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Eight years after the legalization of medical marijuana and four years after adoption of recreational cannabis, the Massachusetts Medical Society has recognized cannabis as a medical therapy.

The policy, adopted at the most recent Massachusetts Medical Society meeting, seems like a small and incremental step in acknowledging a drug that nearly 300 physicians in Massachusetts are already prescribing to patients. Yet it is a far cry from the prescriptive requirements the state’s leading physician group, which has 25,000 members, had previously placed on doctors who recommend cannabis, and it eliminates the society’s objections to recreational cannabis altogether.

“We’ve missed out as a society on a good deal of therapeutic benefit,” said Jay Broadhurst, chair of the society’s committee on public health and an assistant professor of family medicine and community health at UMass Medical School, who helped write the new policy. “(We were) sidetracked by the politics of reefer madness. And there’s racism that has been tied up in the entire marijuana history. There’s so much sadness I have in this regard and I’m proud of trying to focus the light on how we can help.”

Physicians within the society had been working to amend the policy for 18 months. While it was ready to be voted upon in May, the society ultimately delayed the discussion, not wanting to slip a substantive revision in the midst of a pandemic.

Yet the policy was ultimately adopted at the society’s virtual meeting in December. According to the policy, physicians should be guided by seven principles, including promoting a relationship with the patient, promoting effective treatment options, protecting the health of vulnerable individuals, reducing the stigma of the drug, and achieving health equity and social justice.

Broadhurst said the policy is not an endorsement of cannabis, much in the way the medical society does not endorse any other particular treatments. Rather, the policy accepts that cannabis is a therapeutic option, and says discussions of recreational use should happen the same as they would around alcohol or tobacco.

“We ought to treat cannabis the same way we’d treat any other decision process, and that means we want a positive and therapeutic relationship with patients, and we will base our judgements on the best scientific evidence available and effective treatment,” he said. “You could substitute obesity or eczema or headaches in that. The same principles would apply.”

In adopting its recent policy, the society did away with many of its more aggressive stances around cannabis. Previously, the group had required a litany of standards physicians had to meet if they wanted to get involved in cannabis. Among them, physicians had to have an active medical license with the state, a controlled substances registration with the Department of Public Health, and registration with the federal Drug Enforcement Agency.

The society had additionally voted in 2004, 2011, 2018 and 2019 in opposition to recreational marijuana.

Yet Broadhust said that opposition was a judgment that physicians should not place on any kind of recreational activity.  “That’s a judgmental policy,” Broadhurst said. “It was based on public health evidence that demonstrated there were harms to marijuana use, but if you start shining alight why aren’t we opposed to alcohol use?”

The Massachusetts Medical Society also doesn’t feel the need to regulate physicians involvement in cannabis. Unlike the early days of marijuana legalization, the Cannabis Control Commission now oversees those requirements and enforcements.

That leaves physicians to do what they have always done — approach patients with an openness and a goal to improve their wellbeing.

“I would like to see cannabis treated along with all the other things that people do, as something that is part of a person’s health and wellbeing,” Broadhurst said.”And on the recreational side, as is true of any recreational behavior a person has, that we’re open to understanding what role it plays in a person’s life and we might on the basis of that make recommendations about modifying the use or improving further their health and wellbeing. Approaching this topic in a supportive and non-judgmental way to reduce stigma is incredibly important.”