An updated policy statement issued today by the American Academy of Pediatrics (AAP) calls for the rescheduling of the cannabis plant under federal law to better facilitate clinical trial research and to promote the plant’s eventual pharmaceutical development.
The new position statement resolves: “The AAP strongly supports research and development of pharmaceutical cannabinoids and supports a review of policies promoting research on the medical use of these compounds. The AAP recommends changing marijuana from a Drug Enforcement Administration schedule I (controlled substance) to a Schedule II drug to facilitate this (clinical) research.”
By definition, schedule I controlled substances are defined as possessing no “accepted medical use.” Clinical protocols involving cannabis are strictly controlled and require authorization from various federal agencies, including DEA, FDA, and the National Institute on Drug Abuse (NIDA) – the latter of which is designated under federal law as the sole provider of cannabis and/or organic cannabinoids for research purposes.
“A Schedule 1 listing means there’s no medical use or helpful indications, but we know that’s not true because there has been limited evidence showing [marijuana] may be helpful for certain conditions in adults,” said Dr. Seth Ammerman, who co-authored the new policy statement.
The newly amended AAP resolution also acknowledges that certain types of cannabinoid-therapy may provide benefits to adolescents, particularly those patient populations with treatment-resistant forms of epilepsy and chronic seizures. It states, “The AAP recognizes that marijuana may currently be an option for cannabinoid administration for children with life-limiting or severely debilitating conditions and for whom current therapies are inadequate.”
Last year the Epilepsy Foundation of America issued a similar resolution, citing preclinical data and observational reports of the potential therapeutic benefit of the cannabinoid cannabidiol (CBD) in pediatric patients and calling for “an end to Drug Enforcement Administration (DEA) restrictions that limit clinical trials and research into medical marijuana for epilepsy.”
Separate language in the AAP’s position statement also addresses the social use of the plant, affirming, “AAP strongly supports the decriminalization of marijuana use for both minors and young adults and encourages pediatricians to advocate for laws that prevent harsh criminal penalties for possession or use of marijuana.” By contrast, the statement acknowledges the group’s continued opposition to the legalization of marijuana, a policy change that it alleges poses “potential harm to children.”
Text of the amended AAP position paper is online here. A summary of resolutions issued by other medical and health organizations in regard to patient access to therapeutic cannabis is available on the NORML website here.
You don’t have to look too hard to see marijuana legalization efforts in several states that have a good chance of being approved by the voters in 2016. But many of those efforts are mired-down with competing proposals and competing proponents that could easily undermine the ability of supporters in those states to actually change public policy and end prohibition.
The inability to accept compromise in the interest of building a winning coalition threatens to turn some of these political opportunities into losing efforts. And that would be a disaster.
Specifically, different factions with different political demands are competing for control of the issue in Massachusetts, Ohio and California, three large and important states that would add enormous legitimacy and political credibility to the legalization movement, were they to approve legalization in 2016.
How do we move from prohibition to legalization in my state?
That’s one of the most asked questions we hear every week at NORML.
With national media attention focusing on the favorable experience with legalization in Colorado and Washington, and on the not-yet-implemented legalization programs recently adopted in Oregon and Alaska, anyone living in a state that continues arresting and jailing marijuana smokers would naturally wonder why their state seems to have missed out on the drive to end marijuana prohibition.
More accurately, many of those states are lagging behind in the legalization movement, but that, too, will change. As we continue to gather data demonstrating these new laws are working as intended, with few unintended consequences, the drive to end marijuana prohibition will soon reach every state in the union, and beyond. We are no longer debating theory and conjecture; we now have real-life experiences that can be evaluated, and that data resource will grow with each new state.
Patience and persistence still required
We all need to accept the reality that changing public policy is a complex process that requires financial resources, re-education and political organizing. Following more than 75 years of criminal prohibition, and “reefer madness” propaganda by our state and federal governments, many Americans — especially older Americans — hold a negative view of marijuana and marijuana smoking, believing it presents a risk to health or public safety.
