November 11th, 2009
02:06 PM ET

The changing debate over medical marijuana

By Stephanie Smith
CNN Medical Producer

The national conversation about medical marijuana - in particular smoked marijuana - is complex and often polarizing.

I liken it to having a conversation with my father-in-law about politics/race/religion/poverty/health care – you name it. We start off meaning to have dignified conversation, but we inevitably spiral into growling matches peppered with words like, “those liberals…” and “c’mon, you’re smarter than that…” or “that’s crazy! That’s insane.” In reality, we are not so far apart on the issues, but somehow we can muddy the conversation so that it seems like we are.

The medical marijuana debate has been historically cast in equally polarizing terms: Groups are either for or against legalizing it.

That is what makes a subtle, nuanced move by the American Medical Association at a board meeting on Tuesday such a remarkable twist in the dialogue. The AMA shifted a 72-year-old policy about smoked marijuana, acknowledging that there could be some medical benefits, and urging reconsideration of the drug’s Schedule I status (Schedule I is a drug of abuse with “no accepted medical use.” Heroin and ecstasy are also Schedule I).

The AMA’s new policy language suggests that “marijuana’s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines.”

What that means is that marijuana should be reconsidered as a Schedule I drug so that wider studies can be conducted that may establish that it is worthy of prescription drug status.

The organization is quick to add that it is by no means endorsing state-based cannabis programs or legalization. It also does not go as far as to say there is evidence that cannabis meets the rigorous standards met by prescription drugs on the market now – yet.

But that “yet” is key. What the new policy - and a forthcoming study - concede is that several short-term trials have shown that smoked cannabis is effective to treat neuropathy (nerve pain) in patients with HIV and hepatitic C. It is also effective, again, in a small number of trials, for stimulating appetite for people on chemotherapy; it may also be useful for patients with multiple sclerosis, to ameliorate pain and spasms.

The idea behind this policy shift is to widen the berth of studies about smoked marijuana, and to conduct them in a controlled manner, just as is done with prescription drugs, so that the debate can quiet down and give way to scientific evidence.

Now if only I could quiet down those debates with my father-in-law.

What do you think about the AMA’s new position on medical marijuana? Do you agree that it should be taken off of Schedule I status to make way for more studies in this area?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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soundoff (317 Responses)
  1. Windy

    If we allow the government (FDA), or Big Pharma (aren't they the same thing, really, under the corporatism we live with?) to "regulate" and/or control marijuana production and distribution, you can pretty much count on a weak and adulterated product (witness cigarettes vs organic unprocessed tobacco).

    We need to make certain this is handled by the REAL free market. Individuals should be allowed to grow their own, just as individuals are allowed to make wine and beer for their own personal use. Individuals should be allowed to sell or trade the product of their harvest, just like home tomato growers can sell their tomatoes at the farmers market or out of a stand on their own property (variety is the spice of life).

    In fact we need to go back to that kind of free market for EVERYTHING! Let consumers drive the market, businesses and products should succeed or fail because consumers will vote with their purchases, not because of government mandates or bans or regulating to extremes.

    November 16, 2009 at 14:59 | Report abuse | Reply
  2. Willie G

    I mean really, this plant has been used for thousands of years and there are not recorded overdoses. It is impossible. People that are against it have never tried it and are therefore just ignorant, but they should realize that not everyone has to try pot. It is your decision, just like it is my decision to smoke it. Everyone in this god-awful country (no pun intended) needs to just mind their own business.

    November 16, 2009 at 17:31 | Report abuse | Reply
  3. Ken

    Come on America (Home of the Free), why would you have cannabis schedule 1 and meth and cocaine schedule 2? I am not sure whom the U. S. Government is trying to protect from cannabis. In the thousands of years that humans have been using cannabis medicinally or spiritually, there has not been one overdose death. Now let’s compare that with those schedule 2 narcotics or even the legal ones like alcohol, sleeping pills, caffeine, or aspirin. Not to mention the prescription ones like xanax or oxycotin. Thousands of people overdose and DIE every year on these drugs. When will people open there eyes and realize people and governments have agendas and don't always tell the truth.

