How trustworthy are crowd-sourced medical treatments? Smart Approaches to Marijuana, a group that bills itself as “preventing another ‘big tobacco'” has written to the editor of The Denver Post to express disapproval regarding medical information provided by Leafly, one of the sponsors of The Cannabist, the marijuana site run by The Denver Post.
As a marijuana resource site, Leafly allows users to review strains of marijuana; part of the review process allows users to select medical conditions and symptoms they believe a strain can treat, as well as allowing them to add their own medical conditions and symptoms they believe are treatable with specific strains.
On Leafly’s strain review form, there are 40 medical conditions and symptoms to select from. The conditions include mental illnesses, and that is what has gotten the attention of Smart Approaches to Marijuana. On August 6, Bob Doyle, Dr. Eden Evins and Dr. Christian Thurston sent a letter to Greg Moore, editor of The Denver Post, and Ricardo Baca, editor of The Cannabist; they asked to be provided the data by which Leafly makes its claims about treatment of mental health illness.
So far, marijuana hasn’t been tested in a clinical atmosphere for its treatment against any sort of mental illness. Dr. Suzanne Sisley is working with the Multidisciplinary Association for Psychedelic Studies to begin a Food & Drug Administration-approved clinical trial about the efficacy of marijuana in treating post-traumatic stress disorder. As of today, MAPS and Dr. Sisley are seeking a new venue for the study, because the University of Arizona’s termination of Sisley caused the project’s upheaval.
According to Martha Montemayor, the general manager of Healthy Choices Unlimited, told The Cannabist that when it comes to marijuana prescriptions, doctors who write prescriptions tend to see their patients only once per year. Colorado Department of Public Health and Environment has also denied all petitions to add mental illnesses to the list of approved conditions for medical marijuana. Conditions such as PTSD, severe anxiety, clinical depression, Tourette’s Syndrome and bi-polar disease have all been specifically denied as conditions eligible for medical marijuana prescriptions in Colorado.
Colorado has also denied petitions for adding Chron’s Disease, hypertension and asthma to the list of approved conditions for medical marijuana prescriptions. Adding those conditions to the mental conditions listed above equates to 20 percent of the pre-populated medical symptoms and conditions on Leafly’s strain review form.
Essentially, 20 percent of the suggested medical conditions on Leafly’s strain review form have been specifically rejected by Colorado as afflictions that may be treated with marijuana. Furthermore, Leafly’s strain review form allows users to add their own medical conditions and symptoms they believe are treatable with specific strains. Ultimately, the top five of each symptom or condition selected by the users shows up in a list on the strain review page.
Through its terms of service, Leafly indemnifies itself by saying it doesn’t actually stand by anything written on its site. Additional to pointing out that all information is for informational purposes, the terms of service state, “Leafly does not endorse, and is not responsible for the accuracy or reliability of, any opinion, advice, or statement made on the site or services.” Basically, the medical conditions and symptoms listed on Leafly are of no authoritative value whatsoever. MJIN reached out to Leafly by phone and was directed to send an inquiry by email. MJIN has yet to receive a response to the email request for comment from Leafly.
When Greg Moore, editor of The Denver Post, responded to the letter sent by SAM, Moore said that SAM ought to take the issue up with Leafly. Moore also compared Leafly’s process of determining symptoms and conditions to the Rotten Tomatoes rating system. Doyle replied by stating that the system is “absurd” and the FDA and other regulatory agencies ought to “get off the sidelines” and do something to regulate this. Perhaps the FDA actually has been off the sidelines for a while. Marijuana is a Schedule I drug on their list of controlled substances, meaning it has no medical value whatsoever, is a drug of abuse, and therefore not subject to clinical trials.
In an emailed response to a request for comment made by MJIN through SAM’s website, Kevin Sabet said, “We have been very public with what we would like FDA to do – vigorously fund research into legitimate medical uses of marijuana and [its] components, but also go after illegitimate companies making false and unfounded medical claims about smoked marijuana. Marijuana may be schedule I, but these companies are getting away with advertising and product claims and placement as if [their] product was water. There’s plenty more to be done – for starters we could make sure we’re not encouraging false medical claims and advertising.” Bob Doyle was copied on the email.
Even if Congress were to allow the FDA to reschedule marijuana, it’s pretty much uncontrolled under Colorado state law for recreational use, aside from limits on growing and possession. Basically, marijuana will either need to be regulated by the FDA on the order of tobacco, or it will be considered a dietary supplement. It is likely that marijuana will be treated by the FDA like tobacco, with its own regulatory rules to be written, which may include regulations on labeling, potency, advertising and who-knows what else. But again, in order for this to happen, marijuana will need to be removed from the list of controlled substances.
If for some reason, marijuana is treated like a herbal dietary supplement after it is legalized, it will be subject to the laws under the Dietary Supplement Health and Education Act, which means that the burden of proof in disputing claims of medical benefits would fall upon someone trying to prove marijuana was unsafe. DSHEA would prohibit marijuana as a supplement making any specific claims for treating or curing a disease or ailment, but marijuana marketers could still use clever wording to suggest what a strain is purported to do. For instance, if a particular strain is defined on Leafly as curing depression, the producer of the strain could not advertise that information, but they could describe the strain as a mood enhancer. Enforcing the truthfulness of those claims would be the responsibility of the Federal Trade Commission.
For now, marijuana remains illegal at the federal level. It is also regarded by the FDA as one of the most nefarious drugs on the market. The FDA can’t really get off of the sidelines against marijuana any more than that unless something were to change dramatically in the law. Furthermore, as Leafly’s terms of service points out that everything is the collected opinion of their users, people can say whatever they want about a strain on the site. Before the world seriously figures out how specific strains of medical marijuana should be recommended for therapeutic or medical treatment, marijuana needs to be removed as a controlled substance. In the meantime, marijuana will enjoy a period of “Wild West” hucksterism.