Experts Gather at National Conference to Discuss Medical Marijuana Risks and Benefits
The National Institutes of Health recently hosted a conference titled, "Marijuana and Cannabinoids: A Neuroscience Research Summit" attended by medical and public health experts and Practical Pain Management. Here, some highlights from the meeting.
With a growing number of states embracing the concept of medical marijuana, and legalization becoming more mainstream across the nation, there are many pressing health and safety concerns that are important to understand in order to ensure supportive practices and policies are in place, according to medical and public health experts.
This was the theme of a conference convened by the National Institutes of Health (NIH) on March 22-22, 2016 in Bethesda, Maryland. The event brought together key federal organizations and researchers to explore the latest advances and scientific findings on marijuana and cannabinoids use and to determine where the nation should go from here.
The Current Landscape
There is widespread acceptance today of the therapeutic benefits of the marijuana plant to treat a variety of health conditions such as epilepsy, multiple sclerosis, and autoimmune conditions. In fact, as of March 21, 2016, the National Conference of State Legislatures (NCSL) reports that 23 states, plus the District of Columbia and Guam, have enacted comprehensive medical marijuana and cannabis programs.
In addition, 17 states have also approved products containing high amounts of a component of the marijuana plant called cannabidiol (also known as CBD), and low amounts of tetrahydrocannabinol (referred to as THC, which is the psychoactive ingredient in marijuana that causes some of its side effects) for certain medical situations such as epilepsy, cancer and HIV/AIDS.
But managing all of these developments also requires closely weighing the benefits and risks of medicinal and recreational marijuana use, as well as the long-term consequences.
Concurrent Alcohol and Other Drug Use
Conference presenters raised a number of critical questions and findings related to safeguarding communities from the ill effects of marijuana use.
For instance, several of the researchers stressed that with medical marijuana becoming more accessible, there is growing concern that the drug may also be much more available to teenagers. In addition, the use of marijuana for medical and recreation uses poses a public health risk for people of all ages. Marijuana use is often accompanied by alcohol and other drug use, and it can cause changes in motor skills and judgment, thereby leading to impaired driving and related traffic accidents. It can also impact memory, coordination, and cause other brain changes.
The Edocannabinoid System and Pain
Andrea Hohmann, PhD, of Indiana University, talked about the therapeutic potential of the endocannabinoid signaling system (a system in the body that regulates a variety of functions related to health and disease). She discussed the role of cannabis and how it acts on the body’s own system to activate natural chemicals to mediate the pain response. She also mentioned the benefit of using a compound that is high in CBD (because this form of the marijuana plant has been found to bring anti-spasmodic, anti-epileptic, anti-anxiety, and anti-psychotic benefits) and low in THC (which brings the “high” people associate with marijuana use). When these CBD and THC levels are combined, she said people may achieve the full therapeutic value of cannabis without the associated tolerance and other side effects.
Achieving Similar Results at Lower THC Levels
Presenter Barth Wilesy, MD, an associate physician in the Department of Psychiatry and Anesthesiology at the University of California, San Diego, referred to the results of clinical studies confirming cannabis’ effectiveness for treating neuropathic pain that accompanies conditions like diabetes, strokes, and spinal cord injuries.
In particular, he said that researchers have discovered that selecting low doses of THC (as low as 1.29%) can bring the same analgesic benefits as higher (up to 7%) doses, but can avoid some of the psychoactive side effects.
These findings are based on short-term studies but Dr. Wilesy said that a more intensive clinical trial is being planned for this summer to see if the findings remain consistent over the long-tern.
Other Risks of Marijuana Use
Other concerns that were raised during the 2-day sessions included whether people who smoke marijuana or cannabis could be at risk for lung problems or other health issues related to long-term use, making it important to look at other options, including edible and vaporized products.
In addition, most of the experts agreed that there is a strong need for policies that create uniform standards for medical marijuana, since the strength, makeup, dosage, and form can vary from dispensary to dispensary and from state to state. Since there is currently no oversight on marijuana products the way that there is on other medications (ie the Food and Drug Administration)0, this means patients don’t know what they are getting. In addition, it can be difficult to compare data from state to state if the details vary a great deal.
Looking to Tobacco Control Lessons
Stanton Glantz, PhD, of the University of California, San Francisco, recommended that policymakers look to tobacco control efforts for lessons learned that can help to regulate the field and help reduce underage access to marijuana and cannabis.
Further, a major takeaway from the conference was that despite the value that medical marijuana clearly offers, there is also reason for concern about the health impact and safety profile. Therefore, more research needs to be done on the benefits, risks, and ill effects of different forms of marijuana use. This information is essential to inform policymakers on both state and national levels on how best to create policies and practices that will balance the benefits and risks of marijuana use moving forward.
Conference sponsors included the National Institute on Drug Abuse(NIDA); the National Institute on Alcohol Abuse and Alcoholism (NIAAA); the National Center for Complementary and Integrative Health (NCCIH); the National Institute of Mental Health(NIMH); and the National Institute of Neurological Disorders and Stroke(NINDS).
For more information about medical marjuana, see "Drug Facts: Is Marijuana Medicine?" published by NIH and available on its website.