Medical &lt;i&gt;Cannabis&lt;/i&gt;: A guide to the clinical and legal landscapes

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Applied Evidence

Medical Cannabis: A guide to the clinical and legal landscapes

J Fam Pract. 2019 September;68(7):390-394,396-399

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References

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12. US Department of Justice, Drug Enforcement Administration, Diversion Control Division. Title 21 United States Code (USC) Controlled Substances Act. Subchapter I—Control and Enforcement. Part A—Introductory Provisions. §801. Congressional findings and declarations: controlled substances. www.deadiversion.usdoj.gov/21cfr/21usc/801.htm. Accessed July 10, 2019.

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15. United States Senate. The STATES Act. Senator Elizabeth Warren and Senator Cory Gardner. 2018. www.warren.senate.gov/imo/media/doc/STATES%20Act%20One%20Pager.pdf. Accessed July 10, 2019.

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Based on recent observational data from New York Cannabis dispensaries, cancer patients pursing Cannabis to treat chemotherapy-induced symptoms report that (1) either products with a high concentration of THC or products that contain THC and CBD in a 1:1 ratio are most effective and (2) products in 1:1 ratio of THC and CBD are most tolerable.

A legal system at oddsover the status of medical Cannabis

The core legal issue underlying medical Cannabis is a contradiction between federal and state laws.

At the federal level. The federal government regulates the lawful production, possession, and distribution of controlled substances through the Controlled Substances Act (CSA).¹² The CSA is the basis for categorizing certain plants, drugs, and chemicals into 5 schedules, based on the substance’s medical use, potential for abuse, and safety or dependence liability.¹³ Under the CSA, marijuana (along with substances such as heroin and methamphetamine) is categorized as Schedule I¹⁴; ie, the substance

has high potential for abuse,
has no accepted therapeutic medical use in the United States, and
lacks acceptable safety for use under medical supervision.

Despite waxing and waning efforts to protect states from federal prosecution, any use of a Schedule-1 substance violates federal law.¹⁵

Physicians are protected from prosecution or revocation of their prescriptive authority based on their First Amendment right to discuss medical marijuana with patients.

In June 2018, a bipartisan group of federal lawmakers introduced a bill designed to amend the CSA and guarantee the rights of states and territories to self-determine marijuana regulation. The bill established a so-called STATES (Strengthening the Tenth Amendment Through Entrusting States) Act that “amends the Controlled Substances Act (21 U.S.C. § 801 et seq.) so that—as states and tribes comply with a few basic protections—its provisions no longer apply to any person acting in compliance with state or tribal laws relating to the manufacture, production, possession, distribution, dispensation, administration, or delivery of marijuana.”¹⁵

Continue to: The bill was referred to the Senate...