currently accepted medical use in treatment in the United States." Eight states have officially legalized its medical use. A minimum of 35,000 patients are currently using medical marijuana legally in these states. Over 2,500 different physicians have recommended it for use by their patients. As many as 5% of all registered physicians have recommended marijuana in Oregon and Northern California. Usage rates vary greatly among different regions. The average usage rate in the general population ranges from 80 to 90 per 100,000 in California and Oregon, where there are numerous patient support groups, to fewer than 10 per 100,000 in Colorado and Nevada, where cannabis medicine is still underdeveloped. As many as 1% of the population in Mendocino County, California, are legal medical marijuana users, while Canadian surveys suggest illegal medical usage as high as 2% - 4% in the general population. The widespread and growing popularity of medical marijuana and its potential for treating a wide range of conditions indicate a growing role in American medicine. These facts refute marijuana's current Schedule One misclassification as a drug lacking "currently accepted medical use"” (Gieringer 2002).

A considerable number of organizations representing health care professionals, the medical community, and the general public support granting greater access to medical cannabis for patients in need and recognizing explicitly marijuana’s medical use both in the United States and in the international community.


Organizations Supporting Access to Therapeutic Cannabis

  1. AIDS Action Council - 1996
  2. Alaska Nurses Association - 1998
  3. Alaska Voters - 1998
  4. Alliance for Cannabis Therapeutics – 1981
  5. +American Academy of Family Physicians – 1989, 1995
  6. American Civil Liberties Union (ACLU)
  7. American Medical Students Association - 1993
  8. American Preventive Medical Association – 1997
  9. +American Public Health Association (APHA) - 1995
  10. Arizona Voters - 1996 & 1998
  11. Berkeley, CA - 1979
  12. Breckenridge, CO - 1994
  13. Burlington, VT - 1994
  14. California Academy of Family Physicians - 1996
  15. California Democratic Party - 1993
  16. California Legislative Council for Older Americans - 1993
  17. +California Medical Association - 1994
  18. California Nurses Association - 1995
  19. California-Pacific Annual Conference of the United Methodist Church - 1996
  20. California Pharmacists Association - 1997
  21. California Society of Addiction Medicine - 1997
  22. California Voters - 1996
  23. Cannabis Freedom Fund – 1996
  24. Colorado Voters - 2000
  25. Colorado Nurses Association - 1995
  26. Contigo-Conmigo - 1997
  27. Consumer Reports Magazine - 1997
  28. Crescent Alliance Self Help for Sickle Cell - 1999
  29. Cure AIDS now - 1991
  30. District of Columbia Voters - 1999
  31. +Episcopal Church of the U.S. - 1982
  32. Farmacy - 1999
  33. Federation of American Scientists - 1994
  34. Florida Governor’s Red Ribbon Panel on AIDS - 1993
  35. Florida Medical Association - 1997
  36. Frisco, CO - 1994
  37. Hawaii Kokua Council of Senior Citizens - 2000
  38. Hawaii Legislature - 2000
  39. Hawaii Nurses Association - 1999
  40. Institute of Medicine - 1982 & 1999
  41. International Cannabis Alliance of Researchers and Educators (I-CARE) - 1992
  42. Iowa Civil Liberties Union
  43. Iowa Democratic Party - 1994 & 2000
  44. Kaiser Permanente - 1997
  45. Life Extension Foundation - 1997
  46. Libertarian Party – 1999
  47. Los Angeles County AIDS Commission - 1996
  48. Lymphoma Foundation of America - 1997
  49. Madison, WI – 1993
  50. Maine AIDS Alliance - 1997
  51. Maine Voters - 1999
  52. Marin County, CA - 1993
  53. Minnesota Democratic Farm-Labor Party - 1992
  54. Mississippi Nurses Association - 1995
  55. Mothers Against Misuse and Abuse (MAMA) -1992
  56. Multiple Sclerosis California Action Network (MS-CAN) - 1996
  57. National Association for Public Health Policy - 1998
  58. National Association of Attorneys General - 1983
  59. National Association of Criminal Defense Lawyers (NACDL)
  60. National Association of People with AIDS - 1992
  61. National Nurses Society on Addictions (NNSA) - 1995
  62. Nevada Voters - 1998
  63. New England Journal of Medicine - 1997
  64. New Mexico Nurses Association - 1997
  65. New York State Nurses Association - 1995
  66. North Carolina Nurses Association - 1996
  67. Oakland, California - 1998
  68. Oregon Voters – 1998
  69. Oregon Green Party - 2001
  70. Oregon Democratic Party - 1998
  71. Patients Out of Time - 1995
  72. Physicians Association for AIDS Care
  73. Physicians for Social Responsibility (Oregon) - 1998
  74. Republican Liberty Caucus National Committee - 1999
  75. San Diego, CA - 1994
  76. San Francisco, CA - 1992
  77. San Francisco Medical Society - 1996
  78. Santa Cruz County, CA - 1993
  79. Virginia Nurses Association - 1994
  80. Virginia Nurses Society on Addictions - 1993
  81. Washington Hemp Education Network - 1999
  82. Washington Democratic Party - 1998 & 2000
  83. Washington Voters - 1998
  84. Wisconsin Democratic Party - 1997
  85. Wisconsin Public Health Association - 1999
  86. Wisconsin Nurses Association - 1999
  87. Women of Reform Judaism - 2000

