COLUMBUS, Ohio – After listening to 80 minutes of testimony late Wednesday afternoon – this time mostly from opponents – a State Medical Board of Ohio committee rejected medical marijuana for people with anxiety and autism spectrum disorder.

The four physicians who testified against medical marijuana for the conditions said the drug offers a momentary relief from anxiety but leads to panic attacks or worsening of anxiety over the long run for some patients. They all noted that marijuana – which is difficult to legally obtain to research because the federal government classifies it as a Schedule I controlled substance, the same category as heroin – hasn’t been thoroughly vetted in the U.S. though scientific methods as pharmaceutical drugs have been. And there were concerns about marijuana’s effects on children’s developing brains and potential liver damage for children and adults.

It is the second time the committee looked at the issue.

The first time, it recommended to the full, 12-member Medical Board cannabis for the conditions. But in June, the full board decided to delay the decision, after physicians from Nationwide Children’s Hospital in Columbus said they opposed children’s use of medical marijuana.

“There are over 100 chemicals that have potential activity or psychoactivity... over 100 chemical compounds,” said Anup Patel, a doctor of pediatric neurology at Nationwide Children’s and a professor at Ohio State University. “And so for us to be able to understand what each of those 100 compounds can do, unless we isolate them and study them individually, is very difficult and dangerous.”

Rebecca Baum, a development behavior pediatrician at Nationwide’s Center for Autism Spectrum Disorders, noted that Pennsylvania just approved medical marijuana for anxiety, but only for adults. The Ohio committee never considered the proposals for adults only, before rejecting them.

“Often when I bump into families that are at the end of their rope, what they need is access to supports like a home health aide, or in-home behavioral interventions,” Baum said. “Those are the pieces I would like to be able to help my families with. And that’s where I would like to see the efforts and resources diverted to.”

Michael Schottenstein, a Columbus-area child psychiatrist and Medical Board president, moved ahead with the vote without a quorum present. Some committee members had left early. To ensure there was a quorum, he appointed medical board members who were not committee members – but who were present to listen to discussion – to vote in their places.

“At the very least, approval feels premature to me at this time,” he said. “For me, for the Medical Board to approve an indication for use of medical marijuana, I feel like there should be consensus to do so. Among respected medical authorities, it’s clear that we don’t have that.”

He also reminded the committee of the Medical Board’s position that once a condition is added to the list of conditions, it cannot be removed if new evidence shows marijuana is ineffective.

Members of the Ohio General Assembly have said that interpretation was never their intention and they can amend the law if the Medical Board requests it.

“I can appreciate the pressures that these families are going through,” said Betty Montgomery, a medical board member and former Ohio attorney general. "But the doctors have been very persuasive that the evidence is not here yet. And if medicine is anything, it’s doing its best to be scientifically based.”

Thomas Rosenberger, associate director of the Ohio Medical Cannabis Cultivators Association, called the board’s action disappointing.

He said in 10 states, patients suffering from anxiety have access to medical marijuana. It’s explicitly a qualifying condition in New Jersey, Nevada and Pennsylvania.

Patients with autism in 22 states, plus Washington, D.C. and Puerto Rico, have access to medical marijuana. Last week, Illinois became the latest state to add autism.

Ohioans can return to the Medical Board in November with requests to expand the conditions list for medical marijuana. However, it’s unclear whether any will ever get added since the board is concerned about not being able to remove them.