Date: Fri, 8 Dec 1995 06:21:44 -0600
From: [c--o--n] at [dsmnet.com] (Carl E. Olsen)
Subject: American Public Health Association
9513: Access to Therapeutic Marijuana/Cannabis
The American Public Health Association,
Being aware that cannabis/marijuana has been used medicinally
for centuries and that cannabis products were widely prescribed
by physicians in the United States until 1937;1,2 and
Being aware that "marijuana" prohibition began with the
Marijuana Tax Act of 1937 under false claims despite disagreeing
testimony from the AMA's representative;3,4 and
Being further aware that the Controlled Substances Act of 1970
completely prohibited all medicinal use of marijuana by placing
it in the most restrictive category of Schedule I, whereby drugs
must meet three criteria for placement in this category: 1) have
no therapeutic value, 2) are not safe for medical use, and 3)
have a high abuse potential;5 and
Being cognizant that the Drug Enforcement Administration's own
administrative law judge ruled in 1988 that marijuana must be
removed from Schedule I and made available for physicians to
prescribe;6-8 and
Knowing that 36 states have passed legislation recognizing
marijuana's therapeutic value;9,10 and
Also knowing that the only available access to legal marijuana
which was through the Food and Drug Administration's
Investigational New Drug Program has been closed by the Secretary
of Health and Human Services since 1992;11 and
Understanding that while synthetic Tetrahydrocannibinol (THC)
is available in pill form, it is only one of approximately 60
cannabinoids which may have medicinal value individually or in
some combination; and
Understanding that marijuana has an extremely wide acute
margin of safety for use under medical supervision and cannot
cause lethal reactions;6,32,34 and
Understanding that marijuana has been reported to be effective
in: a) reducing intraocular pressure in glaucoma;12,13 b)
reducing nausea and vomiting associated with chemotherapy;14-16
c) stimulating the appetite for patients living with AIDS
(acquired immunodeficiency syndrome) and suffering from the
wasting syndrome;17-19 d) controlling spasticity associated with
spinal cord injury and multiple sclerosis;20-25 e) decreasing the
suffering from chronic pain;26-28 and f) controlling seizures
associated with seizure disorders;29-31 and
Understanding that marijuana seems to work differently than
many conventional medications for the above problems, making it a
possible option for persons resistant to the conventional
medications;32,33 and
Being concerned that desperate patients and their families are
choosing to break the law to obtain this medicine when
conventional medicines or treatments have not been effective for
them or are too toxic;34,35 and
Realizing that this places ill persons at risk for criminal
charges and at risk for obtaining contaminated medicine because
of the lack of quality control; and
Realizing that thousands of patients not helped by
conventional medications and treatments, may find relief from
their suffering with the use of marijuana if their primary care
providers were able to prescribe this medicine; and
Concluding that cannabis/marijuana was wrongfully placed in
Schedule I of the Controlled Substances depriving patients of its
therapeutic potential;
Recognizing that APHA adopted a resolution (7014) on Marijuana
and the Law which urged federal and state drugs laws to exclude
marijuana from classification as a narcotic drug;36 and
Concluding that greater harm is caused by the legal
consequences of its prohibition than possible risks of medicinal
use; therefore
1. Encourages research of the therapeutic properties of
various cannabinoids and combinations of cannabinoids; and
2. Encourages research on alternative methods of
administration to decrease the harmfull effects related to
smoking; and
3. Urges the Administration and Congress to move
expeditiously to make cannabis available as a legal medicine
where shown to be safe and effective and to immediately allow
access to therapeutic cannibis through the Investigational New
Drug Program.
References:
1. Abel EA: Marihuana: The First Twelve Thousand Years.
New York: McGraw-Hill Book Company, 1982.
2. Mikuriya TH, Ed: Marijuana: Medical Papers 1839-1972.
Oakland, CA: Medi-Comp Press, 1973.
3. Bonnie RJ, Whitebread II, CH: The Marihuana Conviction:
A History of Marihuana Prohibition in the United States.
Charlottesville, VA: University Press of Virginia, 1974.
4. National Commission on Marihuana and Drug Abuse (RP
Shafer, Chairman): Marihuana: A Signal of
Misunderstanding. New York: The New American
Library, Inc., 1972.
5. Controlled Substances Act of 1970 (Pub.L. 91-513,
October 27, 1970, 21USC801 et seq.).
6. In the Matter of Marihuana Rescheduling Petition, Docket
86-22, Opinion, Recommended Ruling, Findings of Fact,
Conclusions of Law, and Decision of Administrative Law
Judge, September 6, 1988. Washington, DC: Drug
Enforcement Agency, 1988.
7. Randall RC: Marijuana, Medicine and the Law,
Washington, DC: Galen Press, 1988.
