Pubdate: Sun, 06 Nov 2011
Source: San Diego Union Tribune (CA)
Copyright: 2011 Union-Tribune Publishing Co.
Contact:  http://www.signonsandiego.com/
Details: http://www.mapinc.org/media/386
Note: Seldom prints LTEs from outside it's circulation area.
Author: James T. Hay
Note: Hay, a resident of Del Mar, is the newly installed president of
the California Medical Association. To read the full paper adopted by
CMA, go online to
http://www.cmanet.org/files/pdf/news/cma-cannabis-tac-white-paper-101411.pdf
Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization)

THE CASE FOR LEGALIZATION

The California Medical Association recently adopted a white paper 
that is now our policy, which lays out a strong and thoughtful 
position on medical cannabis (marijuana). As a family physician, I 
want to be clear that CMA's position is not to make the substance 
more readily available to the general public, but actually quite the opposite.

The problem is that states are decriminalizing medical cannabis on a 
state-by-state basis, but without any groundwork for federal 
regulations requiring warning labels, product consistency, purity and 
reliably predictable dosage. In order for there to be a robust 
regulatory system, we must first legalize medical cannabis on a federal level.

This isn't a decision that CMA came to lightly. "Promoting the 
science and art of medicine, the care and well-being of patients, the 
protection of the public health and the betterment of the medical 
profession," are the words inscribed on the wall in the CMA lobby. 
It's a mission that we as a community of physicians stand behind, and 
the reason physicians like me participate in setting policy for CMA.

Our 500-member House of Delegates last fall called for the creation 
of a technical advisory committee made up of experts to research, 
evaluate and recommend a policy for our organization. For over a 
year, this committee has met and combed through what available data 
there is on medical cannabis and, last month, submitted its 
conclusions to the CMA Board of Trustees.

Let's not pretend that medical and recreational cannabis aren't easy 
to come by. The fact is, despite prohibition-like efforts, 
unregulated cannabis continues to be easily accessible, often at low 
cost. The most frightening concern to us as physicians is that it is 
unregulated. We have no way of knowing the purity, strength or 
chemical makeup of the substance that many of our patients are receiving.

Even with a physician recommendation, patients must go to a location 
of their own discretion and choose their own doses and type of drug. 
Under no circumstance would we ever send our patients to an 
unregulated pharmacy and then also tell them to choose what they think is best.

Physicians are also put in the untenable position of violating 
federal law if they do believe there would be a medical benefit to 
their patient and then recommend it. Medical cannabis has been 
decriminalized at a state level in California and in 16 other states, 
but is still illegal federally.

Despite some limited research primarily done in other countries, the 
effectiveness in treatment and the possible risks associated with 
medical cannabis are still generally unclear. Currently, cannabis is 
a Schedule I drug, which means it is very hard to do research and 
evaluate it clinically the way we do any other potentially useful 
medical treatment. CMA advocates for the rescheduling of medical 
cannabis, just as the American Medical Association did in 2009, so 
that we can better understand the potential benefits and risks. Until 
we do, it's impossible to say whether or not recommending it is in a 
patient's best interest.

Our problem with current policy is twofold. First, we need a 
regulatory system in place at a federal level that allows for a 
robust standardization of the drug. That is critical for patient 
safety and the health of a large portion of the public that is using 
this drug already. Second, we need to better understand the substance 
itself and, until there is the ability to collect more comprehensive 
and scientific evidence through legally sanctioned research, we can't 
know what the risks or benefits are.
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MAP posted-by: Jay Bergstrom