This month President Biden signed into law the Medical Marijuana and Cannabidiol Research Expansion Act, and it’s a good first start. But as a board-certified emergency physician working directly with medical cannabis patients in Maryland since our medical cannabis law passed, I know we need to do more.
First, the bill still does not allow research to be done on the cannabis products that almost 5.5 million patients are using legally in their state programs today. For the last quarter century, states have had to individually pass medical cannabis laws to help their citizens. This fragmented approach, with each state having their own regulations and no federal oversight or guidance, creates a lack of standardization in product quality, safety, accessibility and affordability, as well as some patients having no access at all. This puts the onus on patients to self-educate, while they circumnavigate their therapeutic treatments. This is despite the fact that, 76% of doctors, 93% of Americans and 83% of veterans support the legal medical use of cannabis.
The politicization of this medicinal plant for almost a century has caused our country to lag far behind other countries that have created federal cannabis program for the benefit of their sickest citizens. Countries like Israel have standardized their approach to medical cannabis, making it accessible to patients through their state health care systems like any other medication, assuring uniform, high-quality products are available and paving the way for groundbreaking research known around the world. Australia has created a national data registry to track and improve evidence-based therapeutic guidelines for their patients.
While the recent legislation is an initial step in the right direction, it really seems to be too little, and almost too late. It was back in 2017 that the National Academies of Science Engineering and Medicine published their report showing clinical evidence for medical cannabis use and calling for more research. Additionally, the expensive and long drawn-out requirements for successful Food and Drug Administration sponsored research can take decades, leaving U.S. physicians and patients even further behind.
The lack of standardized medical cannabis programs and products today in the U.S., doesn’t allow for a clinically meaningful approach to therapeutic recommendations. For example, a recent study published this month in JAMA Oncology found that cancer patients may be able to forgo opioid use during treatment when taking cannabis. It was a population study looking at opioid use in cancer patients around the country comparing states with and without medical cannabis legalization programs. While encouraging to see that cannabis may in fact lower opioid use, this type of research provides us with no information on the quality, doses or frequency of cannabis needed to create reproducible evidence-based guidelines for our patients.
We need to unify our approach to medical cannabis science and therapeutics, with federal guidance and oversight, by rescheduling its status on the Controlled Substance Act. It’s archaic to classify cannabis as a schedule 1 drug, which, by definition, states it has no currently accepted medical use. Our patients deserve access, quality, safety and affordability just as they would for any medical treatment. As physicians and researchers, we are asking Congress and our leadership to pass more comprehensive, clinically meaningful cannabis legislation, our patients deserve no less.
Dr. Leigh Vinocur is a board-certified emergency physician with one of the first master’s degrees in the country in Medical Cannabis Science and Therapeutics from the University of Maryland School of Pharmacy. She is the founder and Chief Medical officer of Ananda Medical Practice and Consulting. She writes a monthly column for the Hearst publication GreenState.com answering readers’ cannabis questions and co-hosts an educational podcast on medical cannabis for clinicians called Cannabis Grand Rounds.
Originally published in The Baltimore Sun, December 26, 2022.