| March 27, 2012
Marijuana is a plant that contains, among other things, cannabinoids. The potential medical application of cannabinoids has been explored for many years and, based on the evidence so far, is deserving of continued study with respect to risks, benefits, and potential applications. This was the conclusion of both the American Medical Association and ASAM when the two groups, separately, composed white papers addressing the issue.
We left many questions unanswered. These questions largely deal with legal issues which many of our state legislatures are now addressing. Should marijuana be a legal regulated drug akin to alcohol and tobacco products? What actions should be taken with respect to those who possess, use, and sell marijuana? What should be done about physicians who write recommendations or who otherwise approve patient applications for “medical marijuana?”
The California Society of Addiction Medicine (CSAM) composed a paper titled “Youth First” over the last year. The paper was circulated among CSAM members and has gained significant traction within the group. Essentially, CSAM is distressed about physicians being utilized as middlemen between the marijuana industry and consumers, and the harm to young people that will likely arise from increased availability of marijuana if legalized. CSAM believes that marijuana legalization is likely to pass within the near future and constructed their paper within that context. Their recommendation is to restrict sales to adults only, and to use tax revenues to prevent child and adolescent marijuana use, and provide early intervention treatment to youth with marijuana-induced problems.
CSAM’s paper was circulated outside of the organization and ASAM was asked by the media its position regarding the issues raised by “Youth First.” Although we have older policies that allowed us to say that we are opposed to legalization of marijuana, we do not have more extensive policy that would permit the questions such as those asked above to be fully addressed. Further pressure upon us to elaborate on our earlier policy comes with ASAM’s bylaws, which state that a state chapter cannot have policy at odds with ASAM’s own policies.
I therefore asked Drs. Teitelbaum and Kraus, our Public Policy Committee chairs, to set up a writing committee specifically tasked with writing what will be a second marijuana-focused white paper. They in turn have asked Drs. DuPont and Barthwell to chair the committee, which will specifically include two CSAM representatives. In my initial discussion with the group, I noted the importance of our paper being based upon available evidence rather than opinion. I also noted, given our national status and the wide range of opinions present on these issues, the importance of developing consensus. To that end, if there are topics on which we cannot reach consensus, I believe we should continue to have no policy.
There are parallels within other medical organizations on other issues. For example, the American Medical Association has never taken a stand with respect to abortion. The AMA recognizes that this is a divisive issue with opinions driven by multiple domains, many of which lie outside the scientific purview. It may be that the ultimate question as to legalization of marijuana will face similar conflict. On the other hand, if ASAM cannot reach consensus as to whether a plant with known addictive and other health-related risks should be legalized, that alone will send a message.
Your input, comments, and suggestions are welcome. Feel free to post your thoughts here or to send an email. While we may not respond to each message, you can be certain your comments will be considered as the writing committee goes about its work.