Since all but a few of us have lived under prohibition for our entire lives, it is understandable that many would presume there must have been some justification for those tens of millions of marijuana arrests. Surely our own government would not needlessly wreak havoc on all those lives and careers without a good reason.
District of Columbia city officials this week moved forward with their intentions to implement a voter-approved municipal initiative depenalizing marijuana possession and cultivation offenses.
On Tuesday, city officials confirmed that Initiative 71 was transmitted to Congress for review. Under federal law, all District laws are subject to a 30-day review process by Congress, during which time members may take action to halt the law’s implementation.
Speaking to Roll Call this week, House Oversight and Government Reform Chairman Jason Chaffetz (R-Utah) said that language previously adopted by Congress in a December 2014 spending bill already prohibits DC officials from implementing I-71 and, thus, no further action by Congress is necessary. However, several District officials – including DC Delegate Eleanor Holmes Norton and DC Council Chairman Phil Mendelson – said that the federal provision in question in no way blocks city officials from enacting the new law.
“The District’s examination agrees with our analysis that the initiative was enacted when voters approved it and will take effect at the end of the 30-day congressional review period,” Del. Norton said in a statement.
Chairman Mendelson agreed, saying, “I happen to believe that the initiative was enacted so I think there’s no question that after the 30-day review it will be law.”
The District of Columbia Attorney General’s office has not yet commented in regard to how the District will respond if Congress does not address the initiative during the review process, Roll Call reported.
In November, 70 percent of District voters approved I-71, which removes criminal and civil penalties regarding the adult possession of up to two ounces of cannabis and/or the cultivation of up to six plants.
Separate DC municipal legislation – ‘The Marijuana Legalization and regulation Act’ – which seeks to regulate commercial cannabis production and retail sales, is also pending before the Council. If enacted, this legislation would also go before lawmakers for Congressional review and likely would force a federal challenge.
The inhalation of one marijuana cigarette per day over a 20-year period is not associated with adverse changes in lung health, according to data published online ahead of print in the journal Annals of the American Thoracic Society.
Investigators at Emory University in Atlanta assessed marijuana smoke exposure and lung health in a large representative sample of US adults age 18 to 59. Researchers reported that cannabis exposure was not associated with FEV1 (forced expiratory volume) decline or deleterious change in spirometric values of small airways disease.
Authors further reported that marijuana smoke exposure may even be associated with some protective lung effects among long-term smokers of tobacco. Investigators acknowledged, “[T]he pattern of marijuana’s effects seems to be distinctly different when compared to that of tobacco use.”
Researchers also acknowledged that habitual cannabis consumers were more likely to self-report increased symptoms of bronchitis, a finding that is consistent with previous literature. Separate studies indicate that subjects who vaporize cannabis report fewer adverse respiratory symptoms than do those who inhale combustive marijuana smoke.
Authors concluded, “[I]n a large representative sample of US adults, ongoing use of marijuana is associated with increased respiratory symptoms of bronchitis without a significant functional abnormality in spirometry, and cumulative marijuana use under 20 joint-years is not associated with significant effects on lung function.”
This study is the largest cross-sectional analysis to date examining the relationship between marijuana use and spirometric parameters of lung health.
A separate study published in 2012 in The Journal of the American Medical Association (JAMA) similarly reported that cumulative marijuana smoke exposure over a period of up to 7 joint-years (the equivalent of up to one marijuana cigarette per day for seven years) was not associated with adverse effects on pulmonary function.
A 2013 review also published in the Annals of the American Thoracic Society acknowledged that marijuana smoke exposure was not positively associated with the development of lung cancer, chronic obstructive pulmonary disease (COPD), emphysema, or bullous lung disease. It concluded: “[H]abitual use of marijuana alone does not appear to lead to significant abnormalities in lung function. Findings from a limited number of well-designed epidemiological studies do not suggest an increased risk of either lung or upper airway cancer from light or moderate use. … Overall, the risks of pulmonary complications of regular use of marijuana appear to be relatively small and far lower than those of tobacco smoking.”
You may view an abstract of the study, “Effects of marijuana exposure on expiratory airflow: A study of adults who participated in the US National Health and Nutrition Examination Study,” here.