April 16, 1999

A convergence of developments has refocused attention on how organized medicine is dealing with the medical marijuana issue.

On March 17 the National Academy of Sciences' Institute of Medicine (IOM) issued a report affirming, with qualifications, the medical potential of marijuana. The report was preceded by the March 2 introduction of H.R. 912 by Rep. Barney Frank (D-Mass.), which would permit states to shape their own medical marijuana policies without federal interference. On March 3 Canadian Minister of Health Allan Rock authorized clinical trials on medical marijuana in Canada.

APA components addressed the issue in a policy guideline approved by the Board of Trustees in December 1997. The guideline calls for further "expedited" research comparing smoked cannabis (marijuana), aerosol delivery (no mechanism exists yet for this delivery method), and oral preparations containing THC (tetrahydrocannabinol), one of the plant's key active compounds, already available as a legal, Schedule II drug marketed under the brand name Marinol by Unimed Pharmaceuticals Inc.

The policy guideline also calls for further research on constituent compounds of whole marijuana and states that the FDA's provisions for drug approval and "compassionate use" should be followed. The policy guideline further suggests that marijuana, if approved, should be a Schedule II drug. APA's "guiding principles in the assessment and approval process of marijuana's medical efficacy" should be "compassion for the ill, along with research support for safety and efficacy."

The guideline was approved by the Council on Addiction Psychiatry, the Commission on AIDS, and the Joint Reference Committee prior to approval by the Board.