Debate is raging in the United States about marijuana. Everything about it, legalization, its uses, its benefits and its dangers. Right now more than half of the country, 25 states plus the District of Columbia, have policies legalizing or decriminalizing the use of marijuana either recreationally or for medicinal purposes. For the first time in more than 40 years of polling the issue, most Americans support legalization, according to a Pew Research Gallup poll done March 2013. The poll showed 52 percent of Americans in favor of legalization and 45 percent against, rising 11 points since 2011.
The federal government’s official position on marijuana, according to a document released January 2011 and featured on the Drug Enforcement Administration’s (DEA) website, is that, “The clear weight of the currently available evidence supports [Schedule I] classification, including evidence that smoked marijuana has a high potential for abuse, has no accepted medicinal value in treatment in the United States, and evidence that there is a general lack of accepted safety for its use even under medical supervision… Specifically, smoked marijuana has not withstood the rigors of science –it is not medicine, and it is not safe.”
Though public opinion may be turning toward viewing marijuana as not a big deal, federal laws make it exceedingly difficult for even medical researchers to obtain supplies. In the United States, research-grade cannabis is controlled by the National Institute on Drug Abuse (NIDA,) whose mission to curb abuse often poses a significant hurdle for researchers interested in studying marijuana’s curative properties.
“If you’re going to run a trial to show this [cannabis] is going to have positive effects, they’re [NIDA] essentially not going to allow it,” said Lyle Craker in an article from Popular Science. Craker is a professor and horticulturist at the University of Massachusetts Amherst.
“We have FDA-approved [Federal Drug Administration] protocol, but the only way to actually get marijuana for the study, the only federally approved source, is at [the] University of Mississippi,” he said. “NIDA refused to sell us the marijuana for study.”
In the same article, the director of communications for the Multidisciplinary Association of Psychedelic Studies (MAPS,) Brad Burge, said, “The United States government has gone to great lengths to prevent [medical] research on whole-plant marijuana.” MAPS is currently involved in a lawsuit with the DEA over the right to establish a medical marijuana farm.
But although it may be difficult for many researchers to obtain supplies for testing and clinical trials, there are those who manage to make it through the arduous requirements to be allowed access to cannabis to use in their research. The Center for Medical Cannabis Research (CMCR) at the University of California has been studying cannabis since the 1999 passing of the state’s Marijuana Research Act. According to their website, their purpose is to conduct “rigorous scientific studies to assess the safety and efficacy of cannabis and cannabis compounds for treating medical conditions.”
“The regulatory and other approval processes involved in clinical trials with cannabis requires authorization for each research [trial] by the Research Advisory Council of California, the US National Institute on Drug Abuse, the US Department of Health and Human Services and the US Food and Drug Administration,” writes Dr. J.H. Atkinson, Co-Director of CMCR, in an email. “Every branch was cooperative and helpful. On the other hand it is likely that some researchers will be put off by the requirements.”
The Center organizes and assists cannabis research throughout California. Research focuses on the latent medicinal benefits of cannabis for the treatment of various diseases and conditions. Currently the emphasis of their funding goes toward researching the treatment of ailments such as:
Severe appetite suppression, weight loss and cachexia due to HIV infection and other medical conditions. Chronic pain, particularly neuropathic pain.Severe nausea and vomiting associated with cancer and its treatment. Severe muscle spasticity caused by diseases such as multiple sclerosis.
According to Atkinson, the study that has provided the most promising results for the use of cannabis in medical treatments so far was for the treatment of HIV-related peripheral neuropathy (PPN) –injury to the nerves that supply feeling to your arms and feet.
“Our research focused primarily on chronic pain due to nerve injury (neuropathic pain), where the injury is due either to physical trauma, the effects of diabetes or infection with HIV,” writes Atkinson. “Several of our studies of these conditions all pointed in the same direction–that cannabis helped alleviate pain that was otherwise not responsive to standard treatments.”
In the study, Dr. Donald Abrams evaluated the safety and effectiveness of marijuana when smoked to treat pain caused by HIV-related PPN in order to measure its effect on pain relief. Marijuana was compared to a placebo. The placebo was a cigarette that smelled and tasted like marijuana but had no active ingredients such as tetrahydrocannabinol (THC) or cannabidiol.
Cannabinoids are the active chemicals in cannabis which are responsible for the ‘high’ feelings felt throughout the body. The main active cannabinoid is THC. Another active cannabinoid is cannabidiol, which relieves pain and lowers inflammation without causing the ‘high’ of THC, according to the National Cancer Institute.
The influence of the study was grounded in “…background of research in chronic pain and in multiple sclerosis…that helped identify conditions most likely to benefit from cannabis (e.g., pain from nerve injury, muscle spasm from multiple sclerosis),” writes Atkinson.
50 participants made it to the end of the trial. Smoking marijuana reduced daily pain by 34 percent compared to 17 percent with the placebo. The smoked marijuana was tolerated well and relieved the chronic pain. The findings were comparable to clinically proven oral drugs for the same pain.
So can the results of cannabis research help lead to legalization?
Not necessarily, Atkinson cautions.
“The CMCR was established, authorized and funded by the Legislature of the State of California to conduct high quality medical research that will ‘enhance understanding of the efficacy and adverse effects of marijuana as a pharmacological agent,’ stressing that the project ‘should not be construed as encouraging or sanctioning the social or recreational use of marijuana,’” Atkinson writes. “Thus, our work was separate from the question of ‘legalization.’ Government policy makers may or may not wish to consider the research conducted by the CMCR as part of discussions of legalization.”
In 2009 the American Medical Association (AMA) called on the federal government to reconsider its classification of marijuana as a Schedule I controlled substance. As the nation’s largest physicians’ organization, the AMA has maintained that marijuana should remain a Schedule I controlled substance since 1997. Such a significant shift in long-held ideology by such a prestigious group reflects the rapid shift of opinion in the nation as a whole.
Five years later the federal government has yet to heed that call, from the public and from the experts.
“Marijuana is a linchpin in the war on drugs,” says Burge. “There’s a lot of investment in marijuana remaining illegal.”