Change We Can Believe In? Not for Medical Marijuana Research

What will it take to stimulate the commencement of long-overdue human studies into the safety and efficacy of medical cannabis?
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It was nearly two years ago that the Obama White House issued its "Scientific Integrity" memorandum stating, "Science and the scientific process must inform and guide decisions of my Administration."

Those of us involved in marijuana law reform welcomed the memo -- which came just months after the American Medical Association called for "facilitating ... clinical research and [the] development of cannabinoid-based medicines" -- and we hoped that it would stimulate the commencement of long-overdue human studies into the safety and efficacy of medical cannabis.

Those hopes were snuffed, however, when a representative from the U.S. National Institute on Drug Abuse (NIDA), the agency that oversees 85 percent of the world's research on controlled substances, reaffirmed its longstanding "no medi-pot" policy to The New York Times. "As the National Institute on Drug Abuse, our focus is primarily on the negative consequences of marijuana use," a spokesperson told the paper in 2010. "We generally do not fund research focused on the potential beneficial medical effects of marijuana."

A review of the U.S. National Institute of Health website shows that NIDA's kibosh on medical marijuana trials continues unabated. Though an online search of ongoing FDA-approved clinical trials using the keyword "cannabinoids" (the active components in marijuana) yielded me 65 worldwide hits, only six involved subjects's use of actual cannabis. (The others involved the use of synthetic cannabinoid agonists like dronabinol or nabilone, the commercially marketed marijuana extract Sativex, or the cannabinoid receptor blocking agent Rimonabant).

Of the six, two of the studies have already been completed: "Opioid and Cannabinoid Pharmacokinetic Interactions" and "Vaporization as a Smokeless Cannabis Delivery System," both of which were spearheaded by researchers (primarily Dr. Donald Abrams) at the University of California at San Francisco.

The four remaining studies are still in the "recruitment" phase. Of these, only two pertain to the potential medical use of cannabis: "Cannabis for Spasticity of Multiple Sclerosis," which is taking place at the University of California at Davis and is likely the final clinical trial associated with the soon-to-be-defunct and defunded California Center for Medicinal Cannabis Research and "Cannabis for Inflammatory Bowel Disease," led by researchers at the Meir Medical Center in Israel.

Of the remaining studies, one focuses on the detection of cannabinoids and their metabolites on drug screens, while the other, entitled "Effects of Smoked Marijuana on Risk Taking and Decision Making Tasks," seeks to establish pot-related harms, hypothesizing that subjects "demonstrate poorer decision-making abilities and increased risk-taking behaviors" after smoking marijuana.

So much for the AMA's demand for clinical cannabis research.

By contrast, preclinical (animal) trials assessing the therapeutic efficacy of cannabinoids are occurring at a record pace. A keyword search on the search engine PubMed using the term "cannabinoids" yielded over 1,300 published papers in 2008, some 1,700 papers in 2009 and another 1,200 published last year.

While many of these studies highlight the ability of cannabinoids to manage a wide range of symptoms, even more intriguing are the results indicating the potential of cannabinoid intervention to halt the development of serious diseases, such as cancer, diabetes, Lou Gehrig's disease and multiple sclerosis. Nevertheless, without abrupt changes at the highest levels of government -- changes that do not appear to be forthcoming despite this administration's public demand for "scientific integrity" -- scientists will indefinitely lack the human follow-up data necessary to adequately answer societal questions regarding cannabis safety, efficacy and proper dosage.

"Change we can believe in?" Not when it comes to studying pot.

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