Marijuana Policy in the US
Federal Stance on Marijuana
It is the Federal government’s position that marijuana be subjected to the same rigorous clinical trials and scientific scrutiny that the Food and Drug Administration (FDA) applies to all other new medications, a comprehensive process designed to ensure the highest standards of safety and efficacy.
It is this rigorous FDA approval process, not popular vote, that should determine what is, and what is not medicine. The raw marijuana plant, which contains nearly 500 different chemical compounds, has not met the safety and efficacy standards of this process. According to the Institute of Medicine (IOM), smoking marijuana is an unsafe delivery system that produces harmful effects.
The FDA has, however, recognized and approved the medicinal use of isolated components of the marijuana plant and related synthetic compounds. Dronabinol is one such synthetically produced compound, used in the FDA-approved medicine Marinol, which is already legally available for prescription by physicians whose patients suffer from nausea and vomiting related to cancer chemotherapy and wasting (severe weight loss) associated with AIDS. Another FDA-approved medicine, Cesamet, contains the active ingredient Nabilone, which has a chemical structure similar to THC, the active ingredient of marijuana. And Sativex, an oromucosal spray approved in Canada, the UK, and other parts of Europe for the treatment of multiple sclerosis spasticity and cancer pain, is currently in late-stage clinical trials with the FDA. It combines THC and another active ingredient in marijuana, cannabidiol (CBD), and provides therapeutic benefits without the “high” from the drug.
A number of States have passed voter referenda or legislative actions allowing marijuana to be made available for a variety of medical conditions upon a licensed prescriber’s recommendation, despite such measures’ inconsistency with the scientific thoroughness of the FDA approval process. But these state actions are not, and never should be, the primary test for declaring a substance a recognized medication. Physicians routinely prescribe medications with standardized modes of administration that have been shown to be safe and effective at treating the conditions that marijuana proponents claim are relieved by smoking marijuana. Biomedical research and medical judgment should continue to determine the safety and effectiveness of prescribed medications.
