The American Medical Association has taken a number of new positions on drug policy. These include advocating for psychedelics, opposing criminalization of kratom and calling for the end of the disparity in sentencing between crack cocaine and powder cocaine. They also support the inclusion of marijuana metabolites as part of employment-based drug testing.
The House of Delegates of the organization, which met in late July to discuss numerous resolutions and revise their stance on marijuana, declined to accept an additional measure that would have affirmed its opposition to legalization, while also implicitly acknowledging the benefits of regulating products derived from cannabis. Instead, the House of Delegates chose to continue its advocacy of prohibition without the newly-proposed regulatory language.
The AMA delegates voted a year ago to change its position on policy to support expungement past marijuana convictions for states that have legalized this plant.
The most recent meeting of the group covered a variety of topics related to drug policy.
The American Kratom Association (AKA) cheered the adoption of a new resolution that says people “who are using kratom only for personal use should not face criminal consequences”–though the measure also says that the substance should be “evaluated by the relevant regulatory entities for its appropriateness for sale and potential oversight via the Controlled Substances Act, before it can be marketed, purchased, or prescribed.”
The American Medical Association House of Delegates, in their 2023 meeting, rejected the extreme policy of criminalizing the use of kratom pic.twitter.com/jbElApXDJ8
American Kratom Association July 17, 2020 HTML0
The document also states that kratom should “be regulated by [Food and Drug Administration] and its safety and effectiveness should be determined in clinical trials before being marketed or prescribed for any condition.”
AKA believes that the adoption of the resolution is a positive step, as it moves away from an aggressive criminalization approach.
In relation to psychedelics the AMA delegates voted for a separate measure that advocates “for continued research into psychedelics and entactogenic drugs with the same scientific integrity, regulatory standards and ethical principles applied to other promising treatments in medicine.”
The Resolution advocates against the use of psychedelics or entactogenic compounds (such as MDMA or psilocybin) for treating any mental disorder, except those that have been approved by the FDA or prescribed within the context of approved research studies.
In a recent press release, AMA Immediate past President Jack Resneck Jr. stated that the organization believes that “scientifically valid and well controlled clinical trials are needed to assess the safety of new drugs and the effectiveness of those drugs. This includes the potential use of psychedelics in the treatment of psychiatric disorder.”
He said that the AMA understands the desire of lawmakers to address the mental illness crisis in the U.S. but that there are more straightforward solutions that do not impede drug safety assessment and regulation. For example, increasing coverage for evidence-based treatment and removing any barriers to accessing care is one such solution.
The delegates adopted an additional resolution which voices support for the continued inclusion of “cannabis-metabolite analyses in relevant drug test analysis performed for occupational or municipal purposes.”
AMA’s position, which is coming at a time when many institutions are removing marijuana testing requirements in the wake of state-level legalization, states that it supports cannabinoid testing for “pre-employment screening, post-accident testing, random testing and for cause” testing.
Members could also add to the existing marijuana positions by introducing a new resolution opposing legalization until research has proven its medical effectiveness and calling for warning labels and advertising restriction. The delegates decided instead to reaffirm their existing platform, which still opposes legalization and calls cannabis a dangerous drug. They also support social equity for states that have implemented the reform.
The proposed amendment would have included language that implicitly acknowledges the potential benefits of legalizing and regulating cannabis:
The AMA Council on Legislation should draft a state model law for states which have legalized medical’ or recreational marijuana. This would prohibit dispensaries selling marijuana if they made any misleading health claims and/or therapeutic ones, require dispensaries include a warning on the label of all marijuana products similar to alcohol and tobacco warnings, and ban advertising marijuana dispensaries in areas where children are present.
The resolution, while opposing legalization of cannabis, seems to acknowledge that, unlike the illicit market states that allow and control cannabis sales offer the opportunity to implement labeling and advertisement rules – though the measure was not ultimately approved.
The delegates did adopt a measure that expressed support for eliminating the disparity in sentencing between crack cocaine and powder cocaine, and for retroactive sentencing to those affected.
“The disparity is not based on science,” AMA Trustee Ilse Levine said. There are no significant differences in the pharmacology of these drugs. We need to not only stop the disparity but also go back to ensure justice for those convicted under unjust laws.
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AMA has published a series of studies on cannabis policy in the past year. The organization has been a vocal opponent to legalization for many years and worked to reverse a Mississippi voter-approved cannabis reform initiative.
For instance, published a study in March that showed the use of medical cannabis is associated with “significant improvement” in the quality of life of people with chronic pain or insomnia. These effects are also “largely sustained”.
In a separate AMA study published earlier this year, chronic pain patients receiving medical cannabis for more than a month experienced significant reductions in opioids.
AMA published research in late 2017 that linked state cannabis legalization to decreased opioid prescribing by certain cancer patients. Numerous studies have shown that cannabis legalization, and self-reported marijuana usage, are linked to decreased opioid prescribing.
Medical Marijuana is Linked to Lower Pain and Reduced Dependence on Opioids and Psychiatric Drugs, Another Study Shows
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