June was another action-packed month when it came to cannabis news. Significant funds were allocated to new research, the USA moved to facilitate further study on cannabinoids, and new reports highlighted the shortcomings in evidence to support the USA s legalisation of medicinal cannabis for some illnesses.
Medical cannabis: research and regulation update
Medicinal cannabis continues to be a highly contentious issue, particularly in the media, with strong advocates for legalisation within Australia. It is interesting to note, the beginning of a subtle media shift last month, with the main take-home message starting to really emphasise the need for further research to ensure cannabis can do as promoted without causing harm.
Cannabis, cash and cures
Last month, there was extensive media coverage of a private donation of more than $30 million for medical cannabis research. An Australian couple, Barry and Joy Lambert, donated the money to the University of Sydney for the establishment of the Lambert Initiative, which will be dedicated to research into the effectiveness of cannabis in treating specific illnesses.
The Lamberts were motivated by the debilitating epilepsy suffered by their granddaughter, and the potential of medical cannabis, based on the seeming effectiveness of USA studies using pharmaceutically prepared CBD marketed as Epidiolex. The drug was tested on epilepsy sufferers in a pilot study by the New York University s Langone Comprehensive Epilepsy Centre. While the study did see a decrease in seizures for almost half of participants, the side-effects were so intense that some participants dropped out, and the study was not conducted with placebos for comparison. Though results did indicate some positive outcomes, the study leader, Dr Devinsky, argued larger, controlled studies need to be undertaken.
In June, the NSW State Government also announced a $9 million commitment to cannabis research over four years, and the establishment of a Centre for Medicinal Cannabis Research and Innovation.
AMA: patients deserve trials
Last month, Dr Saxon Smith, President of NSW s branch of the Australian Medical Association, took to the media to encourage further research in medicinal cannabis, saying, It has long been the AMA position that more medical research needs to be conducted on cannabis not to stop patients from accessing medicines that may help them, but to ensure drugs available for doctors to prescribe have consistent and predictable effects for patients, over both the short term and the long term.
He applauded the establishment of research centres and the investment in future studies, and emphasised the point, To protect the safety of the Australian community, all medicines are required to be exhaustively tested to ensure their effectiveness and their safety, especially when it comes to children. Many will remember the example of Thalidomide, a medicine that was effective but not safe. He went on to say patients deserve the safety and support of data from clinical trials.
News from the USA
On the US-front, the path for further research into medicinal cannabis has also been partly cleared, with restrictions on cannabis research somewhat decreased at a Federal level and the production of various cannabinoids for research purposes being stepped up. This change will enable more quality studies and ultimately, combined with research being undertaken in the rest of the world, the potential for a better understanding of what components of cannabis can do, how effective they may be, what dosages work best and what side effects may be triggered.
The Journal of the American Medical Association, published an interesting but not very surprising piece last month, based on the evaluation of 79 cannabis studies which involved more than 6,000 patients.
The article suggested evidence of the effectiveness of cannabis as a medicine is strongest in multiple sclerosis patients suffering muscle stiffness and spasticity, but evidence is weak for many other conditions and much more research is required. This review specifically pointed out US states that legalised medicinal cannabis, did so despite the lack of evidence of its effectiveness for illnesses it purports to treat. While this does show a significant need for more high-quality research (especially for whole-plant use as it has been legalised for medicinal use in several US states, and no gold-standard studies exist), it also emphasises that those considering the drug should be careful, consult medical professionals, and not base their decision on stories they read online.
Finally, The Lancet Psychiatry has published findings from a review of 24 years of data from the Monitoring the Future Survey , which included a total of 1.1 million teenagers attending school in 48 states in the USA. It suggests cannabis use by teenagers does not increase at a greater rate in states where the drug has been legalised for medicinal use. It did find that cannabis use increased overall and was higher in those states with medicinal cannabis availability. The study was conducted so researchers could help identify and disqualify factors that lead to increased use in teenagers, which they describe as a priority due to the effects use can have on developing brains. It will be interesting to see further exploration of this issue in states where cannabis use is legalised. In addition, given its well-known negative impact on school performance and drop-out, studies that include adolescents out of school will shed further light on this important issue.
Cannabis harms: new research on mixing alcohol and weed
In June, the University of Iowa released results from a study undertaken using a driving simulator, to assess the impact of alcohol and cannabis on driving skills. Not surprisingly, the results show getting behind the wheel under the influence, means getting behind the wheel impaired.
The study highlighted those who consumed alcohol or vaporised cannabis both weaved during the simulation, though those who consumed alcohol did weave more. An even greater effect was experienced by drivers who combined the two drugs. The study is part of a much larger project motivated by the increase in people driving with drugs in their system, and the introduction of medical cannabis in several states in the USA.
Last month also saw the publication of one of our own surveys, a poll of more than 4,600 people, around half of whom had recently used cannabis. The survey was designed to look at the effects of cannabis on driving, how users perceive the level of impairment and if this affects their decision to drive. The result was more than 16% had driven within five hours of using cannabis, and 25% did so weekly or monthly. Some believed cannabis made them better drivers because they drove slower and more carefully to compensate for the impairment. Dr Peter Gates, who led the survey, indicated that despite this tactic, drivers still experienced decreased coordination, focus and reaction-time which made them up to three times more likely to crash.
On a lighter note
Media this month also covered the establishment of the First Church of Cannabis in the United States. Led by self-appointed leader, Bill Levin, the church will exercise what it sees as its religious right to use cannabis as part of worship even in states where the drug is illegal. While readers found the whole thing just a little odd and out-there, the group crowdsourced $11,000 to fund a building and have been given not-for-profit status. Interestingly, the church charges a membership fee and sells rolling papers, calls its congregation cannabiterians and has established its own set of commandments, including, firstly, Don’t be an a hole .
Whether the church will be a positive or negative move when it comes to the stance of pro-cannabis advocates remains to be seen, but initial responses indicate it may have some impact on credibility.