In November 2010, the citizens of Arizona passed Proposition 203, thereby establishing a medical marijuana program. Despite many delays, Arizona is now in the process of awarding licenses to nearly 100 new dispensary operators. Yet as patients eagerly anticipate regulated cannabis, they find themselves in the crosshairs of a political battle they should not have to fight.
Arizona doctors seeking to utilize the program for their patients’ care must turn to the limited scientific literature on the efficacy of medical marijuana. Despite great demand for more FDA-approved research from Arizona and elsewhere, obstructive federal regulations are creating enormous barriers to new research and thwarting peer-reviewed studies of medical cannabis.
The call to open up marijuana research comes from a diverse cross-section of the medical community. Among the organizations seeking new research are the American Academy of HIV Medicine, the American College of Physicians, the Leukemia and Lymphoma Society, and the American Nurses Association. In June 2012, the Arizona Medical Association joined these respected organizations in requesting the elimination of barriers to research.
The federal policies obstructing FDA-approved research include a redundant multi-agency review process that creates unnecessary red tape and wasteful government spending. Like other drugs, cannabis should undergo the rigorous FDA approval process. But unlike studies done for other schedule I drugs, only cannabis research must pass this additional review process before the National Institute on Drug Abuse will release the research material. By law NIDA is the sole, monopolistic supplier of all cannabis to be used for these studies.
NIDA administers this additional review process and has a fundamental conflict of interest in deciding which studies it will allow. The agency’s very mission statement restricts it from approving research that may help uncover any therapeutic potential of marijuana. Thus, scientists who hope to provide relevant information about medical marijuana regarding dosing, administration mechanisms, and other practicalities are prevented from obtaining the necessary source material. Even researchers obtaining NIDA’s approval must still contend with ludicrously inferior and radically more expensive cannabis than is readily available from state regulated dispensaries.
My research is intended to address some of the unanswered questions surrounding medical marijuana, particularly the proper dosage for patients. Yet despite receiving FDA approval, our study is on indefinite hold by NIDA. To put patients rather than politics front and center, there is a desperate need to expand cannabis research. To this end, medical marijuana researchers want to utilize state funds received from dispensary and patient application fees to fund more peer-reviewed research, so that doctors can make scientifically grounded decisions when treating their patients with cannabis.
Without more research, society is leaving medical marijuana open for opportunists who want to politicize the issue, rather than allowing doctors to explore viable new options that work to serve the best interests of those in need — our patients.
— Dr. Sue Sisley, M.D., is a board member of the Maricopa County Medical Society who specializes in internal medicine and psychiatry.