    I know I would rather my teenagers try cannabis, that cannot kill them, then to try alcohol and die from alcohol poisoning. How many young people die every year because they do not know their limit because they are young and not experienced with the dangerous drug alcohol. Now if they have too much cannabis all that will happen is they will fall asleep...NO DEATH!!

    One more point to make. Those that keep saying smoking anything is bad for you have not heard of vaporizing. Vaporizing is using heated air, not fire, to release the essential oils of the cannabis flower. No smoke (carcinogens) is produced, all you get is the cannabinoids and people THC is only one cannabinoid. There are many others in cannabis that do many great things for the human body.

    November 16, 2009 at 18:23 | Report abuse | Reply
  4. janly

    Absolutely. Prohibition against marijuana is harming this country. It brings criminals across the borders and encourages drug cartels. I'm 55 years old and have tinitis. If I knew where to get the drug, I would...but what's my option? Even in my state of WA where it's legal, I can't find a doctor to recommend it. If I found a doctor, where am I suppose to get it? Should I roam the streets looking for someone who might have connections? Get real.

    November 16, 2009 at 18:29 | Report abuse | Reply
  5. TheTruthPlease

    I think this is well over due. For cocaine and meth (schedule 2) to be considered less harmful than cannabis is absolutely crazy. Even the numerous other over-the-counter drugs that are available to anyone( even a kid can buy aspirin or tylenol) but does anyone ever consider people can overdose and die using them? There are many overdose deaths from all these legal and illegal drugs but not one person has overdosed and died from cannabis. This fact cannot be over looked any longer and things need to change! Consider alcohol, how many young people overdose and DIE every year from it but marijuana is the gateway drug? Come on now, who do you think you can fool? Not me and I'm one of those "stoners" you bash for not being intelligent. For you non-smokers it should be easy for you to figure it out.

    November 16, 2009 at 20:25 | Report abuse | Reply
  6. Rev22:2

    Jesus drank wine at the Last Supper. If he would of smoked a doobie too this would all be over with already.

    November 16, 2009 at 22:24 | Report abuse | Reply
  7. Lou

    I am relieved that the AMA is taking this study up.
    I Have had many an accident in my days and mostly I just went home and self medicated with aspirin and pot, Doctors would not help and being of hispanic origins I do not get the "good" pain drugs that are offered to most people. Thank god for that, I have met many people who have become addicted to their "good" drugs. Jackson, nicole smith and other celebrities have even been killed by over medication of prescription drugs.that would not happen with marijuana. I have been smoking for
    close to 30 years and if the AMA wants a guinea pig, well here I am.
    I am an insomniac with many broken bones, head injuries and other malady's that require medical marijuana. I hate the fact that my money is going to drug gangs and feel very responsible for drug wars but I am in constant pain and no doctor will subscribe me pain killers, they think all I want to do is get high. Even though I have proof of all these accidents, usually caused by other drivers running into me, doctors think that I just want to be a vegetable. WRONG, I need marijuana to control the pain. Besides I cannot afford the xpense of prescribtion drugs anyhow. and usually the drugs they offer are real dangerous stuff. Can kill ya.
    Marijuana allows me to sleep much better and reduce the incredible pain I constantly feel in my back, legs, knees, neck and head.
    I am afraid that the medical establishment will produce medical marijuana and then price it way above our ability to afford it so no I do not believe the AMA should make it a pill. I believe that full legalization of marijuana, along with restrictions of use when operating machinery should be the way.

    November 17, 2009 at 10:58 | Report abuse | Reply
  8. mike

    Its an herb and its natural not to legalize it would just be plain stupid.

    November 17, 2009 at 11:21 | Report abuse | Reply
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    November 18, 2009 at 14:49 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.