Medical Use of Marijuana: Policy and Regulatory Issues

Publication Date: March 2002

Publisher: Library of Congress. Congressional Research Service

Author(s):

Research Area: Health

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Abstract:

In recent years, there has been much debate over whether marijuana, an illegal drug, can provide patients with a level of therapeutic relief comparable to existing pharmaceutical treatments. While this idea is hardly new, it is advanced by some proponents as deserving more scientific inquiry. Advocates for the medical use of marijuana contend that there is already sufficient scientific evidence to justify rescheduling marijuana under the Controlled Substances Act, a change that would give it the necessary legal recognition to be used for medicinal purposes. This has already occurred in the case of dronabinol, the synthetic form of the main psychoactive ingredient in marijuana, which has been available as an oral prescription drug since 1986 under its brand name Marinol.

To address these viewpoints, several comprehensive studies were done in the late 1990s to evaluate medicinal claims made for smoked marijuana and determine whether they are supported by convincing scientific evidence. In 1997, the NIH convened an Ad Hoc Group of Experts, which concluded that scientific evidence was insufficient to definitively assess marijuana's therapeutic potential and advised that the traditional scientific process should be allowed to evaluate the drug's use for certain disorders. In its 1999 report Marijuana and Medicine: Assessing the Science Base, the Institute of Medicine (IOM) concluded that the therapeutic effects of smoking marijuana were modest. IOM noted, however, that while marijuana's active components are potentially effective in treating certain medical conditions, they should be tested rigorously in controlled clinical trials.

The medical marijuana debate gained attention at the state level in 1996, when voters in California and Arizona approved ballot initiatives allowing doctors to prescribe the drug for therapeutic uses. In 1998, similar propositions were adopted in Alaska, Nevada, Oregon, and Washington, and reaffirmed in Arizona. Voters in Maine adopted a medical marijuana initiative in 1999. In 2000, medical marijuana was approved by voters in Colorado, reconfirmed in Nevada, and passed by the legislature in Hawaii. Federal health officials assert that these initiatives are part of a strategy to soften the nation's drug laws, and that public policy would be better served if science, rather than the ballot box, were used to judge the drug's utility.

Congress has responded to the state initiatives by passing various measures reconfuming marijuana's status as a Schedule I controlled substance with no currently accepted medical use in the United States. Congress has also said that it supports the existing federal legal process for determining the safety and effectiveness of drugs, and opposes efforts to circumvent this process by legalizing marijuana, or any other Schedule I controlled drug, for medical use without valid clinical evidence and the approval of the Food and Drug Administration. Although bills have been introduced in the 107th Congress to let doctors prescribe marijuana in states with laws that allow it, thus far Congress has opposed this idea until the drug's alleged therapeutic benefits have been confirmed scientifically. Until such studies are done, and more convincing data emerge, reports of marijuana's medicinal prowess will hinge as much on anecdotal evidence as the controlled clinical investigation.