Early this week, the Brookings Institution released a report titled 'Ending the U.S. government's war on medical marijuana research', which analyzes the ways in which the federal government hinders effective research, and how these policies could be changed.
The federal government is stifling medical research in a rapidly transforming area of public policy that has consequences for public health and public safety. As medical marijuana becomes increasingly accessible in state-regulated, legal markets, and as others self-medicate in jurisdictions that do not allow the medical use of cannabis, it is increasingly important that the scientific community conduct research on this substance. However, statutory, regulatory, bureaucratic, and cultural barriers have paralyzed science and threatened the integrity of research freedom in this area. It is time for the federal government to recognize the serious public policy risks born from limited medical, public health, and pharmaceutical research into cannabis and its use.
You can read the full report here.
Huge news broke today in the world of marijuana policy reform. Governors Christine Gregoire (D-WA) and Lincoln Chafee (I-RI) announced in a joint conference call that they had petitioned the federal government to reschedule marijuana. We can expect that this will produce headlines across the country. We can also expect that the coverage will tout this as a far more significant – and positive, from the perspective of patients – event than it actually is.
Before harping on the negative, let’s appreciate the positive aspect of the announcement. What we have here is two governors filing a petition with the federal government, backed by extensive documentation, saying that marijuana has an accepted medical use in our society. We have known this for years, but it is nice that it is becoming the general consensus. Unfortunately, that’s about all we have on the positive side of the ledger. After that, it is mostly bad news wrapped in good news clothing.
The misleading coverage started the moment the news broke, when The New York Times published its exclusive on the announcement. Describing how the governors wanted marijuana moved from Schedule I to Schedule II, the Times wrote, “Such a classification would allow pharmacies to dispense marijuana.” While technically true, in the sense that pharmacies cannot dispense Schedule I drugs, the reader is led to believe that marijuana would be available in pharmacies as soon as it is rescheduled. This is far from certain and could be a long way off on the horizon.
Given the long-held position of the federal government that it is the FDA that determines whether a substance is a medicine, it is likely that marijuana will not be available in pharmacies until it has made its way through the FDA approval process.* This is a process that could take up to a decade under the best of circumstances. But marijuana research does not exist in this country under the best of circumstance. In fact, as I wrote about recently in a Washington Post piece about stalled research on the use of marijuana for PTSD, it is almost impossible to conduct research on marijuana in this country. Moving marijuana to Schedule II will not change the rules under which marijuana research is (or is not) conducted.
Even if we were to ignore this not-so-minor problem about research and FDA approval, the governors clearly left the impression that they were pursuing rescheduling over embracing, implementing and defending existing medical marijuana laws in their own states. Yet they know that the rescheduling process will take years, perhaps more than a decade. In the meantime, patients in their states will suffer. The best Gov. Gregoire could say about this unfortunate delay during the press conference was that she was going to “encourage the federal government to not take nine years” to consider the petition. Woo. Hoo.
Finally, there is the additional matter of the specific request for Schedule II, a category of drugs defined under law as having a “high potential for abuse” that “may lead to severe psychological or physical dependence.” Drug like cocaine and morphine fall in this category. Marijuana does not belong there. At worst, marijuana should fall in Schedule III – where Marinol, which is synthetic THC is placed – a category of drugs that “may lead to moderate or low physical dependence or high psychological dependence.”
The New York Times article even included a quote from Governor Gregoire, suggesting that marijuana was not on the same level as the more dangerous Schedule II drugs.
Ms. Gregoire noted that many doctors believe it makes no sense to place marijuana in a more restricted category than opium and morphine. “People die from overdose of opiates,” she said. “Has anybody died from marijuana?”
No, Ms. Gregoire, they haven’t. And the harms from marijuana overall are quite limited. You and Mr. Chafee have come a long way today. Now it is time to step entirely out of the world of negative marijuana stereotypes and allow medical marijuana programs to move forward in your states. Rescheduling will happen eventually -- and we commend you for petitioning for it -- but you shouldn’t make patients in your state suffer in the meantime.
* The author would like to include a clarification, or perhaps it is a correction, here. After consulting with experts, he believes that a lengthy FDA approval process, meaning full trials to prove that marijuana is effective for a specific condition, would not be needed before marijuana could be available in pharmacies. However, there could still be a significant delay before marijuana appears in pharamacies after rescheduling (a process that could be quite lengthy itself). The DEA would have to license entities to cultivate the marijuana -- a process likely to be slow, given the DEA's history in this area. Then, maybe six months to a year later, the FDA would need to examine the marijuana produced by any entity to ensure that it is a consistent, reliable and pure product. And even after all of these steps have concluded, patients may have to deal with obstacles stemming from marijuana being listed as a Schedule II drug, including the fact that doctors and pharmacies would have to report every prescription to the DEA and that there would be no refills allowed, increasing the number of times patients would need to see doctors.