Organizations Supporting Research on the Therapeutic Use of Cannabis

  1. American Academy of Addiction Psychiatry - 2000
  2. +American Academy of Family Physicians - 1977
  3. American Cancer Society – 1997
  4. American Nurses Association, Congress of Nursing Practice - 1996
  5. +American Society of Addiction Medicine – 2000
  6. +California Medical Association - 1997
  7. +Council of Health Organizations - 1971
  8. Federation of American Scientists – 1995
  9. National Institute of Health Workshop on the Medical Utility of Marijuana - 1997
  10. +Northern New England Psychiatric Society
  11. Wisconsin State Medical Society – 1998

No Criminal Penalty

  1. Alaska Medical Association - 1972
  2. +American Academy of Family Physicians - 1977
  3. American Bar Association - 1977
  4. American Medical Association – 1977
  5. +American Public Health Association - 1971
  6. American Social Health Association - 1974
  7. +Berkeley, CA - 1972
  8. B’nai B’rith Women - 1974
  9. Central Conference of American Rabbis - 1973
  10. +Council of Health Organizations - 1971
  11. District of Columbia Medical Society - 1973
  12. +Episcopal Church of the U.S. - 1973
  13. Episcopal Diocese of New York - 1975
  14. Gray Panthers - 1975
  15. Illinois Bar Association - 1974
  16. Lutheran Student Movement - 1975
  17. Massachusetts Bar Association - 1974
  18. National Association for Mental Health - 1972
  19. National Association of Social Workers - 1975
  20. National Council of Churches - 1973
  21. National Education Association - 1978
  22. New York Bar Association - 1974
  23. +Northern New England Psychiatric Society
  24. Southern California Psychiatric Society - 1979
  25. United Methodists - 1976
  26. Unitarian Universalist Association - 1970
  27. Vermont Bar Association - 1974
  28. +Washington Democratic Party - 2000

Non-U.S. Organizations Supporting Access to Therapeutic Cannabis

  1. Australian National Task Force on Cannabis – 1994
  2. Australian Medical Association (New South Wales) Limited - 1999
  3. British Medical Association - 1997
  4. Bundesverband Poliomyelitis (Federal Union for Polio), Germany – 1998
  5. Canadian Association of Chiefs of Police - 2001
  6. Canadian Medical Association – 2001
  7. Canadian Medical Journal - 2001
  8. Deutsche AIDS-Hilfe (German AIDS Support Organization)-1998
  9. Deutsche Epilepsievereinigung (German Association for Epilepsy) -1998
  10. Deutsche Gesellschaft für Algesiologie (German Society for Algesiology) -1998
  11. Deutsche Gesellschaft für Drogen-und Suchtmedizin (German Society for Drug and Addiction Medicine) -1998
  12. Deutsche Gesellschaft niedergelassener Ärzte zur Versorgung HIV – Infizierter (German Working Group for Therapists of the HIV infected) - 1998
  13. French Ministry of Health - 1997
  14. German Bundestag (German Federal Parliament) - 2000
  15. Health Canada - 1997
  16. House of Lords (UK) Select Committee on Science and Technology - 1999
  17. Legalise Cannabis Alliance - 2000
  18. New South Wales (Australia) Parliamentary Working Party on the Use of Cannabis for Medical Purposes - 2000
  19. Lancet (UK) – 1995, 1998
  20. Medical Cannabis Research Foundation (UK) - 2000
  21. Preventive Medical Center, Netherlands - 1993
  22. Schmerztherapeutisches Kolloquium (Society for Pain Therapists) Germany - 1998
  23. Stichting Institute of Medical Marijuana, Netherlands - 1993
  24. United Church of Jamaica and Cayman Islands – 2000

+ denotes listing in multiple categories
Source: Patients Out of Time, http://www.medicalcannabis.com/Grouplist23.pdf

In addition national medical organizations in the United States and Canada are beginning to attend to issues related to medical cannabis use. In a resolution on 19 June 2001 the 547 delegates of the American Medical Association reasserted its opposition to criminalizing patients or doctors who use cannabis (Reuters of June 19, 2001). "Our plea again is that no criminal sanctions be applied to marijuana use, and to encourage our patients to discuss this freely with their doctors," Dr. Herman Abromowitz said.

On May 15, 2001 the Canadian Medical Association Journal (CMAJ) called on the government to decriminalize the possession of marijuana for personal use. Editor John Hoey argues the social and legal consequences of being arrested for marijuana possession far outweighs the minimal health affects of moderate use of the drug (Hoey 2001). The founding president of the International Society for Addiction Medicine, Dr. Nady el Guebaly, backs the federal governments move to legalize the medical use of cannabis (Calgary Herald of 20 July 1999). The medical director of Foothills Hospital's addiction centre supports the limited use of marijuana for treating nausea associated with chemotherapy and as an appetite stimulant for people suffering from AIDS. But el Guebaly stressed marijuana should only be used on a short-term basis under medically controlled conditions where other therapies have failed and under the supervision of a review board.

