The State of Cannabis Research Legislation in 2020 (USA) – New England Journal of Medicine
As growing numbers of Americans use federally unregulated cannabis products and develop complications — such as psychosis, cannabis use disorder, and electronic-cigarette, or vaping, product use–associated lung injury (EVALI) — the need to facilitate research on the products that our patients purchase from dispensaries is becoming increasingly pressing.
Patients in our clinics routinely report using vape pens, dabs, waxes, edibles, and oils purporting to contain various concentrations of cannabinoids such as cannabidiol (CBD) and tetrahydrocannabinol (THC). Physicians register patients to obtain medicinal cannabis, counsel them on safe use of cannabis products, and monitor them for side effects of such products, yet they don’t have access to reliable evidence on the effects of the products that patients are using.
This dilemma was underscored by witnesses from federal agencies who testified before the House subcommittee. To date, 33 states and Washington, D.C., have legalized cannabis for medicinal use. Other states, predominantly in the Southeast, have laws allowing people with certain medical conditions such as cancer to possess products that contain CBD and low concentrations of THC. The majority of Americans now live in a state where use of marijuana for medical or recreational purposes is legal, despite cannabis’s designation as a Schedule I drug under the Controlled Substances Act, with no currently accepted medical use and a high potential for abuse.
They added that both the NIH and the FDA support enabling researchers who hold a Schedule I license to study cannabis to obtain products from state sanctioned dispensaries. Their recommendations, however, have not resulted in proposed legislation that would support researchers who want to conduct clinical trials using products obtained from dispensaries
The state of cannabis research policy in 2020 resembles that of the previous decade: there is still only a single grower officially allowed by the DEA to produce cannabis for research purposes, and researchers lack appropriate access to commercially available products for clinical trials. We believe that it is important to facilitate research on cannabis products that patients are currently using in order to mitigate potential harms
This burden could be alleviated quickly, and allowing multiple investigators to work under a single institutional license would increase the amount and quality of cannabis-related research. The government could take this step without removing appropriate controls on cannabis access and distribution.
Although the campaign for rigorous research involving clinical trials of commercial products is moving in the right direction, progress has been slow. In the meantime, our patients continue to use various state-sanctioned cannabis products marketed as medicines in the absence of evidence to support their benefits or define their harms. We believe that the federal government should create prompt and practical ways for investigators to study the products that patients are using. We cannot wait for another public health disaster like the EVALI outbreak to push us forward.
For complete perspective piece go to https://www.nejm.org/doi/pdf/10.1056/NEJMp2003095?articleTools=true