Last week's request by Govs. Chris Gregoire and Rhode Island's Lincoln Chafee to have the federal government reclassify marijuana as medicine--which at first glance looked like unalloyed good news for those who support safe access for patients--is actually a double-edged sword.
Colorado has become the third state to ask the U.S. Drug Enforcement Administration to reclassify marijuana in a way that allows doctors to prescribe it as a medical treatment. The state asked the Drug Enforcement Administration to reclassify marijuana from Schedule 1, a category that includes heroin, to Schedule 2. The change would allow doctors to prescribe pot and pharmacies to fill marijuana prescriptions. The governors of Rhode Island and Washington have made similar requests.
Washington Gov. Chris Gregoire and Rhode Island Gov. Lincoln Chafee have filed a petition with the U.S. Drug Enforcement Administration asking the agency to reclassify marijuana so doctors can prescribe it and pharmacists can fill the prescription. The governors want the federal government to list marijuana as a Schedule 2 drug, allowing it to be used for medical treatment. Marijuana is currently classified a Schedule 1 drug, meaning it's not accepted for medical treatment and can't be prescribed, administered or dispensed.
Medical marijuana advocates are hoping state governments can succeed where their efforts have failed by asking federal authorities to reclassify pot as a drug with medical use. Recently, Colorado became the fourth state to ask the U.S. Drug Enforcement Administration to reclassify marijuana as a narcotic in the same league as heavyweight painkillers including oxycodone. The governors of Washington and Rhode Island filed a formal petition with the agency in November, and Vermont signed onto that request shortly afterward.
A disabled veteran has told an appeals court that the department of veteran affairs policy on medical marijuana has caused him pain and significant economic harm, in a development campaigners say is a positive step in the battle to push for the drug's reclassification. Michael Krawitz, one of five plaintiffs involved in a legal case before the court of appeal for the District of Columbia Circuit, told the Guardian that the VA denied him pain treatment after they discovered he had been prescribed medical marijuana while abroad.
Marijuana will continue to be considered a highly dangerous drug under federal law with no accepted medical uses, after a U.S. appeals court refused to order a change in the government's 40-year-old drug classification schedule. The decision keeps in place an odd legal split over marijuana, a drug deemed to be as dangerous as heroin and worse than methamphetamine by federal authorities, but one that has been legalized for medical use by voters or legislators in 20 states and the District of Columbia.
A medical marijuana advocate urged a federal appeals court to require the U.S. government to relax, or at least rethink, a more-than-40-year-old rule that treats marijuana as a highly dangerous drug with no medical value. Federal drug regulators "have failed to weigh the evidence" from a growing number of medical studies showing that marijuana is effective for relieving pain and nausea, said Joe Elford, counsel for Americans for Safe Access. (See also: Appeals Court hears case on medical value of marijuana)
The US Food and Drug Administration is reviewing the medical evidence surrounding the safety and effectiveness of marijuana, a process that could lead to the agency downgrading the drug's current status as a Schedule I drug, the most dangerous classification. "FDA conducts for Health and Human Services a scientific and medical analysis of the drug under consideration," FDA Press Officer Jeff Ventura said. "HHS then recommends to DEA that the drug be placed in a given schedule. DEA considers HHS’ analysis, conducts its own assessment, and makes a final scheduling proposal in the form of a proposed rule." (See also: Scheduling in the international drug control system)
Neuropathic pain affects between 5% and 10% of the US population and can be refractory to treatment. Opioids may be recommended as a second-line pharmacotherapy but have risks including overdose and death. Cannabis has been shown to be effective for treating nerve pain without the risk of fatal poisoning. The author suggests that physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids. This harm reduction strategy may reduce the morbidity and mortality rates associated with prescription pain medications.