A US appeals court will hear evidence that the drug has medical benefits – a claim with which the federal government disagrees

This article is more than 7 years old

This article is more than 7 years old

Michael Krawitz, from Elliston, Virginia, suffered a car accident while serving in the US air force which left him permanently disabled and in chronic pain.

Years later he received a prescription for medical marijuana while abroad, which, when used with other pain treatment, stabilised his condition for the first time.

But when the department of veteran affairs found out about his cannabis prescription, they asked him to undergo a drug test, he said, which he refused.

They have now denied him further treatment.

Later this month, Krawitz, 49, and other advocates for medical marijuana will go before the US court of appeal as part of a historic lawsuit that they hope will challenge the federal government's classification of marijuana.

Under the Controlled Substances Act, marijuana is classified alongside heroin as a dangerous drug, with no medical benefits. Advocates argue that marijuana has a medical benefit and so should be reclassified.

A wide range of US organisations support either medical access to cannabis, its reclassification or both. They include two of nation's largest physician groups, the American Medical Association and the American College of Physicians, in addition to the American Nurses Association, the Federation of American Scientists and the American Academy of Family Physicians.

Oral arguments in the case are scheduled to be heard at the US court of appeal for the DC circuit on October 16.

It is the result of a long legal battle by the Americans for Safe Access (ASA), a group of physicians, medical professionals and patients advocating legal access to marijuana for medical use and research.

It marks the first time in 20 years the scientific evidence regarding the therapeutic value of marijuana will be reviewed by the courts. Previous efforts have not been successful.

"Medical marijuana patients are finally getting their day in court," said Joe Elford, chief counsel with ASA. "This is a rare opportunity for patients to confront politically motivated decision-making with scientific evidence of marijuana's medical efficacy."

Federal government says drug has no proven medical benefit

The case began more than a decade ago, when Coalition for Rescheduling Cannabis (CRC) filed its petition.

In that time, ASA says, much has changed, and the government's position is out of step with increasing evidence of the benefits of the drug.

Steph Sherer, executive director of ASA said: "At the heart of this issue of the scheduling of marijuana and the federal government's refusal to look at the research that's out there every day is a bigger gap growing between patients and doctors and the federal government."

Advocates say that even the therapeutic research required to prove the case for the beneficial effects of the drug is subject to a unique and overly rigorous approval process.

While there is no conclusive scientific evidence in favour of medical marijuana, the research that does exist indicates it can be effective.

In a conference call sponsored by ASA, Dr Donald Abrams, director of clinical programs at San Francisco general hospital, told reporters research had shown cannabis benefited patients suffering from HIV.

He also said he recommended it to his cancer patients as treatment for a variety of symptoms.

"In my practice every day as a cancer specialist I see patients who have loss of appetite, nausea and vomiting from their chemotherapy, pain on and off of opiates, anxiety, depression and insomnia," Abrams said. He added that cannabis could effectively treat all of those symptoms in lieu of five separate drugs.

Krawitz said: "The definition of cannabis as schedule I has caused my fellow patients to be imprisoned, denied work, housing, right to own a firearm, a place on a transplant list, and of greatest concern to me, is the latest casualty of the drug war, my VA doctor."

In its decision last year rejecting ASA's petition to reschedule marijuana, which has since been appealed, the drug enforcement agency concluded there was no substantial evidence that marijuana should be removed from schedule 1.

The DEA included the required scientific assessment from the US department of health and human services (HHS) which had been prepared five years earlier.

The HSS found there were no "NDA-quality [new drug application] studies that have assessed (marijuana) … for any medical condition".

It went on to say that there was no consensus of medical opinion on the medical applications of marijuana.

Patient advocates claim that marijuana is treated unlike any other controlled substance and say that successive petitions to reclassify the drug have been blocked by politics.

ASA say that there have been no NDA-quality drug studies of other substances, for instance Platelet rich Plasma (PrP) treatment of Achilles tendinitis, that are still widely accepted for medical use.

They cite the support of the AMA and the ACP and other groups as evidence of a growing medical consensus.

The AMA concluded in 2009 that "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."

Four states have filed petitions to reschedule the drug, including Washington, Rhode Island, Vermont and Colorado.

The drug remains illegal under federal law, although medical marijuana is legal in 17 states.

Government authorities have re-enforced the federal law by raiding dispensaries in states including California and Washington.