The state's largest doctor group is calling for legalization of marijuana, even as it pronounces cannabis to be of questionable medical value.
Trustees of the California Medical Assn., which represents more than 35,000 physicians statewide, adopted the position at their annual meeting in Anaheim late Friday. It is the first major medical association in the nation to urge legalization of the drug, according to a group spokeswoman, who said the larger membership was notified Saturday.
Dr. Donald Lyman, the Sacramento physician who wrote the group's new policy, attributed the shift to growing frustration over California's medical marijuana law, which permits cannabis use with a doctor's recommendation. That, he said, has created an untenable situation for physicians: deciding whether to give patients a substance that is illegal under federal law.
"It's an uncomfortable position for doctors," he said. "It is an open question whether cannabis is useful or not. That question can only be answered once it is legalized and more research is done. Then, and only then, can we know what it is useful for."
The CMA's new stance appears to have as much to do with politics as science. The group has rejected one of the main arguments of medical marijuana advocates, declaring that the substance has few proven health benefits and comparing it to a "folk remedy."
The group acknowledges some health risk associated with marijuana use and proposes that it be regulated along the lines of alcohol and tobacco. But it says the consequences of criminalization outweigh the hazards.
Lyman says current laws have "proven to be a failed public health policy." He cited increased prison costs, the effect on families when marijuana users are imprisoned and racial inequalities in drug-sentencing cases.
The organization's announcement provoked some angry response.
"I wonder what they're smoking," said John Lovell, spokesman for the California Police Chiefs Assn. "Given everything that we know about the physiological impacts of marijuana — how it affects young brains, the number of accidents associated with driving under the influence — it's just an unbelievably irresponsible position."
The CMA's view is also controversial in the medical community.
Dr. Robert DuPont, an M.D. and professor of psychiatry at Georgetown Medical School, said the association's call for legalization showed "a reckless disregard of the public health. I think it's going to lead to more use, and that, to me, is a public health concern. I'm not sure they've thought through what the implications of legalization would be."
Dr. Igor Grant, head of the Center for Medicinal Cannabis at UC San Diego, defended the drug's therapeutic use.
"There's good evidence that it has medicinal value," he said. "Can you say it's 100% bulletproof? No. But the research we've done at the center shows it's helpful with certain types of pain."
The federal government views cannabis as a substance with no medical use, on a par with heroin and LSD. The CMA wants the Obama administration to reclassify it to help promote further research on its medical potential.
But Washington appears to be moving in the other direction. As recently as July, the federal government turned down a request to reclassify marijuana. That decision is being appealed in federal court by legalization advocates.
In recent weeks, the Obama administration has begun cracking down on California's medical marijuana industry, threatening to prosecute landlords who rent buildings to pot dispensaries.
California's marijuana laws have eased over the last 15 years. State voters passed Proposition 215 in 1996, decriminalizing it for medicinal purposes. Federal law still prohibits the sale or possession of the drug for any reason.
The CMA opposed Proposition 215, and it argues that doctors have been placed unwillingly in the center of the feud over the drug.
"When the proposition passed, we as an organized medical community got thrown into the middle of this issue, because the posture of the proposition and its proponents found that cannabis is a medicinal product that is useful for a long list of specific ailments," Lyman said.
The state has since softened its laws on even recreational use of the drug. In 2010, Gov. Arnold Schwarzenegger signed a bill that reclassified possession of less than an ounce from a misdemeanor to an infraction.
At the same time, the number of marijuana dispensaries was skyrocketing, to between 1,000 and 2,000 statewide, according to estimates by law enforcement officials. In January, the Los Angeles City Council set strict limits on pot outlets, ordering the closure of hundreds of them.
Opinion polls show that state voters continue to be in favor of medical marijuana but are divided on the question of total legalization. A recent survey by the Public Policy Institute of California found 51% opposed to complete legalization and 46% in favor.
Last November, California voters rejected Proposition 19, which would have legalized the possession and cultivation of limited amounts of cannabis and permitted local governments to regulate it and tax sales. The CMA took no public position on the measure, its leaders said.
Across the country, physicians have called for more cannabis-related research. The CMA's parent organization, the American Medical Assn., has said the federal government should consider easing research restrictions.
Meanwhile, Lyman said, "there is considerable harm being done."