ACP: Research, legalize medical-use marijuana
Position paper seeks more research, less debate
Calls to legalize marijuana for medical use have come from an assortment of groups, but none with the status and influence of the American College of Physicians (ACP), the country's second-largest medical association, until now.
The ACP issued a 13-page report in February endorsing the use of marijuana for medical purposes and urging the federal government to ease restrictions and support studies of marijuana's medical uses.
The 124,000-member organization, in its report, points to evidence that marijuana's nausea-quelling effects are beneficial to cancer patients undergoing chemotherapy and AIDS patients experiencing uncontrollable weight loss.
"Preclinical, clinical, and anecdotal reports suggest numerous potential medical uses for marijuana," according to the ACP report. But not enough is known about other potential uses for the drug, because the legalization issue has hindered clinical research into marijuana's medical applications, the report's authors write.
A dozen states have legalized medical marijuana. But the federal government has resisted attempts to legalize medical marijuana, and marijuana is listed as a Schedule I controlled substance (the category that includes heroin and LSD), a categorization the ACP seeks to have changed.
States that have legalized the medical use of marijuana: Alaska, California, Colorado, Hawaii , Maine, Maryland, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington.
FDA not likely to agree
The U.S. Food and Drug Administration (FDA) weighed in on medical-use marijuana in 2005, saying state measures legalizing medical marijuana "are inconsistent with efforts to ensure that medications undergo the rigorous scientific scrutiny of the FDA approval process."
As it stands now, the FDA's position is that no sound scientific studies support medical use of marijuana for treatment, and no animal or human data support its safety, and that nonsmoked forms of marijuana's main psychoactive component, THC, are available instead.
The ACP encourages the use of nonsmoked forms of THC that have shown to be beneficial, and urges more study of both smoked and nonsmoked versions of the drug.
According to the ACP position paper, potential medical uses for marijuana include:
- appetite stimulation/antiemetic — to treat severe weight loss associated with AIDS (HIV/AIDS wasting), and nausea and vomiting associated with chemotherapy in patients who fail to respond to other antiemetics;
- glaucoma — cannabis has been shown to have neuroprotective properties and to reduce high intraocular pressure;
- neurological and movement disorders — anecdotal, survey, and clinical trial data suggest that smoked marijuana and oral THC provide relief of spasticity, pain, and tremor in some patients with multiple sclerosis, spinal cord injuries, or other trauma;
- analgesic — the ACP cites research demonstrating that oral doses of THC have pain-reducing effects similar to those of codeine.
ACP researchers also note the adverse effects, particularly of the smoked form of marijuana:
- increases heart rate and decreased blood pressure on standing;
- impairment of short-term memory, attention, motor skills, reaction times, and the organization and integration of complex information;
- chronic effects of smoking — gas and tar phases contain many of the same compounds as tobacco smoke. Chronic use of smoked marijuana is associated with increased risk of cancer, lung damage, bacterial pneumonia, and poor pregnancy outcomes;
- withdrawal symptoms (restlessness, irritability, mild agitation, insomnia, sleep disturbances, nausea, cramping) with the onset of abstinence.
The ACP statement on medical use of marijuana is available on_line at www.acponline.org.
Calls to legalize marijuana for medical use have come from an assortment of groups, but none with the status and influence of the American College of Physicians (ACP), the country's second-largest medical association, until now.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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