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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
- AIDS Action Council - 1996
- Alaska Nurses Association - 1998
- Alaska Voters - 1998
- Alliance for Cannabis Therapeutics –
1981
- +American Academy of Family Physicians –
1989, 1995
- American Civil Liberties Union (ACLU)
- American Medical Students Association - 1993
- American Preventive Medical Association –
1997
- +American Public Health Association (APHA)
- 1995
- Arizona Voters - 1996 & 1998
- Berkeley, CA - 1979
- Breckenridge, CO - 1994
- Burlington, VT - 1994
- California Academy of Family Physicians -
1996
- California Democratic Party - 1993
- California Legislative Council for Older
Americans - 1993
- +California Medical Association - 1994
- California Nurses Association - 1995
- California-Pacific Annual Conference of the
United Methodist Church - 1996
- California Pharmacists Association - 1997
- California Society of Addiction Medicine
- 1997
- California Voters - 1996
- Cannabis Freedom Fund – 1996
- Colorado Voters - 2000
- Colorado Nurses Association - 1995
- Contigo-Conmigo - 1997
- Consumer Reports Magazine - 1997
- Crescent Alliance Self Help for Sickle Cell
- 1999
- Cure AIDS now - 1991
- District of Columbia Voters - 1999
- +Episcopal Church of the U.S. - 1982
- Farmacy - 1999
- Federation of American Scientists - 1994
- Florida Governor’s Red Ribbon Panel
on AIDS - 1993
- Florida Medical Association - 1997
- Frisco, CO - 1994
- Hawaii Kokua Council of Senior Citizens -
2000
- Hawaii Legislature - 2000
- Hawaii Nurses Association - 1999
- Institute of Medicine - 1982 & 1999
- International Cannabis Alliance of Researchers
and Educators (I-CARE) - 1992
- Iowa Civil Liberties Union
- Iowa Democratic Party - 1994 & 2000
- Kaiser Permanente - 1997
- Life Extension Foundation - 1997
- Libertarian Party – 1999
- Los Angeles County AIDS Commission - 1996
- Lymphoma Foundation of America - 1997
- Madison, WI – 1993
- Maine AIDS Alliance - 1997
- Maine Voters - 1999
- Marin County, CA - 1993
- Minnesota Democratic Farm-Labor Party - 1992
- Mississippi Nurses Association - 1995
- Mothers Against Misuse and Abuse (MAMA) -1992
- Multiple Sclerosis California Action Network
(MS-CAN) - 1996
- National Association for Public Health Policy
- 1998
- National Association of Attorneys General
- 1983
- National Association of Criminal Defense
Lawyers (NACDL)
- National Association of People with AIDS
- 1992
- National Nurses Society on Addictions (NNSA)
- 1995
- Nevada Voters - 1998
- New England Journal of Medicine - 1997
- New Mexico Nurses Association - 1997
- New York State Nurses Association - 1995
- North Carolina Nurses Association - 1996
- Oakland, California - 1998
- Oregon Voters – 1998
- Oregon Green Party - 2001
- Oregon Democratic Party - 1998
- Patients Out of Time - 1995
- Physicians Association for AIDS Care
- Physicians for Social Responsibility (Oregon)
- 1998
- Republican Liberty Caucus National Committee
- 1999
- San Diego, CA - 1994
- San Francisco, CA - 1992
- San Francisco Medical Society - 1996
- Santa Cruz County, CA - 1993
- Virginia Nurses Association - 1994
- Virginia Nurses Society on Addictions - 1993
- Washington Hemp Education Network - 1999
- Washington Democratic Party - 1998 &
2000
- Washington Voters - 1998
- Wisconsin Democratic Party - 1997
- Wisconsin Public Health Association - 1999
- Wisconsin Nurses Association - 1999
- Women of Reform Judaism - 2000
Organizations Supporting Research on
the Therapeutic Use of Cannabis
- American Academy of Addiction Psychiatry
- 2000
- +American Academy of Family Physicians -
1977
- American Cancer Society – 1997
- American Nurses Association, Congress of
Nursing Practice - 1996
- +American Society of Addiction Medicine –
2000
- +California Medical Association - 1997
- +Council of Health Organizations - 1971
- Federation of American Scientists –
1995
- National Institute of Health Workshop on
the Medical Utility of Marijuana - 1997
- +Northern New England Psychiatric Society
- Wisconsin State Medical Society – 1998
No Criminal Penalty
- Alaska Medical Association - 1972
- +American Academy of Family Physicians -
1977
- American Bar Association - 1977
- American Medical Association – 1977
- +American Public Health Association - 1971
- American Social Health Association - 1974
- +Berkeley, CA - 1972
- B’nai B’rith Women - 1974
- Central Conference of American Rabbis - 1973
- +Council of Health Organizations - 1971
- District of Columbia Medical Society - 1973
- +Episcopal Church of the U.S. - 1973
- Episcopal Diocese of New York - 1975
- Gray Panthers - 1975
- Illinois Bar Association - 1974
- Lutheran Student Movement - 1975
- Massachusetts Bar Association - 1974
- National Association for Mental Health -
1972
- National Association of Social Workers -
1975
- National Council of Churches - 1973
- National Education Association - 1978
- New York Bar Association - 1974
- +Northern New England Psychiatric Society
- Southern California Psychiatric Society -
1979
- United Methodists - 1976
- Unitarian Universalist Association - 1970
- Vermont Bar Association - 1974
- +Washington Democratic Party - 2000
Non-U.S. Organizations Supporting Access
to Therapeutic Cannabis
- Australian National Task Force on Cannabis
– 1994
- Australian Medical Association (New South
Wales) Limited - 1999
- British Medical Association - 1997
- Bundesverband Poliomyelitis (Federal Union
for Polio), Germany – 1998
- Canadian Association of Chiefs of Police
- 2001
- Canadian Medical Association – 2001
- Canadian Medical Journal - 2001
- Deutsche AIDS-Hilfe (German AIDS Support
Organization)-1998
- Deutsche Epilepsievereinigung (German Association
for Epilepsy) -1998
- Deutsche Gesellschaft für Algesiologie
(German Society for Algesiology) -1998
- Deutsche Gesellschaft für Drogen-und
Suchtmedizin (German Society for Drug and Addiction Medicine)
-1998
- Deutsche Gesellschaft niedergelassener Ärzte
zur Versorgung HIV – Infizierter (German Working Group
for Therapists of the HIV infected) - 1998
- French Ministry of Health - 1997
- German Bundestag (German Federal Parliament)
- 2000
- Health Canada - 1997
- House of Lords (UK) Select Committee on Science
and Technology - 1999
- Legalise Cannabis Alliance - 2000
- New South Wales (Australia) Parliamentary
Working Party on the Use of Cannabis for Medical Purposes
- 2000
- Lancet (UK) – 1995, 1998
- Medical Cannabis Research Foundation (UK)
- 2000
- Preventive Medical Center, Netherlands -
1993
- Schmerztherapeutisches Kolloquium (Society
for Pain Therapists) Germany - 1998
- Stichting Institute of Medical Marijuana,
Netherlands - 1993
- 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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