Cannabis On Deck: Government Health Agency Shares Priorities for Marijuana Research
As many are aware, one of the biggest obstacles standing in the way of cannabis’ U.S. journey was a lack of legitimate research and (of course) funding for said research. Though myriad studies and trial results emerged in recent years (especially following events like the passage of the 2018 “Farm Bill”), cannabis lacks the kind of significant database of factual evidence and general rules that other medications legal in this country benefit from. This may change far quicker than expected, however, with the newest release from the National Institute on Drug Abuse (NIDA).
On August 14th, NIDA shared the Notice of Special Interest (NOSI): Public Health Research on Cannabis, which identifies key areas within the cannabis realm that are of special priority for research. The specific purpose of this release--which highlights more than ten topics that it deems deserving of consideration--is “to encourage grant applications on the effects of changing cannabis laws and policies in the US and globally on public health.”
So, what topics does NIDA and, by extension, the federal government consider to be “priority?” And, perhaps more importantly, how might additional research into these 13 proposed areas help to change the climate of cannabis in the United States?
Lucky Number Thirteen
While it is hard to determine how many or which vocal cannabis advocates actually have pull within the National Institute on Drug Abuse, the organization’s support for cannabis use doesn’t appear to be the driving force behind this release. The statement written into the release itself recognizes cannabis’ rapid expansion throughout the country and the associated and growing need for further scientific understanding. As a “background” behind the notice’s issue, NIDA explains:
“Policies around cannabis use in the United States (and globally) are changing rapidly, and far outpacing the knowledge needed to determine and minimize the public health impacts of these changes. A growing number of states have loosened restrictions on cannabis, including those on sales and use, by passing medical marijuana laws or by making cannabis legal for adult recreational use, and in some cases, states have done both.”
Thankfully, this rapid change has inspired rapid response. A 2018 collaboration between NIDA and an Advisory Council Workgroup identified the “cannabis policy research areas with the greatest urgency and potential for impact.” These areas include:
Developing standards for measuring cannabis (including hemp and hemp product) dose, intoxication, and impairment.
Enhancing existing epidemiology research to study trends for cannabis use and CUD; including new products, patterns of use, and reasons for use in different populations.
Characterizing the composition/potency of cannabis, methods of administration, cannabis extracts/concentrates, and cannabis of varying constituents (e.g. cannabinoid or terpene content), as well as how those factors impact physical and mental health.
Determining the physical and mental health antecedents of use, as well as outcomes of use.
Exploring the impact of polysubstance use on health outcomes, including interactions (substitution/complementation) with alcohol, tobacco, and prescription and nonprescription opioids;
Examining reasons for initiation and continued use of marijuana for therapeutic purposes.
Investigating the effects of different patterns of cannabis use on brain development, educational attainment, and transition to work and adult roles.
Identifying the effects of maternal cannabis consumption during pregnancy and breastfeeding.
Developing effective roadside tests for cannabis impairment that can be practically deployed by law enforcement.
Determining the prevalence of cannabis-involved vehicular crashes and other types of injury or property damage.
Investigating how cannabis industry practices, including research on marketing, taxes, and prices, impact use and health outcomes (e.g. how different price points impact consumption patterns across different levels of use).
Determining the impact of federal, state, and local marijuana policies and their implementation on use and health outcomes.
Exploring the heterogeneity of regulatory schemes (e.g. models for retail distribution of cannabis) to understand which combinations or components minimize harm to public health.
An Evolved Understanding
There are several items on this list that show an improved and more comprehensive understanding of cannabis compared to what we’ve seen from federal agencies in past years. While the items relating to healthcare are significant, it’s the other mentioned priorities that speak to a more evolved approach. For example, NIDA calls for studies into “how the cannabis industry practices,” giving weight to details like marketing, retail distribution and pricing. In doing so, NIDA is nearing a cannabis approach that seems eerily similar to that of established over-the-counter and prescription medications. Treating cannabis the same as its peers may make all the difference, after all.
Several of the thirteen appear to be direct attacks on prevalent misconceptions, as well. For example, a look into roadside impairment testing related to cannabis will address concerns that many have about driving after treating with cannabis. For example, despite popular belief, driving under the influence of THC (the psychoactive component of cannabis that is not present in CBD products or most medical applications) can be just as dangerous as driving under the influence of alcohol. Furthermore, comprehensive research into general topics like “vehicular crashes and other types of injury of property damage” may address some beliefs that cannabis use leads to violent or destructive behavior while showing that impairment of judgment can still come with THC consumption (again, not present in most medical applications. When THC is used medically, it is by doctor recommendation and with the doctor’s explicit instructions and warnings).
Repairing the damage done by false claims and cannabis-negative propaganda has proven difficult, though the impact of a federal agency like NIDA taking an interest could be huge. Regardless of position, the factual evidence delivered in response to NIDA’s call for research will mean that the industry can begin to settle debates using legitimate results rather than anecdotal evidence and simple hearsay.
The Medical Bits
Of course, specific medical topics are what capture doctor and patient attention most. These start with the basics, like composition and potency, and extend as far as the very reasoning behind initiation of and prolonged use of cannabis. Even forms of administration, the possible impact on brain development, and pregnancy and breastfeeding considerations make the list. For doctors like myself, this is essentially a holiday wishlist of most-desired research topics. With increased study, regulation, and acceptance, more cannabis treatments options will thus be available to patients for relief associated with a range of different symptoms and conditions.
Though there is little question as to whether the research prompted by NIDA’s priority list will be welcomed, it’s important to note that we do still have some significant evidence associated with cannabis’ treatment capabilities. Research from just the past few years has coalesced into an ever-expanding pool of improved understanding. As shown by a collection from Cannabis-med.org, studies both ongoing and complete show positive results for diagnoses like anxiety, pain, depression, gastrointestinal disorder, epilepsy, sleep disorders, and more. It will be interesting to watch this list grow as NIDA’s request for research is fulfilled. Even more interesting is the fact that schools like the University of Maryland have launched advanced degree programs in medical cannabis science and therapeutics that will no doubtedly help advance scientific understanding and widespread knowledge alike.
If you are considering treatment with medical cannabis for the relief of physical or mental symptoms, or if you have any questions about hemp or cannabis use as part of a holistic approach towards achieving better overall wellness, be sure to discuss your health goals with Doctor Jane or your licensed medical cannabis physician. There are many factors involved in determining whether cannabis is the appropriate course of action and developing a proper treatment plan. You can schedule a consultation for a time and location that is convenient for you using our website, or reach out to me directly via phone or text at (561) 406-0685.
Today’s blog post is written by Rick Liogier-Weyback, MD, founder and president at Doctor Jane and our licensed medical cannabis physician. If you are considering cannabis treatment or are wondering if medical cannabis may be right for you, please contact our team at your earliest convenience.
About Doctor Jane
Doctor Jane is South Florida’s most discreet, professional, and convenient concierge medical cannabis practice. Dr. Luis Enrique R. Liogier-Weyback and his wife, Katie Liogier-Weyback, B.S., R.N., founded Doctor Jane on the core tenets of bringing personal, convenient, professional and discreet patient care to the medical cannabis treatment process. Doctor Jane provides South Florida patients and their caregivers with a safe space where they can exercise their right to access medical cannabis therapy in an environment of their choosing, free from stigma and complications.
Visit our website to find out more or to schedule your own medical cannabis consultation. www.DoctorJane.net.