In an historic shift, the country's largest physician group, the American Medical Association (AMA), has reversed its long-held position that marijuana has no medical value. The group instead adopted a new policy position on medical marijuana, calling for a review of marijuana's status as a Schedule I drug with no accepted medical use under the federal Controlled Substances Act. The AMA had previously recommended that marijuana be retained in Schedule I.

The AMA adopted a report drafted by the AMA Council on Science and Public Health (CSAPH) entitled, "Use of Cannabis for Medicinal Purposes," which affirmed the therapeutic benefits of marijuana and called for further research. "Short term controlled trials indicate that smoked cannabis reduces neuropathic pain, improves appetite and caloric intake especially in patients with reduced muscle mass, and may relieve spasticity and pain in patients with multiple sclerosis," the CSAPH report found.

"Our AMA urges that marijuana's status as a federal Schedule I 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 new policy says.

But the AMA goes on to say that it is not endorsing existing state medical marijuana programs.

Laying the groundwork for the AMA's shift in position was the adoption in June 2008 by the group's Medical Student Section of a resolution supporting reclassification of marijuana. Leading that effort was University of Washington medical student Sunil Aggarwal, who also played a role as a reviewer of the CSAPH report.

"It's been 72 years since the AMA has officially recognized that marijuana has both already-demonstrated and future-promising medical utility," said Aggarwal. "The AMA has written an extensive, well-documented, evidence-based report that they are seeking to publish in a peer-reviewed journal that will help to educate the medical community about the scientific basis of botanical cannabis-based medicines."

"This shift, coming from what has historically been America's most cautious and conservative major medical organization, is historic," said Aaron Houston, director of government relations for the Marijuana Policy Project, who attended the AMA meeting. "Marijuana's Schedule I status is not just scientifically untenable, given the wealth of recent data showing it to be both safe and effective for chronic pain and other conditions, but it's been a major obstacle to needed research."

The AMA lagged behind one of its competitors. In February 2008, a the American College of Physicians (ACP), the country's second largest physician group and the largest organization of doctors of internal medicine, adopted a resolution calling for an "evidence-based review of marijuana's status as a Schedule I controlled substance to determine whether it should be reclassified to a different schedule."

"The two largest physician groups in the US have established medical marijuana as a health care issue that must be addressed," said ASA Government Affairs Director Caren Woodson. "Both organizations have underscored the need for change by placing patients above politics."

And so the pressure mounts.