American College of Physicians (ACP) supports medical marijuana

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American College of Physicians Speaks Out for Medical Marijuana


In January 2008, the American College of Physicians (ACP) — the largest medical specialty
organization and the second largest physician group in the United States, representing over 124,000
members — released a landmark position paper calling for legal protection for medical marijuana
patients, reconsideration of marijuana’s federal classification as a Schedule I drug (banned for medical
use), and expanded research. Entitled “Supporting Research into the Therapeutic Role of Marijuana,”
the paper cites extensive evidence for the clinical safety and efficacy marijuana and its active
components, called cannabinoids.

ACP is one of the world’s most prestigious medical societies and publishes Annals of Internal
Medicine, the most widely cited medical specialty journal in the world. ACP joins the Institute
of Medicine, American Public Health Association, Leukemia & Lymphoma Society, American
Nurses Association, American Academy of HIV Medicine, and dozens of other medical and health
organizations that support medical marijuana access. Key excerpts from the report are below.

Changing Marijuana’s Legal Status and Providing Protection for Patients
“A clear discord exists between the scientific community and federal legal and regulatory agencies
over the medicinal value of marijuana, which impedes the expansion of research.”

“ACP urges review of marijuana's status as a Schedule I controlled substance and reclassification
into a more appropriate schedule, given the scientific evidence regarding marijuana’s safety and
efficacy in some clinical conditions.”

“Given marijuana’s proven efficacy at treating certain symptoms and its relatively low toxicity,
reclassification would reduce barriers to research and increase availability of cannabinoid drugs
to patients who have failed to respond to other treatments.”

“ACP strongly urges protection from criminal or civil penalties for patients who use medical
marijuana as permitted under state laws.”

Marijuana’s Medical Uses
“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 (MS), spinal cord
injuries or other trauma.”

“Current available data suggest numerous indications for cannabinoids, especially antiemesis,
appetite stimulation, and pain relief.”

“Clinical trials have demonstrated that both oral and smoked marijuana stimulate appetite,
increase caloric intake and result in weight gain among patients experiencing HIV wasting.”

“For patients with AIDS or those undergoing chemotherapy, who suffer severe pain, nausea and
appetite loss, cannabinoid drugs may provide symptom relief not found in any other medication.”

“Studies of chemotherapy patients with nausea and vomiting found THC to be equivalent or
superior to other antiemetics (including prochloperazine or metoclopramide) for
symptom reduction.”

“Research suggests that cannabinoids may have synergistic effects that may indicate its use as an
adjunctive therapy to both antiemetics for nausea and vomiting and opiods for pain relief.”

Disadvantages of Oral THC (Marinol®)
“While useful for some, these drugs have serious limitations. The oral route of administration
hampers the effectiveness of THC because of slow absorption. In addition, for patients with
severe nausea and vomiting, for whom oral THC is indicated, swallowing a pill may not
be feasible.”

“The oral, synthetic THC has low and variable bioavailability. Oral THC is slow in onset of
action but produces more pronounced, and often unfavorable, psychoactive effects that last
much longer than those experienced with smoking. On the other hand, smoked THC is quickly
absorbed into the blood and effects experienced immediately. Studies have found that patients
prefer the immediate effect on symptoms that occurs after smoking marijuana.”

Vaporization Answers Concerns Regarding Smoking
“The development of a vapor route for THC delivery offers promise for the future of medical
marijuana research. A recent study found that THC administered through the Volcano vaporizer
resulted in higher plasma THC levels compared to smoked marijuana at both 30 and 60 minutes
post administration. It also found that exhaled carbon monoxide increased very little after vapor
compared with smoking. ... Vaporization of THC offers the rapid onset of symptom relief without
the negative effects from smoking. It allows patients to self regulate their dosage immediately by
ceasing inhalation when or if psychoactive effects become unpleasant.”

Medical Marijuana and Drug Abuse (the “Gateway Theory”)
“Marijuana has not been proven to be the cause or even the most serious predictor of serious drug
abuse. It is also important to note that the data on marijuana’s role in illicit drug use progression
only pertains to its non-medical use.”

The entire text of the ACP's position paper can be viewed online here.