are No Compelling Medical Reasons to Prescribe Marijuana or Heroin to
US Drug Enforcement Agency
is often suggested that, even if currently controlled substances are not
made available to the general public, some of them, particularly
marijuana and heroin could be used to relieve suffering.
the Anti-Legalization Forum acknowledged that arguments urging the
medical use of marijuana are often used as an entree into the
legalization debate. Medical use arguments can garner public support
because they seem harmless enough to the well-intended audience. The
experts agreed that these issues are peripheral to the real issue.
professionals best debate the medical pros and cons of prescribing
marijuana and heroin to sick people. It should be kept in mind, however,
that the American Medical Association, the American Glaucoma Society,
the American Academy of Ophthalmology, the International Federation of
Multiple Sclerosis Societies, and the American Cancer Society have
rejected marijuana as medicine.
Not one American
health association accepts marijuana as medicine. Statements issued by
these organizations express concern over the harmful effects of the
drugs and over the lack of solid research demonstrating that they might
do more good than harm.
In January 1997,
the Office of National Drug Control Policy (ONDCP) requested that the
Institute of Medicine (IOM) conduct a review of the scientific evidence
for assessing the potential health benefits and risks associated with
marijuana and its constituent cannabinonoids. In response to this
request Marijuana and Medicine: Assessing the Science Base was
released by IOM in March 1998. The following six recommendations were
enumerated in the aforementioned document:
#1 - Research should continue into the physiological effects of
synthetic and plant-derived cannabinoids and the natural function of
cannabinoids found in the body. Because different cannabinoids appear
to have different effects, cannabinoid research should continue, but
not be restricted to, effects attributable to THC alone.
#2 Clinical trials of cannabinoid drugs for symptom management should
be conducted with the goal of developing rapid-onset, reliable, and
safe delivery systems.
#3 Psychological effects of cannabinoids such as anxiety reduction and
sedation, which can influence medical benefits, should be evaluated in
# 4 Studies to define the individual health risks of smoking marijuana
should be conducted, particularly among populations in which marijuana
use is prevalent.
#5 Clinical trials of marijuana use for medical purposes should be
conducted under the following limited circumstances: trials should
involve only short-term marijuana use (less than six months); should
be conducted in patients with conditions for which there is reasonable
expectation of efficacy; should be approved by institutional review
boards; and should collect data about efficacy.
#6 Short-term use of smoked marijuana (less than six months) for
patients with debilitating symptoms (such as intractable pain or
vomiting) must meet the following conditions;
all approved medications to provide relief has been documented;
can reasonably be expected to be relieved by rapid-onset cannabinoid
treatment is administered under medical supervision in a manner that
allows for assessment of treatment effectiveness; and
oversight strategy comparable to an institutional review board
process that could provide guidance within 24 hours of a submission
by a physician to provide marijuana to a patient for a specified
Medical Association policy statement on marijuana says, in part, "The
AMA believes that cannabis (marijuana) is a dangerous drug and as such
is a public health concern." This is not a new position for the AMA; it
was adopted in 1969 and reaffirmed in 1994.
facts, which confirm the observations of the forum participants, may be
used in debates:
federal statute known as the Controlled Substances Act (CSA), (please
refer to page 24) regulated drugs are divided into categories known as
schedules. In Schedule I, for instance, are drugs with a high
potential for abuse and no currently accepted medical use in treatment
in the United States. At the other end of the spectrum is Schedule V,
which is for drugs that have a low potential for abuse and have a
currently accepted medical use in treatment in the United States. The
Act provides a mechanism for substances to be controlled (added to a
schedule), decontrolled (removed from control), or rescheduled
(transferred from one schedule to another).
marijuana are in Schedule I; cocaine, which is sometimes used as a local
anesthetic, is in Schedule II. Much of the debate about medical uses for
currently illegal drugs concerns substituting heroin for morphine,
supplying marijuana to AIDS and glaucoma patients, or using it to treat
side effects of chemotherapy.
A petition to
put marijuana in a less restrictive schedule of the CSA was rejected
by then DEA Administrator John C. Lawn, after public hearings, on
December 29, 1989. The United States Court of Appeals ordered further
proceedings, however, to clear up what it felt were some ambiguities
in the record. Administrator Robert C. Bonner, who succeeded Lawn,
complied and issued a new ruling on March 26, 1992. "By any modern
scientific standard, marijuana is no medicine," Bonner said. The
three-judge appeals court upheld the ruling unanimously on February
18, 1994. "Our review of the record convinces us that the
Administrator's findings are supported by substantial evidence," the
court said, noting the "testimony of numerous experts that marijuana's
medicinal value has never been proven in sound scientific studies."