I am honored and delighted to be able to publish here for the first time a new comprehensive piece written by Dr. Lester Grinspoon, Emeritus Professor of Psychiatry at Harvard Medical School, entitled “Cannabinopathic Medicine”. Dr. Grinspoon started writing this piece in 2012, when I was privileged to read an early draft and give editorial suggestions. He has been looking for a suitable venue for publishing it where it could be read widely. I am grateful that he agreed to allow me to use this blog space to share it. It is approximately 6,000 words and well worth a read.

First, a brief introduction. Dr. Grinspoon, who is in his eighties, is a great physician and researcher who has been a co-author, instructive mentor, and guide of mine. He is known for his pioneering work on the social and medicinal uses of cannabis, but before that, he made significant contributions such as introducing the use of lithium in the treatment of bipolar disorder, the starting of the Harvard Mental Health letter, and many other achievements such as senior psychiatrist at the Massachusetts Mental Health Center in Boston for 40 years, fellow of the American Association for the Advancement of Science and the American Psychiatric Association, founding editor of the The American Psychiatric Association Annual Review, and editor of the Harvard Mental Health Letter for fifteen years, to name a few. It is a wonderful turn of events that Dr. Grinspoon’s home state Massachusetts passed a voter initiative by wide margin to legalize the medicinal use of cannabis for patients with conditions that a physician believes may benefit from its use. That law went into effect this year and now, as of this month, Harvard Medical School-affiliated faculty, in collaboration with the Massachusetts Medical Society, are producing and editing AMA-certified continuing medical education online course series on the medicinal uses of cannabis, vindicating Dr. Grinspoon’s remarkable foresight from over 40 years prior.

(more…)

More than two weeks ago, with less fanfare than it deserved, the California Medical Association (CMA) voted to urge Governor Brown to petition the federal government to reclassify marijuana for medical use. Notably, the vote occurred two days ahead of oral arguments before a federal appeals court in a widely watched case concerning the reclassification of marijuana: Americans for Safe Access v. Drug Enforcement Administration. With this latest resolution from the CMA, pressure continues to build on the federal government to design policy based on sound science and to treat medical marijuana like the public health issue it is.

On October 14th, the 141st annual CMA House of Delegates voted unanimously to approve Resolution 103-12, urging the Governor to petition the Drug Enforcement Administration (DEA) to reschedule cannabis. The resolution was co-authored by Dr. Donald Abrams, Chief of Hematology-Oncology at San Francisco General Hospital and an eminent cannabis researcher in his own right, and Dr. Larry Bedard, president of the Marin Medical Society and a physician who has practiced emergency medicine for more than 30 years.

Resolution 103-12 requests that:

California Governor Jerry Brown petition the DEA and the Administration to reschedule marijuana based on the science that shows medicinal marijuana has ‘accepted medical use.’

The CMA resolution also emphasized that:

[M]edical decisions should be based on science, not politics.

(more…)

ASA v DEA plaintiffs (l-r) Michael Krawitz, Bill Britt, and Cathy Jordan receive the Courage Award from ASA.

On Tuesday evening, October 16th, Americans for Safe Access celebrated our 10th anniversary – and patients’ day in court – with an awards dinner honoring the brave warriors for medical cannabis access who have fought for all patients. (more…)

Just hours after the U.S. Court of Appeal for the D.C. Circuit heard oral arguments in the federal landmark case Americans for Safe Access v. Drug Enforcement Administration, the court ordered supplemental briefing on the issue of “standing.” In a rare move for a case that has been covered by the Associated Press, Reuters, CNN, Bloomberg News, Los Angeles Times, San Francisco Chronicle, Huffington Post, and others, the request for additional briefing indicates that the court is taking the issue of medical marijuana very seriously.

(more…)

This morning, the federal Appeals Court for the DC Circuit heard an appeal in the case called Americans for Safe Access v Drug Enforcement Administration. The case is an appeal of the DEA’s rejection of a petition filed in 2002 seeking to change the placement of marijuana as a Schedule I drug per the Controlled Substances Act. Based on the scientific evidence, ASA and our fellow plaintiffs feel that it is simply untrue that cannabis is a drug with a “high potential for abuse” and “without accepted medical use in treatment in the United States.” The hearing today offered a glimpse at the Court’s approach to this topic.

In front of a packed courtroom in Washington, the three-judge panel questioned ASA’s Chief Counsel Joe Elford and a federal lawyer about the merits of the scientific case, and the crucial legal issue of “standing.” Standing is a legal concept that restricts the right to sue to injured parties – people who are directly hurt by what they are fighting, and can get relief from a legal judgement. The issue of standing has been the reason why two prior appeals of the DEA’s classification of marijuana were rejected. In the past, patients have not been part of lawsuits against the Controlled Substances Act. The three judges were Merrick Garland, Karen Henderson, and Harry Edwards. (more…)

Tomorrow morning, the United States Court of Appeals in Washington DC will hear oral arguments in the landmark case, Americans for Safe Access v Drug Enforcement Administration. The case argues that the Drug Enforcement Administration acted irrationally in ruling that cannabis belongs in Schedule I of the Controlled Substances Act. The plaintiffs argue that this scheduling of marijuana has harmed them physically and financially. Below are the courageous patients and caregivers who have taken on the federal government in this important case.