8. Randall RC: Marijuana, Medicine and the Law. (Volume
II) Washington. DC: Galen Press, 1989.
9. Alliance for Cannabis Therapeutics: No accepted medical
value?? ACT News, Spring, 1995;4.
10. Grinspoon L, Bakalar, JB: Marihuana as medicine: a plea
for reconsideration. JAMA. 1995;273(23):1875-l876.
11. Government extinguishes marijuana access, advocates
smell politics. JAMA. May 20, 1992;267(19):2673-2674.
12. Colasanti BK: Review: Ocular hypotensive affect of
marihuana cannabinoids: correlate of central action or
separate phenomenon. J Ocular Pharmacol.
1986;2(3):295-304.
13. Hepler RS, Frank IM: Marihuana smoking and intraocular
pressure. JAMA. 1971;2l7:1392.
14. Sallan SE, Zinberg NE, Frei III E: Antiemetic effect of
delta-9-tetrahydrocannabinol in patients receiving cancer
chemotherapy. New Engl J Med. 1975;293(16):795-797.
15. Sallan SE, Cronin C, Zelen M, Zinberg NE: Antiemetics
in patients receiving chemotherapy for cancer. New Engl
J Med. 1980;302:135-138.
16. Vinciguerra V, Moore T, Brennan E: Inhalation marijuana
as an antiemetic for cancer chemotherapy. NY State J
Med. 1988;88:525-527.
17. Nelson K, Walsh D, Deeter P. et al: A phase II study of
delta-9-tetrahydrocannabinol for appetite stimulation in
cancer-associated anorexia. J Palliative Care.
1994;1O(1):14-18.
18. Regelson W, Butler JR, Schultz J et al: Delta-9-THC as an
effective antidepressant and appetite stimulating agent in
advanced cancer patients. In Int Conf Pharmacol Cannabis,
Ed S Szara, MC Braude. Savannah: Raven, 1973.
19. Foltin RW, Fischman MW, Byrne MF: Effects of smoked
marijuana on food intake and body weight of humans
living in a residential laboratory. Appetite. 1988;11:1-14.
20. Clifford DB: Tetrahydrocannabinol for tremor in multiple
sclerosis. Ann Neurol. 1983:13:669-671
21. Malec J, Harvey RF, Cayner JJ: Cannabis effect on
spasticity in spinal cord injury. Arch Phys Med Rehab.
1982;35:198.
22. Meinck H, Schonle PW, Conrad B: Effect of cannabinoids
on spasticity and ataxia in multiple sclerosis. J Neurol.
1989;236:l20-l22.
23. Petro D: Marihuana as a therapeutic agent for muscle
spasm or spasticity. Psychosomatics. 198O;21:81-85.
24. Petro D, Ellenberger C: Treatment of human spasticity
with delta-9-tetrahydrocannabinol. J Clin Pharmacol.
1981;21:413S-416S.
25. Ungerleider JT, Andyrsiak T, Fairbanks L, et al: Delta-9-
THC in the treatment of spasticity associated with multiple
sclerosis.
26. Johnson MR, Melvin LS, Althius, TH et al: Selective and
potent analgesics derived from cannabinoids. J Clin
Pharmacol. 1981;21:271S-282S.
27. Maurer M, Henn V, Dittrich A, et al: Delta-9-
tetrahydrocannabinol shows antispastic and analgesic
effects in a single case double-blind trial. Eur Arch
Psychiatry Clin Neurosci. 1990;240:1-4.
28. Noyes Jr. R, Brunk SF, Avery DH, et al: The analgesic
properties of delta-9-tetrahydrocannabinol and codeine.
Clin Pharmacol Ther. 1975;l8(l):84-89.
29. Cunha JM, Carlini EA, Pereira AE, et al: Chronic
administration of cannabidiol to healthy volunteers and
epileptic patients. Pharmacology. 1980;21:175-185.
30. Feeney D: Marihuana use among epileptics. JAMA.
1976;235:1105.
31. Karler R, Turkanis SA: The cannabinoids as potential
antiepileptics. J Clin Pharmacol. 1981;21:437S-448S.
32. Institute of Medicine: Marijuana and Health. Washington,
DC: National Academy Press, 1982.
33. Mechoulam R, Ed: Cannabinoids as Therapeutic Agents.
Boca Raton, FL: CRC Press, 1986.
34. Cannabis clubs open for medicinal business. USA Today,
October 1, 1993:B1,B5.
35. Berger J: Mother's homemade marijuana: a plan to aid her
son leads to arrest and push for change. The New York
Times, October 11, 1993.
36. American Public Health Association Resolution No. 7014:
Marijuana and the Law, APHA Public Policy Statements,
1948-present, cumulative. Washington, DC: APHA, cur-
rent volume.
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