THE CASE FOR LEGALIZATION

The California Medical Association recently adopted a white paper
that is now our policy, which lays out a strong and thoughtful
position on medical cannabis (marijuana). As a family physician, I
want to be clear that CMA's position is not to make the substance
more readily available to the general public, but actually quite the opposite.

The problem is that states are decriminalizing medical cannabis on a
state-by-state basis, but without any groundwork for federal
regulations requiring warning labels, product consistency, purity and
reliably predictable dosage. In order for there to be a robust
regulatory system, we must first legalize medical cannabis on a federal level.

This isn't a decision that CMA came to lightly. "Promoting the
science and art of medicine, the care and well-being of patients, the
protection of the public health and the betterment of the medical
profession," are the words inscribed on the wall in the CMA lobby.
It's a mission that we as a community of physicians stand behind, and
the reason physicians like me participate in setting policy for CMA.

Our 500-member House of Delegates last fall called for the creation
of a technical advisory committee made up of experts to research,
evaluate and recommend a policy for our organization. For over a
year, this committee has met and combed through what available data
there is on medical cannabis and, last month, submitted its
conclusions to the CMA Board of Trustees.

Let's not pretend that medical and recreational cannabis aren't easy
to come by. The fact is, despite prohibition-like efforts,
unregulated cannabis continues to be easily accessible, often at low
cost. The most frightening concern to us as physicians is that it is
unregulated. We have no way of knowing the purity, strength or
chemical makeup of the substance that many of our patients are receiving.

Even with a physician recommendation, patients must go to a location
of their own discretion and choose their own doses and type of drug.
Under no circumstance would we ever send our patients to an
unregulated pharmacy and then also tell them to choose what they think is best.

Physicians are also put in the untenable position of violating
federal law if they do believe there would be a medical benefit to
their patient and then recommend it. Medical cannabis has been
decriminalized at a state level in California and in 16 other states,
but is still illegal federally.

Despite some limited research primarily done in other countries, the
effectiveness in treatment and the possible risks associated with
medical cannabis are still generally unclear. Currently, cannabis is
a Schedule I drug, which means it is very hard to do research and
evaluate it clinically the way we do any other potentially useful
medical treatment. CMA advocates for the rescheduling of medical
cannabis, just as the American Medical Association did in 2009, so
that we can better understand the potential benefits and risks. Until
we do, it's impossible to say whether or not recommending it is in a
patient's best interest.

Our problem with current policy is twofold. First, we need a
regulatory system in place at a federal level that allows for a
robust standardization of the drug. That is critical for patient
safety and the health of a large portion of the public that is using
this drug already. Second, we need to better understand the substance
itself and, until there is the ability to collect more comprehensive
and scientific evidence through legally sanctioned research, we can't
know what the risks or benefits are.