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ASAM Issues New Policy Statement on Marijuana, Cannabinoids and Legalization

by Susan Awad | September 25, 2015

On September 21, ASAM's Board of Directors approved a new Policy Statement on Marijuana, Cannabinoids and Legalization. The new statement is the result of a months-long research and writing process spearheaded by Drs. Michael Miller, Norm Wetterau and Jeff Wilkins, and overseen by ASAM's Public Policy Committee.

As more and more states move to legalize marijuana and other cannabis products for either "medicinal" or adult recreational use, and as Congress considers bills intended to facilitate research into the potential therapeutic effects of marijuana, it was clear that ASAM needed an updated policy statement that speaks to the broad public health and safety aspects of such measures. With legalization ballot initiatives expected in several states in 2016, the development of this new statement could not be more timely.

The new statement details the latest research on the health and public health effects of marijuana use, as well as the potential medicinal benefits of particular cannabinoids. It also discusses the political and social attitudes about marijuana that inform the current debate around legalization, and differentiates efforts to decriminalize marijuana use with efforts to legalize marijuana for commercial distribution and sale. 

The policy recommends a balanced response to legalization efforts, offering support for decriminalization and access to treatment as well as detailing several public health and safety measures that should be instituted by jurisdictions that legalize marijuana to protect vulnerable populations. It also includes recommendations to encourage basic and health services research on marijuana and marijuana use, while reaffirming ASAM's support of our current research-based pharmaceutical development, approval and regulatory process.

To read the full policy statement, please click here.

9 comments

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  1. Ted L., LCSW Dec 03, 2015 - 02:24 PM
    Great read and very informative! Thanks for keeping us updated with the relative politics on Cannabis!  <a href="http://saltlakecitydrugrehab.org"></a>
  2. Harold Bacchus, MD, FAAFP. Oct 30, 2015 - 06:44 PM

    a most eloquent discourse, fact based, from triple boarded Dr. Rick Chavez.

  3. Gerald Maloney DO Oct 19, 2015 - 10:32 PM
    I am a new member to ASAM and a practicing medical toxicologist.  I agree with the above statements about vote pandering leading the legalization effort.  In the states that have legalized marijuana the number of ED-related visits have spiked.  Some of the marijuana products that are out there resemble cookies or candy and have resulted in pediatric ingestions (data from WA state).  There is a difference between decreasing criminal sanctions on use and allowing full legal use.  I think we (ASAM, ACEP, ACMT, AMA, etc) need to be a clear voice stating the differences between medicinal use of marijuana and unfettered full legal use.
  4. Lorne Cross, MD Oct 19, 2015 - 01:53 PM
    Thank you to Dr. Chavez for the insightful response. I practice in Oregon and I am seeing a significant increase in patient problems related to marijuana use. It should be an area of concern for all physicians.
  5. Mark Stevens, MD Oct 15, 2015 - 10:32 PM

    I agree with Dr. Chavez that marijuana has become an untouchable subject politically. Everyone wants the youth vote and that is the demographic most apt to push for legalization. I am an addictionolgist and a family practitioner. I read extensively, as we all do, and I am tracking the debate and what studies are available. When the subject of marijuana comes up with my patients, I relate to them the story of "Howie" and a half a dozen similar characters from my childhood. Howie (and others) were daily pot smokers through highschool, probably before and beyond as well. At our 30th highschool reunion, Howie was delivering pizzas for a living. As I recall, the same job he had in highschool. 2 of the other folks were dead and a couple more were unemployed and/or disabled. I don't have to wait for the definitive studies to show that marijuana is damaging in the short and long-terms. We can all conjure an image of a "Howie" when we think about the term "pothead". We just need to convey that to the folks we serve and make it stick.

  6. Jim Bean MD Oct 06, 2015 - 04:01 PM

    I would prefer having DEA make it a controlled substance and only certified physicians could prescribe. That would better than what is happening, an addictive substance under no control. 

  7. RICK CHAVEZ, M.D. Oct 05, 2015 - 04:26 AM

    We regulate opiates, and all controlled drugs, but why not
    marijuana?  Marijuana is politically untouchable. Talking about It's impact on our society is like talking to people about politics and religion.  The medical
    establishment, politicians, and even our free press are all afraid to talk about the potential negative impact of marijuana on our communities.  As a pain medicine and addiction specialist I am required to balance the safe use of controlled medications with my patient's chronic pain clearly in their medical record.  If I don't have a legitimate reason to prescribe a drug, and if I don't see my patient regularly, the medical board can remove my license to practice
    medicine.  Yet the "doctors" who prescribe marijuana give it out like candy with a license to use for 1 year without follow up evaluation for seemingly minor complaints like hangnails, anxiety, depression, and gastritis without any repercussions. Yet, believe it or not, as a certified pain and addiction
    physician I cannot prescribe it. Not that I believe that it is commonly beneficial.  Only about 1-2 % of my patients get benefit from marijuana.  I have an open discussion with my pain patients about ALL drugs available.  If marijuana is beneficial in treating chronic pain, etc, then my patient is given the option, but the majority of my pain patients find insufficient benefit.

    Currently, up to 10-20% of high school students have used marijuana in the last month. We know that 60% of regular users wont graduate, and a segment of users move on
    to gateway drugs.  While marijuana is not a gateway drug necessarily, for 10% it is a gateway drug.  The brain is still developing until age 25, and we know that IQ is reduced by up to 8% irreversibly in users under age 25.  Additionally, it doubles the risk of schizophrenia, depression, and anxiety in the young (under 25). Few of my pain patients choose marijuana because it is a poor pain killer. Users always point to the windfall $58 million dollar tax revenue that COLORADO collects, yet no one reveals that this is just a drop in the bucket compared to the cost of treating
    all the societal ills such as mental heath problems, unemployment, welfare, birth defects, addiction, high school dropout, crime, etc.  All I know is that I have mothers in my
    office who are desperate because "little Johnny" no longer cares about anything else but their "bong." 

    Californians think our government will have it all under control despite the fact that currently AMERICANS consume 80% of all of the narcotics and controlled drugs in the world, yet we represent only 4% of the world's population. Americans are not like any other society on earth, Americans are a different breed.  We shouldn't worry about China, terrorists, or Putin bringing our 
    society down, we are doing a terrific job of that ourselves.

    I hope that ASAM has the courage to tell the truth and make sure that the discussion with our leaders recommends what we should do, after all, all of us have children and grand children and our leadership in this discussion will affect generations for decades.  We know that THC / Cannibinoids have a role in therapy, but I guarantee that when we create safe medications, the "bong" will still win out. 

    Most countries have decriminalized Marijuana, and that is good.  Everyone should know that only 4 countries in the world have actually legalized Marijuana and they are 5 states in the U.S., Uruguay, North Korea, Spain, Bangladesh.  The Netherlands restricts personal use but there is no widespread sales.  The Point is that every other country in the world sees the dangers of widespread use and have chosen to decriminalize MARIJUANA, but we are going the route of legalization and that is dangerous for our children.  ASAM should take on the leadership regarding this issue before it is too late. 

    Rick Chavez, M.D.

    Board Certified by the American Board of Addiction Medicine, the American Board of Pain Medicine, and the American Board of Family Medicine.  10/04/2015



  8. John J Verdon Jr MD FASAM DLFAPA Oct 04, 2015 - 08:38 PM

    Mike Superb thank you and your crew

     We are in your debt  Jack Verdon

     

     

  9. Dr Ahmed Omar Al Agib Oct 04, 2015 - 03:55 PM

    Thank you for this fruitful information 

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