American Journal of Public Health
March 1996, Vol. 86, No. 3, pp. 441-442
9513: Access to Therapeutic Marijuana/Cannabis
The American Public Health Association, Being aware that
cannabis/marijuana has been used medicinally for centuries and
that cannabis products were widely prescribed by physicians in
the United States until 1937;1,2 and Being aware that
"marijuana" prohibition began with the Marijuana Tax
Act of 1937 under false claims despite disagreeing testimony from
the AMA's representative;3,4 and Being further aware
that the Controlled Substances Act of 1970 completely prohibited
all medicinal use of marijuana by placing it in the most
restrictive category of Schedule I, whereby drugs must meet three
criteria for placement in this category: 1) have no therapeutic
value, 2) are not safe for medical use, and 3) have a high abuse
and Being cognizant that the Drug Enforcement Administration's
own administrative law judge ruled in 1988 that marijuana must be
removed from Schedule I and made available for physicians to
and Knowing that 36 states have passed legislation recognizing
marijuana's therapeutic value;9,10 and Also knowing that
the only available access to legal marijuana which was through
the Food and Drug Administration's Investigational New Drug
Program has been closed by the Secretary of Health and Human
Services since 1992;11
and Understanding that while synthetic Tetrahydrocannibinol (THC)
is available in pill form, it is only one of approximately 60
cannabinoids which may have medicinal value individually or in
some combination; and Understanding that marijuana has an
extremely wide acute margin of safety for use under medical
supervision and cannot cause lethal reactions;6,32,34 and Understanding that
marijuana has been reported to be effective in: a) reducing
intraocular pressure in glaucoma;12,13
b) reducing nausea and vomiting associated with chemotherapy;14-16 c) stimulating the
appetite for patients living with AIDS (acquired immunodeficiency
syndrome) and suffering from the wasting syndrome;17-19 d) controlling
spasticity associated with spinal cord injury and multiple
e) decreasing the suffering from chronic pain;26-28 and f) controlling
seizures associated with seizure disorders;29-31 and Understanding
that marijuana seems to work differently than many conventional
medications for the above problems, making it a possible option
for persons resistant to the conventional medications;32,33
and Being concerned that desperate patients and their families
are choosing to break the law to obtain this medicine when
conventional medicines or treatments have not been effective for
them or are too toxic;34,35 and Realizing that this
places ill persons at risk for criminal charges and at risk for
obtaining contaminated medicine because of the lack of quality
control; and Realizing that thousands of patients not helped by
conventional medications and treatments, may find relief from
their suffering with the use of marijuana if their primary care
providers were able to prescribe this medicine; and Concluding
that cannabis/marijuana was wrongfully placed in Schedule I of
the Controlled Substances depriving patients of its therapeutic
potential; Recognizing that APHA adopted a resolution (7014) on
Marijuana and the Law which urged federal and state drugs laws to
exclude marijuana from classification as a narcotic drug;36 and Concluding that
greater harm is caused by the legal consequences of its
prohibition than possible risks of medicinal use; therefore
1. Encourages research of the therapeutic properties of
various cannabinoids and combinations of cannabinoids; and
2. Encourages research on alternative methods of
administration to decrease the harmfull effects related to
smoking; and 3. Urges the Administration and Congress to
move expeditiously to make cannabis available as a legal medicine
where shown to be safe and effective and to immediately allow
access to therapeutic cannibis through the Investigational New
Abel EA. Marihuana: The First Twelve
Thousand Years. New York: McGraw-Hill Book
Mikuriya TH, ed. Marijuana: Medical Papers
1839-1972. Oakland, CA: Medi-Comp Press, 1973.
Bonnie RJ, Whitebread II, CH. The Marihuana
Conviction: A History of Marihuana Prohibition in the
United States. Charlottesville, VA: University
Press of Virginia, 1974.
National Commission on Marihuana and Drug Abuse (RP
Shafer, Chairman). Marihuana: A Signal of
Misunderstanding. New York: The New American
Library, Inc., 1972.
Controlled Substances Act of 1970 (Pub.L. 91-513,
October 27, 1970, 21USC801 et seq.).
In the Matter of Marihuana Rescheduling Petition,
Docket 86-22. Opinion, Recommended Ruling, Findings
of Fact, Conclusions of Law, and Decision of
Administrative Law Judge. September 6, 1988.
Washington, DC: Drug Enforcement Agency, 1988.
Randall RC. Marijuana, Medicine and the Law.
Washington, DC: Galen Press, 1988.
