During the debate last year over the Massachusetts ballot question on the medical use of marijuana, the Massachusetts Medical Society opposed the proposal. We argued that in the absence of large-scale clinical trials on its safety and effectiveness in treating medical conditions, we could not support legalizing the use of marijuana for medical purposes.
Currently, marijuana is a Schedule I controlled substance, which means the federal government has declared it has no accepted medical use. There are serious concerns about its effects on health, particularly among young people.
Therefore, we formally asked the U.S. Drug Enforcement Administration (.pdf) and the White House Office of National Drug Control Policy to reclassify marijuana so that its use for medical purposes may be further studied and potentially regulated by the Food and Drug Administration.
The DEA responded to our request recently (.pdf), stating that marijuana’s Schedule I classification is not necessarily a barrier to the authorization of “bona fide research,” appropriately registered with and approved by the federal government.
DEA Administrator Michele M. Leonhart wrote, “DEA has never denied a research registration for marijuana and/or THC if the Secretary of the [Department of Health and Human Services] has determined that the applicant is qualified and competent and the research protocol is meritorious.”
Given this information, it’s time for medical and scientific communities to develop large-scale clinical trials to determine whether marijuana is safe and effective as a medical intervention. Such research should identify all the treatment protocols that would apply to a standard pharmaceutical therapy, including indications, contraindications, dosages, length of therapy, side effects, and more.
This would be extremely instructive to Massachusetts physicians, now that marijuana’s use for medical purposes is possible under state (but not federal) law. One interesting model to explore is the state-funded Center for Medicinal Cannabis Research at the University of California San Diego, which is starting to report findings from a handful of very small-scale studies.
Massachusetts was the 18th state to authorize medical marijuana. It would also be extremely useful to collect outcomes data from other states where patients are currently using it, some for many years. Is there statistically rigorous research or data about its use?
The issue about the rightful place of marijuana in medicine can only be determined when it is subjected to the same rigorous testing, research and standard-setting as any other drug developed for patients.
If it’s conclusively shown to be effective, and its side-effects are understood and acceptable to patients, then physicians who are reluctant to recommend it today may be able to responsibly consider using it among the treatment options for patients. If not, let’s focus on therapies which can be effective.
Filed under: Medical Marijuana