Taking Cannabis to a New Level: A Closer Look at Doctors for Cannabis Regulation

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Columns | <b>Cannabis Voices</b>

David L. Nathan, MD, DFAPA, President, Board of Directors, Doctors for Cannabis Regulations (DFCR), discusses how the DFCR was formed, the efforts they have been making in the cannabis field, and plans for the future of the organization.

Cannabis science is still a relatively new term and new field, but it should still be treated like any other scientific field-with experts weighing in and convening on the best path forward. Consumer safety, public awareness, regulations, and labeling are just a few of the challenges facing the cannabis industry. That’s why David L. Nathan, MD, DFAPA, President, Board of Directors, founded his organization Doctors for Cannabis Regulations (DFCR) (1). Here, Dr. Nathan discusses how the DFCR was formed, the efforts they have been making in the cannabis field, and plans for the future of the organization.

Can you tell us how the idea for Doctors for Cannabis Regulation (DFCR) came about and how you got involved?David Nathan: In late 2014, I was asked to sit on the steering committee of New Jersey United for Marijuana Reform. As the only physician in the group, I took it as my mission to rally my peers to support the cause of legalization. Since most of the colleagues I knew discussed their support of legalization in personal conversation, I expected that they would also do so publicly. However, I learned that many were reluctant to speak out publicly, lest they be labeled as soft on drugs or even pro-cannabis. So, I resolved to create an organization that would be comprised of prominent physicians willing to speak on the record about the public health and social justice benefits of cannabis legalization and regulation. As it turns out, this wasn’t difficult, and I assembled a group of doctors including such prominent individuals as former Surgeon General Joycelyn Elders and integrative medicine pioneer Andrew Weil. We created Doctors for Cannabis Regulation and drafted our Declaration of Principles, which was published at the time of our launch in April 2016. I would say the rest is history, but with so much left to do, the history is still being written.

My personal involvement in the drug policy reform movement started when I was in medical school and read an article about the folly of the drug war by then Princeton professor and eventual founder of the Drug Policy Alliance Ethan Nadelmann. He explained how the war on drugs was a clear case of the cure being worse than the disease, resulting in mass incarceration and destruction of communities of color. When I was a resident in psychiatry, I was surprised to learn that the addictionologists who were my teachers favored the continuation of the drug war despite the persistence of drug use and harm to the very people they were trying to help. As a psychiatrist in private practice, I saw many lives ruined by drugs. I also saw lives ruined by cannabis, but not by use of the drug. Cannabis prohibition itself was the problem. So, in 2009 I wrote an article for the Wall Street Journal (2). That resulted in speaking engagements, other writing opportunities, and eventually a much broader involvement in the cannabis legalization movement.

How has the organization grown since its initial founding?Nathan
: It’s been quite a ride! The growth of DFCR has been astounding, and today we have members in nearly every U.S. state and territory as well as countries on six continents. There are dozens of DFCR spokespeople around the country, speaking to audiences of physicians, other healthcare stakeholders, and the public at large. We have testified at more than a dozen state legislatures and on Capitol Hill. Our articles have appeared in medical journals and the lay press, and our physicians have been interviewed or quoted by news outlets around the world. It was an especially proud moment for me when New York Governor Andrew Cuomo convened a commission to study cannabis policy, and the resulting document quoted and referenced DFCR’s Declaration of Principles several times.

Can you tell us how the Doctors and Players for NFL Cannabis Reform started?Nathan: After the launch of DFCR, retired National Football League (NFL) player Eugene Monroe and current player Derrick Morgan approached us about joining current and former NFL players in their effort to end the NFL ban on cannabis use. All of us quickly realized how closely aligned the athletes’ experiences were to the nation as a whole. Here was a situation where individuals-particularly people of color-were being persecuted for their use of a drug that was less harmful than the drugs, like opioids, whose use was accepted and even encouraged by authorities. The suspension of NFL players stood in stark contrast to that of athletes in Major League Baseball and the National Hockey League, both predominantly white sports, in which athletes were not harshly punished for their cannabis use even though it was disallowed. Not only has the DFCR-NFL campaign helped advance the ball on cannabis policy in sports, it has also helped bring attention to cannabis legalization efforts around the country.

What is the average response from physicians about DFCR and cannabis legalization?Nathan: Because DFCR is so dedicated to following the evidence around cannabis use and cannabis policy, rank and file physicians tend to be supportive or at least respectful of our point of view. Physicians may be conservative in their approach to public health, but it’s hard for them to ignore how the effects of cannabis prohibition have proven to be worse than the harms of cannabis use itself. What’s interesting is that many physicians in positions of leadership express their support for cannabis legalization to me privately, even as the medical associations they represent continue to treat cannabis reform as a political third rail. But that, too, is starting to change. We haven’t yet seen a massive shift in the official positions of national medical associations, but after they talk to DFCR-almost always informally-we usually see a decrease or disappearance of their opposition to legalization.

What do you think is the biggest thing lacking in medical cannabis programs in the U.S.?Nathan: My greatest concern at this point isn’t about the legal medical cannabis programs in the United States, but rather the fact that thousands of patients are still obtaining their medical cannabis from the illegal market. The products they’re using are unregulated, potentially adulterated or contaminated, and lack proper labeling about potency or serving size.


Can you tell us about your involvement in trying to get the government to regulate cannabis? Are you doing things on a state-by-state level?Nathan: As I mentioned earlier, DFCR is a national organization with members around the country and beyond. Our active membership has been speaking at national medical conferences, participating in interviews for national broadcast, online and print media, and writing articles for major media outlets. We’re reaching physicians and the public at large, and that increases pressure on the government to embrace change and recognize the failure of prohibition. 

Nonetheless, right now almost all the action on cannabis reform is happening at the state level. With that being the case, we’re focused on individual states, particularly those on the cusp of legalization. Just in the past few weeks, I’ve seen DFCR activity in New Jersey, New York, Massachusetts, Connecticut, New Hampshire, Vermont, Minnesota, North Dakota, Illinois, Texas, Colorado, and California. Some of these states have already legalized cannabis, and in those jurisdictions we continue to fulfill our mission by promoting state regulations that support the social justice and public health priorities in our Platform of Regulations.

Are some states more receptive or responsible about regulation than others?Nathan: As one might expect, more liberal states have tended to be out front on the issue of cannabis reform, but what I find interesting and encouraging is the degree to which legalization is a bipartisan issue during this time of unprecedented political division. That reassures me that our evidence-based approach is persuasive for rational thinking people on both sides of the political aisle. In fact, many Republicans consider cannabis legalization to be their issue given that personal liberty is a core conservative value. And we enjoy the support of the countless liberals and conservatives who are close to someone who has either benefitted from medical cannabis or been harmed by its prohibition.

What are the next steps or big plans for your organization?Nathan: DFCR has achieved a lot in its first few years, and thanks to our active board of directors and highly motivated spokespeople, our influence continues to grow with an incredible spirit of volunteerism. We’re planning an expansion of our NFL campaign to recruit active players, and we’re looking to work with the National Basketball Association (NBA)-the leadership of which has shown greater openness to the scientific evidence-to end its ban on cannabis. We’re also looking to speak on the record with national physician groups, including the American Medical Association and American Psychiatric Association. As we say in our Declaration of Principles, “Once supplied with the evidence, even physicians who vigorously oppose cannabis use may logically advocate its legalization for adults.”