CONTACT MA medical society rejects marijuana - Dr. Christian Thurstone

Physicians in Massachusetts soon will deliberate (May 19, 2012) whether to join a growing body of doctors and healthcare professionals who are speaking up about so-called “medical” marijuana.

Testimony from Kevin Sabet (find him online at kevinsabet.com), an assistant professor at the University of Florida and former senior advisor to the Obama administration in the White House Office of National Drug Control Policy, caught my eye — partly because I like the way he thinks about national drug policy and partly because he quotes me (and correctly. Thanks, Kevin.):

“In  the absence of credible data, this debate is being dominated by bad science and misinformation from people interested in using medical marijuana as a step to legalization for recreational use. Bypassing the FDA’s well-established approval process has created a mess that especially affects children and adolescents. Young people, who are clearly being targeted with medical marijuana advertising and diversion, are most vulnerable to developing marijuana addiction and suffering from its lasting effects.”

Here’s Kevin’s full testimony. I hope you’ll read it.

As he writes, no major medical association has come out in favor of smoked marijuana for widespread medical use. Consider:

American Society of Addiction Medicine: “ASAM asserts that cannabis, cannabis-based products, and cannabis delivery devices should be subject to the same standards that are applicable to other prescription medications and medical devices and that these products should not be distributed or otherwise provided to patients unless and until such products or devices have received marketing approval from the Food and Drug Administration. ASAM rejects smoking as a means of drug delivery since it is not safe. ASAM rejects a process whereby State and local ballot initiatives approve medicines because these initiatives are being decided by individuals not qualified to make such decisions.”

American Cancer Society: “The ACS is supportive of more research into the benefits of cannabinoids. Better and more effective treatments are needed to overcome the side effects of cancer and its treatment. The ACS does not advocate the use of inhaled marijuana or the legalization of marijuana.”

American Glaucoma Foundation: “Marijuana, or its components administered systemically, cannot be recommended without a long term trial which evaluates the health of the optic nerve. Although marijuana can lower IOP, its side effects and short duration of action, coupled with a lack of evidence that its use alters the course of glaucoma, preclude recommending this drug in any form for the treatment of glaucoma at the present time.”

National Multiple Sclerosis Society: “Although it is clear that cannabinoids have potential both for the management of MS symptoms such as pain and spasticity, as well as for neuroprotection, the Society cannot at this time recommend that medical marijuana be made widely available to people with MS for symptom management. This decision was not only based on existing legal barriers to its use but, even more importantly, because studies to date do not demonstrate a clear benefit compared to existing symptomatic therapies and because issues of side effects, systemic effects, and long-term effects are not yet clear.” — Recommendations Regarding the Use of Cannabis in Multiple Sclerosis: Executive Summary. National Clinical Advisory Board of the National Multiple Sclerosis Society, Expert Opinion Paper, Treatment Recommendations for Physicians, April 2, 2008.http://www.nationalmssociety.org.

The American Academy of Pediatrics (AAP) believes that “[a]ny change in the legal status of marijuana,  even  if  limited  to  adults,  could  affect  the  prevalence  of  use  among adolescents.” While it supports scientific research on the possible medical use of cannabinoids as opposed to smoked marijuana, it opposes the legalization of marijuana. — Committee on Substance Abuse and Committee on Adolescence. “Legalization  of  Marijuana:  Potential  Impact  on  Youth.”  Pediatrics   Vol. 113, No. 6 ( June 6, 2004): 1825-1826. See also, Joffe, Alain, MD, MPH, and Yancy, Samuel,  MD.  “Legalization  of  Marijuana:  Potential  Impact  on  Youth.”  Pediatrics  Vol.  113,  No.  6   ( June 6, 2004): e632-e638h.

The American Medical Association (AMA) has called for more research on the subject, with the  caveat that  this  “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  product.”

John  Knight, director of the Center for Adolescent Substance Abuse Research at Children’s Hospital Boston,  recently  wrote:  “Marijuana has gotten a free ride of sorts among the general public, who view it as non-addictive and less impairing than other drugs. However, medical science tells a different story.”

It does indeed. Here’s to hoping the Massachusetts Medical Society reaches the same conclusion as so many of its colleagues in medicine.

UPDATE, May 19, 2012: The Massachusetts Medical Society voted to oppose legalization of medical marijuana. So, we’re adding the organization’s sentiments to the list we started above:

Massachusetts Medical Society “Opposition to the legalization of medicinal marijuana in the absence of scientific studies that demonstrate its safety and efficacy led the list of resolutions adopted by physicians of the Massachusetts Medical Society … The multi-part resolution on medicinal marijuana also advocated that marijuana be reclassified by the U.S. Drug Enforcement Administration so that its potential medicinal use by humans may be further studied and potentially regulated by the U.S. Food and Drug Administration; support for the development of non-smoked, reliable delivery systems of cannabis-derived and cannabinoid medications for research purposes; and support for educating residents of the Commonwealth that there is insufficient scientific information about the safety of marijuana when used for medicinal purposes. A second, separate resolution on medicinal marijuana declared that the Medical Society ‘cannot support legislation intended to involve physicians in certifying, authorizing, or otherwise directing persons in the use of medicinal marijuana outside of scientific and clinical trials.’”

About Chris Thurstone

Dr. Christian Thurstone is one of only a few dozen physicians in the United States who are board-certified in general, child and adolescent and addictions psychiatry. He is Director of Behavioral Health Services at Denver Health and a professor of psychiatry at the University of Colorado, where he conducts research on youth substance use and addiction and serves as director of medical training for the university’s addiction psychiatry fellowship program. You can read more about him here.

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