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Gupta: DEA’s missed opportunity on medical marijuana

Posted at 7:48 PM, Aug 11, 2016
and last updated 2016-08-11 21:48:20-04

By Dr. Sanjay Gupta

Chief Medical Correspondent

(CNN) — There is really just one salient question when it comes to today’s decision by the Drug Enforcement Administration to expand the number of growers of research-grade marijuana while still not changing the scheduling of marijuana: Will this decision make it significantly easier for scientists to study the medical benefits of marijuana?

The answer sadly is: unlikely. And this is a missed opportunity that could further delay potential therapies to countless people.

Up until today, there has been only one federally approved source of research-grade medical marijuana, at the University of Mississippi. In a bit of seemingly positive news today, the DEA also announced it will now allow other places to apply for permission to do the same. The hope is that marijuana available for scientific study could grow in both amount and diversity.

While this will be hailed as a victory for research, it will largely be symbolic, because no matter how much marijuana is available, if access is still difficult, it hardly matters.

Imagine a product that is in high demand but kept behind a locked door. In response to the demand for the product, someone makes a baffling decision to make more of it but still never unlocks the door.

Marijuana is that product, and its Schedule I designation is that locked door.

That is the predicament of medical marijuana.

Because marijuana is a Schedule I substance (meaning that by definition it has “no currently accepted medical use and a high potential for abuse”), there are significant hurdles to getting the door unlocked.

Potential researchers typically go to the DEA first, as it grants the license to begin scientific research. Even if a license is granted, to study a Schedule I substance, institutions must have heavy-duty safes and high-grade security systems installed, which can be expensive. There is also the more subjective consideration of getting approval from your academic institution to do the research on a Schedule I status substance in the first place. Even if individual faculty members want to do that research, the university leadership may not want the hassle or the potential fallout of bad press. This happened at the University of Arizona when Dr. Sue Sisley was let go after trying to pursue a medical marijuana trial.

Sisley eventually had to find private funding for her project, and just in April, seven years after the study was initially proposed, hers became the first DEA approved medical marijuana trial for post-traumatic stress in veterans.

Then, after years of bureaucratic hurdles, it is the National Institute on Drug Abuse that has held the final key to the lock. Today, it is the biggest funder of medical marijuana research and has been the sole supplier of the marijuana itself. Even if more medical marijuana will now be freed up for research, the institute will still have to approve any studies it funds.

The problem, however, is that last word in its name: “abuse.”

According to Dr. Donald Abrams at the University of San Francisco, whom I interviewed for my documentary “Weed,” the institute has a primary mandate to study substances for potential abuse rather than as a medicine. Abrams makes an important point. Even if a study does cross all the hurdles described above, the door may stay locked if the intent is to study the benefits of medical marijuana as opposed to the harm.

Consider this: A quick (and admittedly non-scientific) search through the U.S. National Library of Medicine pulled up 1,434 papers on medical marijuana over the past five years. That same search revealed only 57 papers on medical marijuana benefits. The vast majority were research into the harm of marijuana, such as “Bad trip due to anticholinergic effect of cannabis,” “Cannabis induced pancreatitits” and “Marijuana use and risk of lung cancer.” That imbalance paints a highly distorted picture.

Contradictory policy

The road to medical marijuana research is paved with surprises and hypocrisy nearly everywhere you look.

While the DEA continues to dig in on Schedule I status, deeming no medical benefit, the U.S. Department of Health and Human Services simultaneously holds a patent on cannabinoids for a wide range of medicinal purposes.

The DEA continues to place marijuana alongside heroin and LSD as drugs with high abuse potential even though the DEA’s own former chief administrative law judge, Francis Young, disagreed with this.

This is one of many quotes from his 1988 petition (PDF) to unschedule marijuana.

“In strict medical terms marijuana is far safer than many foods we commonly consume. For example, eating 10 raw potatoes can result in a toxic response. By comparison, it is physically impossible to eat enough marijuana to induce death. Marijuana in its natural form is one of the safest therapeutically active substances known to man. By any measure of rational analysis marijuana can be safely used within the supervised routine of medical care.”

Again, that was from a judge with the DEA itself. And yet nearly 30 years later, little has changed.

Whether we realize it or not, we all accept a certain amount of hypocrisy in our daily lives. Maybe we don’t always have the energy to call it out or we are too speechless and dumbfounded that no one else seems to have noticed.

With regard to the hypocrisy of federal medical marijuana policy, however, it is worth summoning the stamina to relentlessly present the facts. The lives of patients — such as that of Charlotte Figi, whose seizures abated with the use of medical marijuana, and so many others — depend on it.

That a plant could provide so much benefit and still remain behind these locked doors is worth speaking up about.

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