William “Bill” Britt is a 52-year-old resident of Long Beach, California, who developed polio as a child, which caused him to have scoliosis, a fused left ankle, shortened left leg, and bone degeneration in his left hip. Mr. Britt also suffers from epilepsy, depression and insomnia, and uses marijuana to treat chronic pain in his leg, back, and hip. Marijuana has reduced Mr. Britt’s seizures and depression, and helps him sleep. Although Mr. Britt has taken prescription medication such as Marinol, Robaxin, Soma, and Xanax, none has proven as effective as marijuana. Read Mr. Britt’s post about why he is suing for safe access. (more…)

David Sack in his recent HuffPo post entitled “Marijuana: The New Snake Oil” challenges the status of medical marijuana, an increasingly popular alternative treatment, as “good medicine.” This question is particularly relevant because the Washington DC federal Court of Appeals will soon hear a lawsuit disputing the status of marijuana in Schedule I of the Controlled Substances Act, brought by Americans for Safe Access, a national member-based organizaton advocating for medical cannabis access and research. I am a doctor and a board member of the ASA Foundation, and I’m proud to present a medical professionals’ perspectives to the cause.
(more…)

After this blog was posted, prescribing medical professionals have signed a letter acknowledging that cannabis has medical use and should be rescheduled.

Most would agree with the premise that medical decisions regarding the appropriateness of a treatments are best left to doctors and other medicine prescribers in conjunction with patients. When it comes to herbal marijuana or cannabis, Congress and federal regulatory authorities have taken it upon themselves to judge across the board whether this substance has a currently accepted medical use in treatment in the United States, taking little or no input from clinicians who are responsible for actually providing treatments in this country.

Responding to the fact that nothing has been done to organize individual medical professionals to clearly state with one voice to the federal regulatory authorities that there are indeed currently accepted medical uses for cannabis (aka herbal marijuana) in the United States today, the medical prescribers on the board of ASA have started a sign-on letter to give the opportunity for their colleagues to stand and be counted. On Friday August 31st, in collaboration with fellow ASA board and staff, an open national-sign on letter was launched. This sign-on letter is in advance of the federal DC Circuit Court of Appeals hearing on October 16 when judges will consider questions regarding the appropriate classification of marijuana or cannabis in the drug scheduling framework.
(more…)

Two weeks of medical cannabis news in review.

• Congresswoman Introduces Bill to Protect Landlords of Compliant Medical Marijuana Businesses – ASA PR
• Michigan court rules localities cannot use federal law as an excuse for violating state laws protecting medical cannabis patients – The Detroit News
• Case on Benefits of Marijuana Heads to Court – Huffington Post
• LA Councilman Bill Rosendahl comes out at as a medical cannabis patient – LA Times
• Detailed Rules for Medical Marijuana Proposed in Maine – Kennebec Journal
• Pharmacy Shutdown Hoax Revealed – San Diego ASA
• Medical Marijuana Advocates Mourn Pot Club Closures with Mock Funeral – SF Weekly
• Arizona prosecutors urge Governor Jan Brewer to end the medical marijuana program, citing threats from federal prosecutors. The Governor declined to intervene – Arizona Republic

Jonathan Bair is ASA’s Social Media Director.

The article “Medical Marijuana: Clearing Away the Smoke” by Grant, Atkinson, Gouaux, and Wilsey published this month in Bentham Science’s 5-year-old, peer-reviewed, National Library of Medicine-indexed and internationally edited Open Neurology Journal represents a major milestone in the consolidation of knowledge and regularizing of clinical practice with regards to the medicinal use of cannabis.

The authors, well-established faculty members or associates at leading American academic medical centers, have yet again reviewed the gold-standard clinical trials-based evidence for medical uses of cannabis and related cannabinoids and have found:

1. that it is inaccurate to say that cannabis lacks medical utility or that information on its safety is lacking
2. that judgments on relative benefits and risks of cannabis and cannabinoids as medicines need to be viewed within the broader context of risk-benefit of other standard agents as well, many of which are associated with more serious adverse events, and
3. that enough information and clinical experience exists that an algorithm can be constructed to guide decision-making for physicians who may be considering recommending medicinal cannabis to patients with neuropathic pain, which the authors offer.

The authors conclude that “it will be useful if marijuana and its constituents can be prescribed, dispensed, and regulated in a manner similar to other medications that have psychotropic effects and some abuse potential” and state that marijuana’s Schedule I classification is scientifically untenable and the greatest barrier to forward movement in this area of medicine and medical science. This conclusion is made all the more noteworthy given that the article’s first, second, and fourth authors disclose at the end of the manuscript that they have served as consultants and received financial support from major pharmaceutical companies.

Americans for Safe Access is part of a lawsuit challenging the DEA’s scheduling of marijuana as without any currently accepted medical use in treatment in the United States. Download our lawsuit at http://AmericansForSafeAccess.org/downloads/CRC_Appeal.pdf

Sunil Aggarwal, M.D., Ph.D., PGY-3, is a Housestaff Physician at NYU Medical Center and conducts research on the medical geography of cannabis.