The AMA’s reversal on marijuana

For all the debate over whether marijuana has medicinal value, arguments that the drug has significant palliative properties or that it has none suffer from the same flaw: There’s little scientific proof either way.

This lack of conclusive evidence isn’t accidental. In 1970, Congress passed the Controlled Substances Act, classifying marijuana -- which had been illegal since 1937 -- as a Schedule I drug, which meant that it had a high potential for abuse and no medicinal value. In keeping with this position, the government has allowed only the University of Mississippi to cultivate research-grade marijuana, and has so restricted access to its small supply that determining the drug’s efficacy is for all intents and purposes impossible.

So patients’ advocates celebrated last week when the nation’s largest physicians organization, the American Medical Assn., recommended that marijuana’s schedule classification be reviewed for the purpose of facilitating research and the “development of cannabinoid-based medicines.” It was indeed good news.

But hold the brownies. Although the AMA reversed a long-held position, it also issued a series of caveats: The change does not mean the organization supports state-sanctioned medical marijuana programs. It should not suggest that cannabis meets the standard set for prescription drugs. Nor is this an indication that the organization advocates legalization. Moreover, it has specifically rejected language calling for marijuana to be rescheduled.

That medical marijuana is becoming more acceptable to the mainstream is undeniable -- 13 states now permit its use -- but ideally, major healthcare policy shouldn’t be enacted by popular opinion. In that light, the AMA’s recommendation is all the more powerful for its restraint.

In 1913, California became the first state to outlaw marijuana, and in 1996, it became the first to approve it for medical use. We have been supportive of the California Compassionate Use Act, but we have been equally vocal about the need for research. Small studies suggest that cannabis relieves nerve pain in HIV patients, mitigates migraine headaches, reduces ocular hypertension in glaucoma patients and is effective against various forms of severe, chronic pain. The states that have legalized the drug’s use for medicinal purposes have done so on the basis of a small body of research and a large amount of anecdotal evidence, but more facts are needed. The U.S. Food and Drug Administration should heed the doctors’ orders on this matter and open the way to scientific investigation.