Policy update

AOA supports review of cannabis classification

Schedule I status limits research, slows opioid response.

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The AOA supports a review of the classification of cannabis to facilitate advancement in clinical, public health, patient safety and health policy research, according to a resolution approved by the AOA House of Delegates.

The resolution also encourages the National Institutes of Health to support development of clinical research studies. The federal agency funded approximately $140 million in grants for cannabinoid research in fiscal year 2017, significantly less than the allocation for similar research of opiates and benzodiazepines. In fiscal year 2018, the NIH nearly doubled funding for research on opioid misuse/addiction and pain to $1.1 billion, yet the restrictions on cannabis medical research remain.

Thirty states and the District of Columbia have passed legislation to legalize medical cannabis usage when recommended by a physician. Despite this, as a Schedule I controlled substance, cannabis use in clinical trials requires special licensure and approval from the FDA, DEA and NIDA, obstacles other pharmaceuticals do not undergo.

“As a growing number of states change laws to facilitate the use of medical cannabis, it is important that we have a strong foundation of research that can support evidence-based policies,” said AOA President William S. Mayo, DO. “Given the proven efficacy at treating certain symptoms, reclassification could reduce barriers and increase our understanding of how to safely and effectively use cannabinoid drugs for our patients, many of whom do not respond to other treatments.”

The National Academies of Sciences, Engineering, and Medicine’s publication, The Health Effects of Cannabis and Cannabinoids, states there is “conclusive or substantial evidence that cannabis or cannabinoids are effective for treatment for chronic pain in adults, antiemetic in the treatment of chemotherapy-induced nausea and vomiting, and improving patient-reported multiple sclerosis spasticity symptoms.”

The Controlled Substance Act of 1970 defines a Schedule I substance as having no currently accepted medical use in treatment, yet under the FDA Compassionate Investigational New Drug Program, federally regulated medical cannabis is distributed to patients with “serious diseases and health issues for their lifetime.”

“This new policy is recognition of an evolving landscape and the need to support evidence-based policies that serve the needs of our patients,” said Dr. Mayo.

The resolution passed at the AOA’s House of Delegates meeting in Chicago in July.

Further reading:

New policy statement on physician-assisted suicide defeated

AOA President William S. Mayo, DO: ‘Go forward with confidence and embrace change.’

4 comments

  1. Darrin Mangiacarne, DO, MPH

    This is terrible of the AOA. Why should I be a member any longer now that membership is not tied to my board certification? How much is Big Cannabis paying the AOA for this policy? Medical Marijuana is a scam. Soft pathway to legalization.

    1. Joe Morgan

      You sir, have not studied the various cannabinoids of the cannabis plant. They hold cures that are astonishing.
      Too often critics are locked into the smoking of cannabis as the use of it. The entire plant less any smoke produced therefrom contains extremely helpful oils.
      I took 16 hours of medical cannabis CME and was educated in the use and abuse of cannabis. When you have studied for the 16 hours, see if you opinion has changed, and if not then you truly do not need to be a member of such a progressive organization as the AOA.

  2. David Zeiger.D.O.,FAAFP,ABOIM

    There has been no substantive improvement In patient care from the exorbitant expenses time studying as well as lost revenue ,time away from patient care and family for repetitive board examinations.
    By our very nature majority of physicians continue lifelong study via CME not just to meet liscensure and possibly institutional requirements but because we have an innate passion for learning and providing the best quality of healthcare to our patients
    Should those physicians both MD and DO GRANDFATHERED IN within their initial specialty board be removed from a greater than 30-40 year active practice?
    When lawyers are required to retake their BAR EXAM EVERY 7-10 years to continue calling themselves attorney then that will be an interesting discussion indeed!
    I accept the utility of an initial BOARD EXAM after one completes initially their specialty training just like the Bar Exam .
    More discussion of this issue can be found on number of websites ie American Association of Physician Specialists,Doximity,National Board of Physicians and Surgeons

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