Research shows that not only in patients but also in health care professionals the attitude towards the medical value of cannabis depends much on personal experience. Those with some experience regarding the medical use of cannabis are more likely to support having the option of prescribing the drug to patients. This is a strong argument in favor of making the drug available for medical use, since the experience of these professionals must have been overall positive. Otherwise they would not recommend it.

The results of a U.S. survey presented at the annual meeting of the American Society of Addiction Medicine indicate that physicians are divided on the medical use of cannabis (Reuters of 23 April 2001). Researchers at Rhode Island Hospital in Providence asked 960 doctors about their attitude towards the statement, "Doctors should be able to legally prescribe marijuana as medical therapy." 36% of the responders agreed, 38% disagreed and 26% were neutral. Residence in a state that had approved research into the medical use of cannabis as well as a physician’s "permissiveness" were associated with supporting the medical use of cannabis. The researchers surveyed physicians in five specialties: addiction medicine, general psychiatry, gynecology, family practice and internal medicine. They found gynecologists and internists more likely to support the medical use of the drug than other surveyed specialists. Because doctors in those two specialties are more likely to see cancer patients, they may be more sensitive to marijuana's potential for managing the side effects of chemotherapy and of pain, the Rhode Island team proposed. They noted that the other specialists surveyed are more likely to see active substance abusers and may be more concerned about the drug's negative effects.

For example, Schwartz (2002) described his personal experience with cannabis, when his son became dependent on the drug, obviously a very difficult period:

"In 1984, I published in this journal a review entitled "Marijuana: A Crude Drug with a Spectrum of Underappreciated Toxicity." In the introduction to that article, I disclosed that our son Keith, who was 15 years old at the time, was in a long-term, modified outpatient adolescent drug and alcohol rehabilitation program because he had become dependent on marijuana with its associated behavioral, interpersonal, scholastic, and antisocial problems. Keith and most of his friends had experimented several times with LSD, beer, and several other drugs but never used injection drugs. Marijuana was clearly Keith's drug of choice and the only drug he used with regularity. Approximately 1 year later, Keith graduated from the treatment program. He completed the early aftercare component, relapsed several times, and completed a 4-month refresher drug rehabilitation program in another state. Nine years after admission to the first rehabilitation program, Keith finally attained some adult goals. Now 34 years old, he has been drug-free for 10 years. He is the president and owner of a successful discount cellular phone business that he started. More important, a decade ago, he reestablished an excellent and close relationship with his parents. As far as I can tell, Keith remains drug-free except for an occasional beer."

Schwartz became a strong opponent of the medical use of the drug, fighting against legal use in several articles (Voth and Schwartz 1997). From his personal background it might be impossible for him to concede that other people find relief with cannabis.

A peer-reviewed journal and national clinical conferences are evidence of acceptance of cannabis' medical use in the continuing education of doctors and other health professionals. The Journal of Cannabis Therapeutics, edited by Ethan Russo and published by the Haworth Press, began publication in 2001. This peer-reviewed journal addresses doctors, researchers, and other health professionals who require current information on the use of cannabis in treatment for neurological and other diseases as well as the latest research on endogenous and synthetic cannabinoids. This journal covers the history of cannabis, its clinical applications and components, and the biochemical and pharmacological functions of cannabinoids in man and animals as well as related legislative/legal issues. In addition to reporting on current research, the Journal of Cannabis Therapeutics has the goal of facilitating advances in education concerning the history, pharmacology, biochemistry, toxicology, as well as behavioral, psychological, and social effects, of cannabis and the cannabinoids.

National clinical conferences on marijuana’s medical use have been held in Iowa (2000) and Oregon (2002), both organized by Patients Out of Time, an educational group dedicated to advancing public understanding of medical cannabis research and the impact of public policies on medical cannabis patients. The conference in 2002 was co-sponsored by the Portland Community College Institute of Health Professionals, the Oregon Health Division, Mothers Against Misuse and Abuse, and the Oregon Nurses Association. The conference proceedings are evidence both of acceptance of marijuana’s medical use by the scientific and research communities and of the scope of medical applications of cannabis. Attendees of each conference qualified for continuing medical education credits, evidence of acceptance of the conference curriculum by state health professional associations. The conferences are scheduled to continue on a bi-annual basis.

References

Gieringer D. The Acceptance of Medicinal Marijuana in the U.S. J Cannabis Ther 2002;3(1): in press.
Hoey J. Marijuana: federal smoke clears, a little. CMAJ 2001;164(10):1397.
Schwartz RH. Marijuana: a decade and a half later, still a crude drug with underappreciated toxicity. Pediatrics 2002;109(2):284-9
Voth EA, Schwartz RH. Medicinal applications of delta-9-tetrahydrocannabinol and marijuana. Ann Intern Med 1997;126(10):791-8.

 

 
 
 
  
 
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