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Good morning, Chairman McIlhinney, Chairman Boscola, and members of the Senate Law and Justice Committee, I am Michael R. Fraser, PhD, CAE, Executive Vice President and Chief Executive Officer of the Pennsylvania Medical Society. Thank you for the opportunity to present the Medical Society’s views on Senate Bill 1182, which would legalize marijuana for medical use in Pennsylvania. To start, I would like to point out to the Committee that I am not a medical doctor. Unfortunately, our physician leadership was unable to attend today’s hearing and therefore I may have to refer any questions of a medical nature to our physician leadership.
Let me begin by acknowledging that the topic of medical marijuana and its legalization is extremely controversial and the Medical Society has carefully analyzed this issue in light of current scientific evidence. Our physician members are highly trained scientists who use the best of medical research to improve the health of all Pennsylvanians. Good, careful, scientific research takes time. Our current position on the subject of medical marijuana is as follows: further research is needed to build the body of knowledge and evidence base indicating its use by the medical community. This policy mirrors that of the national American Medical Association.
Let me also state in the strongest terms our opposition to the legalization of marijuana for recreational use. Marijuana is a dangerous drug and the public health and safety consequences attendant to its legalization for recreational use would be significant. We acknowledge that there are other states that have or are considering legalizing marijuana for recreational use. Our policy and our comments today should in no way be construed to apply to the legalization of marijuana for recreational use, which the Medical Society sees as an entirely different matter.
Again, to restate our position: we support increased scientific study on the medical use of marijuana. That is to say that until further research clearly demonstrates its safe and effective use in patient care, beyond any reasonable doubt, we urge caution and do not recommend marijuana for medical use in Pennsylvania. We also believe that to enable rigorous research on this topic, the federal Food and Drug Administration should re-examine marijuana’s status as a Schedule 1 controlled substance. Again, this position mirrors that of the national physician’s group, the American Medical Association.
We understand that the legalization of marijuana for medical use is a controversial topic. There is no national consensus: 20 states and the District of Columbia permit it. Only one of these twenty is a neighbor state – New Jersey.
We acknowledge that there is some evidence, primarily anecdotal, that marijuana may provide relief from nausea to cancer patients, and it is asserted that it may aid in the treatment of glaucoma and post-traumatic stress disorder. We are also aware of recent news stories that oil derived from cannabidiol has aided some suffers of Dravet syndrome, a rare form of epilepsy.
We in no way discount the very important experience of those whose lives have been reportedly improved by the use of medical marijuana or its derivates. Instead, we want to focus the discussion on building a better body evidence that allows physicians and other providers to make science-based decisions about the use of marijuana in the treatment of their patients.
Anecdotal evidence is just that – a real, valid, individual experience, but that cannot be applied to other’s experience with great degree of confidence. There is no sure way to know whether the observed changes in one case resulted from the administration of marijuana or from some other source, or combination of sources. It is entirely possible that a case we hear about in which an individual benefited from marijuana may be offset by the case we don't hear about where a patient saw no improvement and, even worse, where a patient suffered harm. Careful, rigorous scientific study is warranted on this important issue. Researchers should be encouraged to begin scientific study of this subject without the constraints of FDA Schedule 1 status.
The first maxim of medical practice that our physician members are taught is this: first do no harm. As they progress in their training they also learn that they are ethically bound to treat patients with the best that medical science recommends. And that is where we are today: at the intersection of the duty to do no harm, and the ethical duty to treat with the best available medicine. You can see why this is an issue requiring further study.
Many Medical Society physicians believe a compelling case exists for a serious scientific examination of the potential medical use of marijuana. That is why four years ago we supported, and continue to support, the American Medical Association in urging that marijuana’s status as a federal Schedule 1 controlled substance be reviewed, with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines, and alternate delivery methods.
The AMA and the Medical Society have also called for further adequate, well-controlled studies of marijuana and related cannabinoids in patients who have serious conditions for which preclinical, anecdotal, or controlled evidence suggests possible efficacy, and the application of such results to the understanding and treatment of disease.
Again, thank you for the opportunity to share our views on this important and controversial issue. I will be happy to answer any questions you may have or refer them to the appropriate member of our physician leadership with appropriate medical expertise.