In recent weeks, lawmakers in several states have moved forward with legislative proposals to permit specific strains and/or extracts of cannabis possessing high quantities of the cannabinoid cannabidiol (CBD), but otherwise maintaining criminal prohibitions on the whole plant.
But is this new direction in the best interest of patients? As I wrote in a recent column for Alternet.org (republished with permission by Cannabis Now under the title “Patients Ought To Be Skeptical Of Proposed CBD-Only Legislation — Here’s Why”), I believe the answer is ‘no.’
Ultimately, patients should not be unnecessarily forced to decide between either accessing the whole plant or its isolated components. They should have safe, legal access to both, and politicians, even well-intentioned ones, should not restrict patients’ right to choose the most suitable option.
Below are excerpts from my commentary. You can read the entire text here.
Patients Ought To Be Skeptical Of Proposed CBD-Only Legislation — Here’s Why
via Cannabis Now
[excerpt] If the plant ain’t broke, why fix it?
For longtime marijuana law reformers, the ongoing political conversation surrounding CBD is instructive. It makes it clear that many politicians’ public opposition to the idea of patients using marijuana therapeutically isn’t because of supposed unanswered questions surrounding the plant’s safety or efficacy. Rather, it is because lawmakers oppose the idea of some people getting high from a naturally growing herb. (The fact that patients can get equally high or even higher from FDA-approved synthetic THC has, for whatever reason, never been an expressed concern of either lawmakers or prohibitionists.) After all, the very same politicians who argue that marijuana isn’t medicine because it hasn’t been approved by the FDA or who allege that the substance hasn’t yet been subjected to sufficient scientific scrutiny utter no such public objections to the idea of legalizing patient access to CBD – a schedule I compound that hasn’t been reviewed, much less approved by the FDA, and that has been clinically studied far less than cannabis.
Perhaps most ironically is that were it not for the advent of legalized whole plant marijuana, a policy change publicly opposed by many present day CBD-only political advocates, lawmakers (and anti-pot groups like SAM) today wouldn’t be aware of CBD, much less advocating for it. The reality is that it was the stakeholders in medical marijuana states, and those who provide for them, who have done the most to explore and promote cannabidiol as a legitimate therapeutic agent. And they were able to do so because they, unlike most federally licensed medical researchers, had access to the whole plant.
We’ve been down this road before. Not long ago, lawmakers and anti-marijuana zealots were dismissing patients’ desire to access the marijuana plant because they alleged that the THC-pill Marinol could adequately meet patients’ needs. Patients and their advocates were skeptical of lawmakers’ claims then, and properly so. Now many of these same politicians are once again dismissing patients’ calls for whole plant medicine by claiming that products and strains containing CBD alone only will suffice. Patients and their advocates ought to be equally skeptical once again.
#1 Public Support For Legalizing Marijuana Hits Historic Highs
An unprecedented 58 percent of Americans believe that marijuana ought to be “made legal” for adult consumption, according to survey data reported in October by Gallup. The percentage is the highest level of support ever recorded by Gallup, which has been inquiring on the issue since 1969, and marks a ten percent increase in voter approval since 2012. Regional polls conducted this year in several states, including California, Louisiana, and Texas, also reported majority support for legalization.
#2 Nation Of Uruguay Passes Legislation Regulating Cannabis Use
Lawmakers in the South American nation of Uruguay enacted legislation authorizing the licensed production and retail sale of cannabis to all citizens age 18 and older. Residents will be able to legally purchase up to 40 grams of cannabis per month from state-licensed stores at a price of $1 per gram. Uruguay is the first country in modern history to officially legalize and regulate the licensed production and retail sale of cannabis.
#3 Feds Pledge Not To Interfere In State-Licensed Retail Sales Of Cannabis
Deputy Attorney General James Cole issued a three-page memorandum in August affirming that the US Justice Department will allow Colorado and Washington to move forward with statewide efforts to license and regulate the adult marijuana market. Cole later reaffirmed the agency’s position in testimony before the US Senate, stating, “We will not … seek to preempt state ballot initiatives.”