Randall RC. Marijuana, Medicine and the Law.
Vol. II. Washington. DC: Galen Press, 1989.
Alliance for Cannabis Therapeutics: No accepted
medical value?? ACT News. Spring,
Grinspoon L, Bakalar, JB. Marihuana as
medicine: a plea for reconsideration. JAMA.
Government extinguishes marijuana access, advocates
smell politics. JAMA. May 20,
Colasanti BK. Review: Ocular hypotensive affect
of marihuana cannabinoids: correlate of central action or
separate phenomenon. J Ocular Pharmacol.
Hepler RS, Frank IM. Marihuana smoking and
intraocular pressure. JAMA.
Sallan SE, Zinberg NE, Frei III E. Antiemetic
effect of delta-9-tetrahydrocannabinol in patients
receiving cancer chemotherapy. New Engl J Med.
Sallan SE, Cronin C, Zelen M, Zinberg NE.
Antiemetics in patients receiving chemotherapy for
cancer. New Engl J Med. 1980;302:135-138.
Vinciguerra V, Moore T, Brennan E. Inhalation
marijuana as an antiemetic for cancer chemotherapy.
NY State J Med. 1988;88:525-527.
Nelson K, Walsh D, Deeter P. et al. A phase II
study of delta-9-tetrahydrocannabinol for appetite
stimulation in cancer-associated anorexia. J
Palliative Care. 1994;1O(1):14-18.
Regelson W, Butler JR, Schultz J et al.
Delta-9-THC as an effective antidepressant and appetite
stimulating agent in advanced cancer patients. In Int
Conf Pharmacol Cannabis. S Szara, MC Braude,
eds. Savannah: Raven, 1975.
Foltin RW, Fischman MW, Byrne MF. Effects of
smoked marijuana on food intake and body weight of humans
living in a residential laboratory. Appetite.
Clifford DB. Tetrahydrocannabinol for tremor in
multiple sclerosis. Ann Neurol.
Malec J, Harvey RF, Cayner JJ. Cannabis effect
on spasticity in spinal cord injury. Arch Phys
Med Rehab. 1982;35:198.
Meinck H, Schonle PW, Conrad B. Effect of
cannabinoids on spasticity and ataxia in multiple
sclerosis. J Neurol. 1989;236:l20-l22.
Petro D. Marihuana as a therapeutic agent for
muscle spasm or spasticity. Psychosomatics.
Petro D, Ellenberger C. Treatment of human
spasticity with delta-9-tetrahydrocannabinol. J
Clin Pharmacol. 1981;21:413S-416S.
Ungerleider JT, Andyrsiak T, Fairbanks L, et
al. Delta-9-THC in the treatment of spasticity
associated with multiple sclerosis.
Johnson MR, Melvin LS, Althius, TH et al.
Selective and potent analgesics derived from
cannabinoids. J Clin Pharmacol.
Maurer M, Henn V, Dittrich A, et al.
Delta-9-tetrahydrocannabinol shows antispastic and
analgesic effects in a single case double-blind
trial. Eur Arch Psychiatry Clin Neurosci.
Noyes Jr. R, Brunk SF, Avery DH, et al. The
analgesic properties of delta-9-tetrahydrocannabinol and
codeine. Clin Pharmacol Ther.
Cunha JM, Carlini EA, Pereira AE, et al.
Chronic administration of cannabidiol to healthy
volunteers and epileptic patients. Pharmacology.
Feeney D. Marihuana use among epileptics.
Karler R, Turkanis SA. The cannabinoids as
potential antiepileptics. J Clin Pharmacol.
Institute of Medicine. Marijuana and Health.
Washington, DC: National Academy Press, 1982.
Mechoulam R, ed. Cannabinoids as Therapeutic
Agents. Boca Raton, FL: CRC Press, 1986.
Cannabis clubs open for medicinal business. USA
Today. October 1, 1993:B1,B5.
Berger J. Mother's homemade marijuana: a plan
to aid her son leads to arrest and push for change.
The New York Times. October 11, 1993.
American Public Health Association Resolution No.
7014: Marijuana and the Law. APHA Public Policy
Statements, 1948-present, cumulative. Washington,
DC: APHA, current volume.
The American Public Health Association (APHA) is the oldest
and largest organization of public health professionals in the
world. The APHA represents more than 50,000 members and has
been effectively influencing policies and setting priorities in
public health since 1872. For more information on the APHA
medical marijuana resolution, please contact Jeff Jacobs of the
American Public Health Association @ (202) 789-5600.