Cannabis policy should be guided by evidence, not the ballot – American Medical Association

The AMA and the Mississippi State Medical Association (MSMA) are urging Mississippians to vote “No” this Nov. 3 on Initiative Measure 65, which would amend the state constitution to legalize cannabis for medicinal use and subject the state board of health to unworkable regulatory requirements.

The measure would allow patients to possess up to 2.5 ounces of marijuana as a treatment for at least one of 22 conditions.

In addition to the lack of rigorous medical evidence to support cannabis as a medical treatment, Initiative Measure 65 would require the Mississippi State Department of Health (MSDH) to create new complex agriculture and revenue programs—diverting resources from its public health mission.

“Physicians advocate for evidence-based solutions,” said MSMA President Mark Horne, MD. “When we were asked to review Initiative 65, it was immediately clear that this is an effort focused on generating profits for an industry that has no ties to the medical or health care community in Mississippi.”

Wrong approach

Dr. Horne and AMA President Susan R. Bailey, MD, emphasized that, rather than a political process, what’s needed to approve new drugs is a scientific process that includes well-controlled clinical trials.

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“Amending a state constitution to legalize an unproven drug is the wrong approach,” Dr. Bailey said. “Early data from jurisdictions that have legalized cannabis are concerning, particularly around unintentional pediatric exposures that have resulted in increased calls to poison control centers and emergency department visits, as well as an increase in traffic deaths due to cannabis-related impaired driving.”

These positions align with AMA policy, which states that:

  • Scientifically valid and well-controlled clinical trials conducted under federal investigational new drug applications are necessary to assess the safety and effectiveness of all new drugs, including potential cannabis products for medical use.
  • Cannabis for medicinal use should not be legalized through the state legislative, ballot initiative, or referendum process.

Additional policy was adopted at the 2019 AMA Interim Meeting that established an AMA Cannabis Task Force to evaluate and disseminate relevant scientific evidence to health care providers and the public.

Evidence shortage

MSMA past President Randy Easterling, MD, represents his state on the task force, and noted the lack of scientific evidence to support cannabis for medical use.

“Of the many diseases and ailments listed in Initiative 65 where ‘medical marijuana’ could be used as treatment, there is little to no credible scientific evidence establishing this as a trusted alternative to FDA-approved pharmaceuticals,” Dr. Easterling said. “Without the rigorous testing of medications, using unverified treatment options poses a great threat to those patients needing reliable relief for their condition.”

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Mississippi State Health Officer Thomas E. Dobbs III, MD, MPH, said Initiative 65 would put the MSDH in charge of a program to distribute a substance that remains illegal under federal law while not generating any additional public health funding.

“Initiative 65 would inappropriately require us to divert already-limited resources for the benefit of an incredibly complicated industry,” Dr. Dobbs said. “Fees and charges generated would only be available to support the marijuana program. No revenue would be available to support the state, communities or public health efforts.”

 

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