#4 States Finalize Regulations Governing Adult Cannabis Sales
Regulators in Colorado and Washington this fall began accepting applications from businesses seeking to engage in the licensed cultivation, production, and retail sale of cannabis and cannabis-infused products. In Washington, several thousand applicants have applied to pot business licenses. In Colorado, regulators have begun approving licenses and several commercial establishments are expected to be open for business on January 1, 2014.
#5 Record Number Of Statewide Marijuana Reform Measures Enacted Into Law
Lawmakers in a dozen states approved some 20 pieces of marijuana law reform legislation in 2013. Specifically, lawmakers in Colorado and Vermont enacted legislation licensing commercial hemp production; Illinois and New Hampshire legalized the use and distribution of marijuana for medical purposes; Oregon and Nevada approved regulations allowing for the establishment of medical cannabis distribution facilities; and Oregon and Vermont significantly reduced marijuana possession penalties.
#6 Cannabis Dispensaries Open In Washington, DC
Medical cannabis facilities opened for business in Washington, DC in 2013. The establishments are licensed and regulated by the District of Columbia, which finally unveiled its long-awaited medical marijuana program earlier this year. State-authorized dispensaries also opened for the first time this year in New Jersey, Rhode Island, and Vermont. Lawmakers in four states, Illinois, Oregon, Nevada and New Hampshire, enacted legislation in 2013 allowing for the establishment of medicinal cannabis facilities.
#7 Study: Blacks Arrested For Pot Offenses At Rates Four Times That Of Whites
African Americans are far more likely to be arrested for marijuana possession offenses than are whites, according to an American Civil Liberties Union (ACLU) report released in June that analyzed arrest data from 945 counties nationwide. The report found that blacks were approximately four times as likely as whites to be arrested for marijuana possession in 2010, even though both ethnicities consumed the substance at similar rates. Authors reported that the racial disparity in arrest rates had grown significantly over the past decade and that in some states African Americans were nearly eight times as likely as whites to be arrested for cannabis possession.
#8 FDA Approves Clinical Trials Of CBD In Cases Of Pediatric Epilepsy
The US Food and Drug Administration this fall granted approval for the importation of cannabidiol (CBD) extracts as an experimental treatment for a rare, intractable form of pediatric epilepsy known as Dravet syndrome. Preliminary clinical trials assessing the safety and tolerability of the compound in children are scheduled to begin in early 2014. Cannabidiol is a non-psychoactive cannabinoid that has been documented to possess a variety of therapeutic qualities, including anti-inflammatory, anti-diabetic, anti-epileptic, anti-cancer, and bone-stimulating properties.
#9 Study: No Association Between Cannabis Smoking And Lung Cancer
Subjects who regularly inhale cannabis smoke possess no greater risk of lung cancer than do those who consume it occasionally or not at all, according to data presented in May at the annual meeting of the American Academy for Cancer Research. UCLA investigators analyzed data from six case-control studies, conducted between 1999 and 2012, involving over 5,000 subjects (2,159 cases and 2,985 controls). They reported, “Our pooled results showed no significant association between the intensity, duration, or cumulative consumption of cannabis smoke and the risk of lung cancer overall or in never smokers.”
#10 Members Of Congress Introduce Legislation To End Federal Pot Prohibition
Members of Congress in February introduced historic legislation, HR 499: The Ending Federal Marijuana Prohibition Act, to remove cannabis from the control of the Drug Enforcement Administration and authorize the US Department of Treasury to license state-authorized retail marijuana producers and distributors. Although Congress refused to vote on the measure in 2013, it was the most-viewed legislation on the Congress.gov website.
Cananbidiol (CBD), a non-psychotropic cannabinoid, alleviates psychotic symptoms and may hold promise as an alternative antipsychotic treatment, according to a review published in the November issue of the journal Neuropsychopharmacology.
Investigators in the Netherlands and in the United Kingdom reviewed preclinical and clinical data on the use of CBD as an antipsychotic agent. Authors reported that both animal and human studies document the ability of CBD to mitigate symptoms of psychosis. Specifically, CBD administration is associated with improved symptoms in clinical evaluations of patients with schizophrenia, Parkinson’s disease, and ketamine-induced dissociative and psychotic symptoms.
Investigators also highlighted a 2012 double-blind, randomized placebo-controlled trial assessing CBD versus the prescription anti-psychotic drug amisulpride in 42 subjects with schizophrenia and acute paranoia. Authors reported that both CBD and the prescription drug were associated with “equally significant clinical improvement” in this patient population, but that cannabidiol “possessed significantly less side effects.”
