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In fall 2013, when other parents were trading stories about the difficulties of balancing homework with little league practice and swimming lessons, I was in my garage, painstakingly measuring amounts of a Schedule 1 narcotic to extract medication for my son. Tinkering with lab equipment and solvents usually only found in chemistry labs, I was trying to purify compounds from cannabis — not to get high, but to save my son’s life.
My son Ben has suffered thousands of seizures in his short, six-year life. Treatment-resistant epilepsy in children is a cruel disease that can lead to significant cognitive, motor, and behavioral delays and, not surprisingly, death. More than one third of all childhood deaths are due to epilepsy. After exhausting FDA-approved treatment options, including a dozen different anti-seizure drugs, surgical implantation of a nerve stimulator, injections of high doses of steroids and even brain surgery removing half of his parietal lobe, he is finally experiencing some relief thanks to a drug regimen that includes a component in cannabis, cannabidiol (CBD).
My son has suffered severe brain damage as a result of years of seizures. It is excruciating to ask what Ben would be like today had he experienced relief earlier in life. We will never know the answer, and not because science has failed him; policies dictated by an inexplicable social phobia of cannabis have.
Last week, the National Institutes of Health (NIH) convened a research summit on the effects of cannabinoids on the brain. This meeting was the first open acknowledgement by a federal agency that there may be medical value to marijuana. Unfortunately, this “historic” meeting was a huge disappointment to those of us interested in improving the quality of life of patients suffering now. Instead of discussing how to advance our clinical understanding of the therapeutic value of cannabis in specific diseases, much of the conference focused on animal models, which are far too removed from human disease to inform clinical treatment. Much time was also given to the potential public health harm that cannabis poses. Where is the methodologically sound clinical data we need to treat people living with diseases right now? Doctors and policymakers alike have been calling for more research on cannabis for decades — why do we still not have it?
The snail’s pace at which clinical research on cannabis is proceeding is not meaningful for patients in distress right now. There is an overwhelming amount of evidence that components found in marijuana can provide significant relief from disease-related symptoms, such as nausea caused by chemotherapy, in addition to changing the course of life-threatening diseases, such as some specific cancers like glioblastoma.
As a mother, I am furious that the federal government has discouraged research into these potentially life-saving therapies for years by restricting clinical research. As a scientist, I decry the federal government for interfering with scientific freedom.
CBD is only one of many cannabinoids that we are just beginning to understand. Cannabis contains more than 80 cannabinoids and more than 400 other compounds. It’s highly likely the therapeutic potential of medical cannabis is greater than one single cannabinoid. But in order to find out, we need the ability to conduct research. Research must be permitted to progress unfettered, not just on a single cannabinoid, but on all the components of the entire plant.
While research gets off the ground, patients like Ben also need to have the ability to access regulated, standardized cannabis-derived preparations that meet the same manufacturing safety guidelines required of any other medication. I am not comfortable ordering an unregulated preparation of CBD from the internet to treat my child’s severe brain disease, but that’s the situation parents like me find ourselves in today.
To be absolutely clear, the debate can no longer be about whether to provide access. The majority of Americans already live in states where medical cannabis is legal. We must now focus on enacting thoughtful policies that will ensure access to safe preparations, allow for research and collect information to inform treatment. The U.S. government must do more than acknowledge the medical legitimacy of CBD and other cannabis compounds. It must make room for full scientific inquiry into standardization of the life-saving treatments many Americans already know exist and remove itself from the doctor-patient relationships it so often obstructs.
Now is the time for momentous changes in federal cannabis policy. Discussions of cannabis legalization inevitably involve political, social, and public health concerns, but clinical research should not be mired in political agendas; it should be a matter of scientific investigation. Patients, like my son Ben, don’t have time to wait.
Dr. Catherine Jacobson is a neuroscientist and the clinical research director of Tilray, a medical cannabis company licensed by the federal government of Canada. Tilray and Leafly are both subsidiaries of Privateer Holdings.
As states across the nation begin to fully legalize adult-use cannabis, many may be wondering what this means for the medical cannabis dispensaries and card holders. What does it mean to be a medical cannabis patient in a world where anyone can walk into a recreational dispensary, present their state ID, and legally purchase cannabis?
Is the hassle of visiting a doctor for a medical card still worth it? Are there any real benefits?
The answer is yes—there are many real benefits for medical cannabis card holders. From dosage to access and affordability, patients will find plenty of support for their ongoing care on the medical side of cannabis legality.
Lower Costs & Taxes
A major benefit offered by many states’ medical dispensaries is lower cost for patients, which is extremely important for people who rely on cannabis for medical issues. Imagine needing life-improving medication, but not having it covered by your insurance—that is the reality of medical cannabis patients all over the country.
Now imagine your medicine was also highly taxed and thus very expensive since it also doubled as a recreational joy for many people—that would be the reality of patients if they only had access to recreational dispensaries.
Medical cannabis dispensaries allow concessions for patients that recreational shops do not. An example of this can be seen in Colorado, where medical cannabis patients avoid the 10% retail marijuana tax and 15% excise tax that recreational dispensary costumers must pay.
Medical cards allow patients to have access to their medicine for lower cost, making their healthcare more affordable and accessible.
Since medical marijuana was passed in Amendment 2 last year, there’s been a lot of change in Missouri already. Marijuana is now legal for those with a qualifying medical condition, and the legalization is bringing business, new rules and more changes to Springfield and Missouri.
Here’s everything you should know:
What does a medical marijuana card do?
A qualifying patient card will allow a patient to enter licensed dispensaries and possess and consume medical cannabis in keeping with Missouri law.
Dispensaries are expected to open in mid-2020. But currently, patients with medical marijuana cards issued by the Missouri Department of Health and Senior Services may consume or possess marijuana, and they may grow it if they have a cultivation authorization from the department. There’s no legal way to buy or sell marijuana in Missouri before those licensed dispensaries open.
By law, patients and caregivers are required to have their medical marijuana ID card available when purchasing or in possession of medical marijuana.
Patients suffering from persistent pain conditions who frequently use cannabis are far less likely to use non-prescription opioids, according to longitudinal data published in the journal PLOS One.
A team of investigators from Canada and the United States assessed drug use trends in chronic pain patients over a multi-year period (June 1, 2014 to December 1, 2017).
Authors reported “an independent negative association between frequent cannabis use and frequent illicit opioid use.” Specifically, subjects who consumed cannabis daily “had about 50 percent lower odds of using illicit opioids every day [as] compared to cannabis non-users.”
Investigators did not identify a similarly significant association between occasional cannabis use and daily non-prescription opioid use.
They concluded, “These findings provide longitudinal observational evidence that cannabis may serve as an adjunct to or substitute for illicit opioid use among PWUD (people who use drugs) with chronic pain.”
The findings are consistent with those of prior studies — such as those here, here, and here — which report that pain patients reduce their use of opioids following access to medical cannabis therapy.
Late last week, federal officials affirmed that no funding from the Substance Abuse and Mental Health Services Administration could be spent toward programs that propose the use of medical cannabis for those suffering with opioid dependence issues.
Full text of the study, “Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis,” is online here. Additional information is available from the NORML fact-sheet, ‘Relationship Between Marijuana and Opioids.’