ASA in the News

By Steven Nelson US News and World Report 

The American Medical Association is hardly a pioneering advocate of more liberal marijuana laws, but this week the largest organization representing U.S. doctors asked Congress to grant immunity to physicians who participate in state medical marijuana programs.

The association has not yet endorsed marijuana’s use as medicine, but it has urged research into the drug’s potential to treat a wide range of conditions and supported “unfettered” patient-doctor discussions that do not “subject either party to criminal sanctions.”

The association's new resolution calls for “legislation ensuring or providing immunity against federal prosecution for physicians who certify that a patient has an approved medical condition or recommend cannabis in accordance with their state’s laws.”

Association spokeswoman Stephanie Johnson says the policy was approved by the AMA's more than 500-member House of Delegates, which wrapped up its annual meeting in Chicago on Wednesday.

"It doesn't change the marijuana policy whatsoever," says Dr. Stuart Gitlow, an association delegate who publicly advocates against relaxing marijuana laws.

Gitlow says current AMA policy "basically says there's no such thing as medical marijuana" and despite the call for immunity he says he may be willing to testify against doctors who help patients acquire it.

"I think all of us recognize that physicians can – and will – certainly have difficulties if they recommend marijuana to a patient who then gets in trouble," he says. "That physician will most certainly have grave liability risks, and I imagine no professional medical organization will be interested in coming to his or her rescue. Quite a few of us, in fact, will be willing to provide expert consultation for the prosecution."

Marijuana possession for any reason outside limited research is a federal crime, but more than half of states allow marijuana or marijuana-derived compounds for medical use under local law. Four states and the nation’s capital have laws allowing recreational use of the drug.

Federal prosecutors and anti-drug agents generally allow states to establish their own policies, though they retain the legal right to intervene and occasionally do so.

The House of Representatives approved a spending prohibition last year to prevent the Department of Justice from going after state-legal medical marijuana programs. The measure, folded into a spending deal that became law, was passed again in a broad 242-186 vote last week.

More comprehensive legislation, such as the Compassionate Access, Research Expansion and Respect States (CARERS) Act from Sens. Rand Paul, R-Ky., Cory Booker, D-N.J., and Kirsten Gillibrand, D-N.Y., would permanently put medical marijuana on a more sound legal footing.

In the meantime, doctors cannot legally prescribe marijuana because it’s a Schedule I drug, a controversial federal classification that means it has no accepted medical value. In states that allow medical marijuana, doctors “recommend” it to patients without FDA approval to treat a diverse range of conditions, from seizures to severe pain and lack of appetite.

Marijuana may at some future point be reclassified as a Schedule II drug or lower, opening the door to FDA-approved use and legitimate prescription. In addition to the high-profile legislative push, the change could be made administratively. The FDA currently is conducting an eight-factor analysis of whether the drug is properly listed.

Kevin Sabet, a former presidential drug policy adviser who now leads the anti-marijuana legalization group Smart Approaches to Marijuana, says the association’s action isn’t a big deal.

“I think it is unremarkable that doctors are simply saying that as a whole they should be protected,” he says. “There are a very small number of doctors who recommend marijuana in the first place.”

Steph Sherer, executive director of the pro-medical marijuana group Americans for Safe Access, meanwhile, welcomed the policy statement.

"Thousands of doctors across the U.S. are recommending medical cannabis to their patients and, with the number of states that allow at least some legal use of cannabis now up to 39 and the District of Columbia, more doctors are able to explore cannabis as a treatment option,” she says.

“[The] resolution on legal immunity for doctors is the appropriate role for a physicians professional organization to play in this debate and reflects the needs and concerns of its membership."