Researchers concluded: “[E]vidence from several study domains suggests that CBD has some potential as an antipsychotic treatment. … Given the high tolerability and superior cost-effectiveness, CBD may prove to be an attractive alternative to current antipsychotic treatment.”
Previous human trials assessing the administration of CBD in healthy human subjects report that the cannabinoid is “safe and well tolerated.”
Separate investigations of CBD, primarily in animal models, have documented the cannabinoid to possess a variety of therapeutic qualities, including anti-inflammatory, anti-diabetic, anti-epileptic, anti-cancer, and bone-stimulating properties. Recently, the FDA approved the experimental use of CBD extracts for the treatment of a rare form of intractable pediatric epilepsy known as Dravet syndrome. Preliminary clinical trials assessing the safety and tolerability of the compound in children are scheduled to begin imminently.
Full text of the study, entitled “Cannabidiol as a potential treatment for psychosis,” appears online here.
Study: Non-Psychoactive Plant Cannabinoids Possess Synergistic Anti-Cancer Activity In Leukemia Cell LinesOctober 15, 2013
The concomitant administration of various non-psychoactive plant cannabinoids demonstrates synergistic anti-cancer activity in human leukemia cells, according to preclinical trial data published online this week in the journal Anticancer Research.
Investigators from Saint George’s, University of London assessed the anti-cancer potential of three non-psychoactive cannabinoids (cannabidiol, cannabigerol, and cannabigevarin) and their respective acids on two types of leukaemia cell lines. Authors reported that the administration of cannabinoids in concert with one another resulted in “in additive/mildly synergistic interaction.”
They concluded: “Our findings indicate that cannabinoids act with each other in a way such that doses for therapy could be reduced without a significant loss of activity. … [T]his study adds further support to the idea that cannabinoids can have a role in the cancer setting, not only as single agents, but also in combination with each other.”
Commenting on the study in a press release, lead author Wai Lui said: “These agents are able to interfere with the development of cancerous cells, stopping them in their tracks and preventing them from growing. In some cases, by using specific dosage patterns, they can destroy cancer cells on their own. Used in combination with existing treatment, we could discover some highly effective strategies for tackling cancer. Significantly, these compounds are inexpensive to produce and making better use of their unique properties could result in much more cost effective anti-cancer drugs in future.”
Plant cannabinoids as well as endogenous cannabinoids have been consistently shown to be potent anti-cancer inhibitors in preclinical models, halting the proliferation of glioma cancer cells, prostate cancer cells, breast carcinoma, lung carcinoma, and lymphoma, among other cancer cell lines. NORML’s review of much of this literature appears online here.
An abstract of the study, “Enhancing the activity of cannabidiol and other cannabinoids in vitro through modifications to drug combinations and treatment schedules,” appears online here.
Republican Gov. Chris Christie has signed legislation, Senate Bill 2842, into law modifying aspects of the state’s medical marijuana regulations.
Specifically, the law amends requirements that state-licensed medical cannabis producers and distributors be limited to providing patients with no more than three strains of the plant – a regulatory rule that has been in place since the program’s inception some three years ago. Proponents of the rule change argued that lifting the three-strain cap will foster the production and distribution of varieties of cannabis high in CBD (cannabidiol) content. Cannabidiol is a non-psychotropic cannabinoid that possesses a variety of therapeutic properties. However, it is typically present at relatively low levels in conventional strains of marijuana, which typically are bred to possess higher quantities of THC – the primary psychoactive ingredient in cannabis.
Senate Bill 2842 also allows for cannabis distributors to produce marijuana-infused edible products. However, at the insistence of the Governor, consumption of such products will be limited to those age 18 and younger.
Governor Christie previously vetoed language that sought to streamline regulations so that qualified patients under the age of 18 could more readily access medicinal cannabis.
Under present New Jersey law, authorized patients may only obtain medical cannabis from state-licensed dispensaries. To date, however, few facilities are actively up and running. Earlier this month, the state’s Economic Developmental Authority approved a $375,000 loan to the Compassionate Care Foundation dispensary, which plans to open its doors in mid-October.