Many were puzzled earlier this spring when Gov. Andrew Cuomo and the New York State legislature reached a deal to legalize medical marijuana, but only in vaporizable form and only for a list of conditions that changed up until the last moment.
Where was scientific rationale when restrictions were being established? The negotiation seems to have been fairly research-free. “What’s happening in the states is not related to science at all,” according to Dr. Donald Vereen, former adviser to the National Institute on Drug Abuse.
There are plenty of anecdotes about marijuana’s benefits—witness the story of Charlotte Figi’s near-miraculous relief from seizures. There are also plenty of anecdotes about hazards, as when Maureen Dowd ate too much of her cannabis-infused candy bar. But both advocates and opponents of legalization agree on one thing: there is very little science. The biggest impediment to reliable scientific research seems to be the federal government itself, but there are glimmers of hope in the states.
Drug Research in the Non-Weed World
In the best of all possible worlds, drug research moves along a predictable path from identification and drug purification, to laboratory tests involving cells or animals, to controlled clinical trials with human beings, to FDA approval and continued monitoring.
The process is not perfect. Industry funded trials are far more likely to produce positive results for a drug than independently funded studies. In what is termed “publication bias,” studies that show problems sometimes simply never see the light of day. Nonetheless, even a little bit of scientific research is better than a collection of often unverifiable stories.
Drug Research in the Weed World
Federal spending on marijuana research peaked at $131 million in 2007, but has dropped off sharply since then. The funding that continues is directed to the NIDA, whose mandate is the one-sided study of abuse. The results have all the biases of drug trials funded by the pharmaceutical industry. More critically, though, NIDA controls access to federally-grown pot, and researchers who want to study the benefits of cannabis simply cannot get samples.
Private funding does not insulate the studies from political interference, either. The University of Arizona apparently caved to pressure from the state legislature in their recent firing of Dr. Suzanne Sisley, who had been preparing to embark on a rigorous, FDA-approved, randomized controlled trial study of marijuana’s potential to treat PTSD in combat veterans.
Dr. Sisley is not alone. Highly restrictive state laws have forced scientists at the University of Minnesota to move to California to complete their NIH-funded clinical trials of marijuana as a treatment for sickle cell pain.
A Glimmer of Hope
The news is not all bad, though. In S.B. 155, signed by Gov. John Hickenlooper in May of this year, Colorado earmarked up to $10 million of the tax revenues generated by legal marijuana sales to study the medical benefits of the drug. Some months earlier, the University of Washington received a grant from the state Attorney General’s office to provide scientific information and training to clinicians and the general public on medical marijuana’s role in pain management.
Is there a potential for reverse bias in these studies and training opportunities? Of course, but they still add other voices to the debate. Perhaps one of the greatest benefits of legalization is that it allows us, at last, to evaluate scientific evidence. Information is a great tool for making political decisions.