Testimony challenges high medical marijuana physician participation rates and FDA acceptance claims

In a significant development, sworn testimony presented during the federal marijuana rescheduling hearing has challenged widespread media claims that six million registered medical marijuana patients indicate broad acceptance within the American medical profession. The testimony, submitted before DEA Chief Administrative Law Judge Derek C. Julius, reveals that physician participation in state medical marijuana programs is far lower than reported, with participation rates below 4% in several major states.

Duane Boise, CEO of MMJ International Holdings, emphasized the discrepancy, stating, "The six million figure may be real, but the medical-consensus narrative built around it is not. A registry card is not a clinical trial, and a recommendation is not an FDA-approved prescription. When approximately 96% to 98% of physicians in major states do not participate, and large portions of state certifications are generated by a small percentage of doctors, the public is not being shown medical consensus. It is being shown a headline without its denominator."

Dr. Kenneth Finn, a board-certified pain medicine and physical medicine and rehabilitation expert, testified that in New York, only 3.4% of active physicians participate in the state’s medical marijuana program, while in Florida, 3.6% of direct-care physicians are approved to order medical marijuana. In Colorado, fewer than 2% of licensed physicians issue marijuana recommendations. These figures indicate that a vast majority of physicians are not engaging with the programs.

Moreover, the hearing highlighted that medical marijuana certifications are highly concentrated among a few doctors. In Colorado, three physicians generated more than one-quarter of the recommendations in 2022. In Florida, approximately 88% of certifications came from 21% of qualified physicians, and in Oregon, nine doctors approved more than half of the state's medical marijuana patient population.

Dr. Finn’s testimony further underscored that the way marijuana is prescribed through state programs does not constitute medical use. He stated, "Marijuana use through state programs does not constitute medical use in my opinion."

The Department of Health and Human Services' survey data also revealed that among 1,447 respondents who identified themselves as exclusive medical-cannabis users in a 2021 survey, only 56.8% reported ever asking a licensed health professional for a recommendation. This suggests that a significant number of self-described medical users do not receive professional supervision.

Additionally, the hearing clarified that the FDA's currently accepted medical use analysis was largely based on data supplied by the Office of the Assistant Secretary for Health, without independent verification by the FDA. Dr. Luli R. Akinfiresoye, a DEA pharmacologist, testified that marijuana failed the DEA's traditional five-factor currently accepted medical use analysis, disagreeing with each of HHS's findings.

Dr. Akinfiresoye stated, "Scientifically, no," when asked if the HHS's two-part approach made sense. She explained that the approach did not adequately address the chemistry, safety, and efficacy of marijuana.

MMJ International Holdings, which has invested more than $10 million over eight years to develop standardized cannabinoid medicines, supports the need for evidence-based practices. Boise said, "If marijuana is going to be called medicine, patients and physicians deserve defined composition, consistent manufacturing, known dosing, stability data, and credible evidence of safety and efficacy."

The testimony, presented in the DEA marijuana rescheduling proceeding, highlights a stark contrast to the widely reported six million patient figure. As the DEA ALJ Tribunal has not yet issued its recommendation, the full implications of these findings remain to be seen.

"The question is no longer whether the public has heard the six million figure," Boise concluded. "The question is whether the public will finally be told what is underneath it. The sworn testimony supplies the answer, and it is not the medical consensus portrayed in the headlines."

The testimony underscores the need for a more nuanced understanding of medical marijuana use and participation within the medical community, highlighting the importance of standardized and scientifically validated treatments.