As a growing number of states recognize the importance of providing legal access to patients who benefit from medical marijuana, it becomes even more implausible that research is so uniquely — and unfairly — restricted.
Patients with conditions such as PTSD (post-traumatic stress disorder), epilepsy, chronic pain and migraines deserve research that can determine the optimum medication content and procedure.
Even with research that has been approved by the Food and Drug Administration (FDA), federal policies require a redundant, multi-agency review process that creates unnecessary red tape and wasteful government spending.
Unlike studies done for other federal Schedule I drugs, only cannabis research must pass an additional review process before the Drug Enforcement Agency (DEA)/National Institute on Drug Abuse (NIDA) will release the research material. By law, NIDA is the sole, monopolistic supplier of all cannabis to be used for research studies.
NIDA administers this additional review process and has a fundamental conflict of interest in deciding which studies it will allow. The agency’s mission statement restricts it from approving research that may help uncover any therapeutic potential of marijuana. Thus, scientists who hope to provide relevant information about medical marijuana regarding dosing, administration mechanisms and other practicalities are prevented from obtaining the necessary source material.
Even researchers obtaining NIDA’s approval must still contend with inferior and radically more expensive cannabis than is readily available from state-regulated dispensaries.
A case in point is PTSD, especially critical given the suicide rate among veterans. The U.S. Veterans Administration estimates that in 2012, about 22 former members of the armed forces, on average, committed suicide every day. One in five, or nearly 300,000 veterans of the Iraq and Afghanistan wars, are diagnosed with PTSD. Treatment has cost the U.S. more than $2 billion so far.
Antidepressants such as Zoloft and Paxil, along with other pills that have been shown to have risky side effects, have been the traditional treatment in doctors’ arsenals, but in many cases these pills have been ineffective.
The use of medical marijuana to treat patients with treatment-resistant PTSD is supported by a number of sources, including research in lab animals, fMRI (functional MRI) imaging in humans and anecdotal reports from countless health practitioners, patients and patients’ families. Additionally, clinical research in Israel evaluating medical marijuana as treatment for PTSD has been promising.
Yet, the government has been slow to act. A study approved by FDA in April 2011, and the U.S. Public Health Service in 2014, is still awaiting DEA/NIDA approval. This study will be the first randomized controlled crossover clinical trial in the United States testing the therapeutic potential of marijuana for PTSD. The research is intended to address some of the unanswered questions surrounding medical marijuana, particularly the proper dosage for patients.
Other medical conditions deserve the same study, and more rapidly. Hawaii has an opportunity to make considerable progress. Our plan is to leverage research such as the PTSD study and conduct pilot studies with dispensary patients to identify strains that are effective for specific disorders. Our agricultural research team can then begin work on discovering the optimum growing conditions and breeding programs for identified strains. Hawaii can be a leader in removing some of the mystery and uncertainty surrounding medical marijuana and contributing to a more defined healing program.
To put patients front and center, we must expand cannabis research. Without more research, society is leaving medical marijuana open for opportunists who want to politicize the issue, rather than allowing doctors to explore viable new options that work to serve the best interests of those in need — our patients.
