the rejection, and also requested a hearing on the matter from a DEA Administrative Law Judge, which was granted. On February 12, 2007, after almost two years of extensive public testimony and evidence gathering, DEA Administrative Law Judge Ellen Bittner issued an 87-page opinion in favor of granting Professor Craker a license. Additionally, 45 members of Congress wrote to DEA Administrator Karen Tandy in September 2007 urging that the decision be upheld. In January 2009, however, acting DEA Administrator Michele Leonhart rejected the recommended ruling of Judge Bittner and declined to issue a license. In response, 16 members of Congress wrote to Attorney General Eric Holder in February 2009, asking that the Leonhart ruling be withdrawn. An additional letter was sent by Senators John Kerry and Ted Kennedy in April 2009. The ruling was upheld by Leonhart in an August 2011 decision, however, and again by the First Circuit Court of Appeals in April 2013. End of monopoly On August 11, 2016, the DEA announced intention to issue additional licenses for the cultivation of research-grade cannabis, in order to end the decades-long monopoly held by NIDA and the University of Mississippi. In August 2019, following inquiries from Congress about the status of the licenses, the DEA clarified that new regulations needed to be developed before the approval of applications could proceed. In May 2021, the DEA announced that it had notified an unspecified number of cultivators that they had been granted preliminary approval for a license. As of August 2022 the DEA lists seven organizations that have active licenses to cultivate cannabis. Advocacy Support Organizations Americans for Safe Access is the leading advocacy group in the U.S. dedicated to medical cannabis policy reform. Founded in 2002 by medical cannabis patient Steph Sherer, it has grown to over 100,000 members in 50 states. Other groups include the National Organization for the Reform of Marijuana Laws, Marijuana Policy Project, and Drug Policy Alliance, although these focus more broadly on policy reform regarding both medical and non-medical use. Medical organizations that have issued statements in support of allowing patient access to medical cannabis include the American Nurses Association, American Public Health Association, American Medical Student Association, National Multiple Sclerosis Society, Epilepsy Foundation, Leukemia & Lymphoma Society, National Women's Health Network, Gay and Lesbian Medical Association, and several AIDS advocacy organizations. Religious denominations in the U.S. that have voiced support for allowing the medical