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The can and can’t of cannabis

Eunice Zhang, MD
Policy
July 15, 2018
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As of now, twenty-nine states have legalized medical marijuana use and eight have legalized recreational use. The debate rages on about legalization, but the actual effects of cannabis get much less attention. A huge issue is that cannabis can be both helpful and harmful for a wide range of symptoms and conditions, and currently, the research is incomplete. But the barriers to actually study this substance are resource-intensive and restrictive.

One of the biggest barriers for researchers who apply for federal funding is regulation. Cannabis is categorized as a Schedule I drug by the Drug Enforcement Agency (DEA). A substance is categorized by its potential for abuse and medical use. Schedule I is the most restrictive category and includes heroin. Narcotics, such as oxycodone and fentanyl, are Schedule II drugs.

This strict regulation means that researchers must undergo additional steps, such as obtaining a special license with mandated site visits and requirements for storage and tracking of cannabis. They must also gain approval not just from the DEA but the Food and Drug Administration (FDA) and National Institute on Drug Abuse (NIDA), though not necessarily in that order. This regulation uses up both time and money and can discourage future study. This is especially counterproductive as research studies must be repeated and retested in order to prove that an outcome is legitimate. Of course, research of any substance should be regulated—the problem is that overregulation seriously hampers the research to begin with. But in August 2016, the DEA denied another petition to reschedule cannabis as Schedule II.

Yet there are other ways to increase research without rescheduling. The same month that they denied the petition, the DEA also announced that it would open up registration for more growers of research cannabis. Currently, researchers can only get their cannabis from one site—the University of Mississippi, which has a contract with NIDA but is licensed by the DEA. It is one step towards decreasing the regulation burden by increasing the supply. Unfortunately, so far no other growers have been approved by the DEA and the timeline for the process remains unclear. Additionally, Attorney General Jeff Sessions, who oversees the Department of Justice and thus the DEA, has been clear on his stance on the criminalization of cannabis use, sending a mixed message.

Although legalization has become a bipartisan issue, the ability to conduct scientific research should not be. In fact, the VA Medicinal Cannabis Research Act, which would allow the VA to expand its research role of cannabis, is sponsored by both House Democrats and Republicans. Similarly, the Marijuana Effective Drug Study Act of 2017, or MEDS Act, proposes to streamline the process for getting approval and supply of research cannabis. No matter your political party, everyone should want to know the truth. Some believe that cannabis is a promise to treat pain, nausea, and seizures. Others worry that its effects on brain function lead to paranoia, reckless behavior such as impaired driving, and addiction. Everyone has their own biases. The point is that the truth—real facts from rigorous research—trumps bias.

If we are going to legalize and regulate cannabis, then let’s also study it. It doesn’t have to be politics — it’s just common sense.

Eunice Zhang is an internal medicine physician.

Image credit: Shutterstock.com

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