Your Aug. 5 editorial ("Illinois stumbles into medical marijuana")calling for physician leadership now that medical marijuana is permissible in Illinois does not fall on deaf ears. However, it is an unfair criticism to take aim at my organization’s neutral stance during the legislative debate on this law.

Your point about the inconsistency between the rules of the states that have adopted medical marijuana legislation is a good one. We harbor similar concern over inconsistency between our new state law and existing federal law.

Federal law prohibits the prescription of Schedule I controlled substances—which includes marijuana—because they have no approved medical usage. The new Illinois law allows physicians to certify bona fide patients to obtain medical marijuana. Certification is not the same as prescribing, the latter of which would put physicians in violation of federal law.

It remains to be seen what actions federal authorities may take in response to the new paradigm of state-approved medical marijuana. Therefore, we’ve argued for a cautious approach that doesn’t place a physician between his or her patient and government bureaucrats.

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There are many perspectives on the use of medical marijuana. Some physicians indeed support its legalization for patient use; however, many of our medical colleagues do not. For example, some addiction medicine specialists and emergency department doctors have deep expressed concern over any marijuana legalization, medical or not.

They hold this view because they are the physicians who most commonly deal with the accidents, addiction and other negative consequences associated with impairment. While there is evidence to suggest certain patients find relief from use of marijuana, developing a sensible policy solution for marijuana is a very complex endeavor.

As the organization for Illinois doctors, ISMS channels the voices of many physician and patient perspectives into sensible policy solutions. Medical marijuana is now the reality in Illinois, but there are numerous issues to work out and rules to be developed before certifications begin on January 1. We stand ready to work with policymakers, patients, physicians and others during the implementation phase of this law.

Dr. Eldon A. Trame, of Belleville, Ill.,  is president of the Illinois State Medical Society.