Why Progress In The Scientific Study Of Cannabis Has Been So Slow?
The push for full cannabis legalization is creating challenges for cannabis research
New laws in Canada and California, along with a high-profile medical case in the United Kingdom, are likely to accelerate international acceptance of marijuana, especially for medical use.
Medical cannabis market size over USD 7.0 billion in 2017 and is expected to witness more than 36.0% CAGR from 2018 to 2024.
Use of medical cannabis is expected to grow, especially for pain relief. Source
Cannabidiol (CBD), one of more than 100 cannabinoids in the marijuana plant, is said to have anti-inflammatory and calming benefits. There are countless claims of health benefits made about the therapeutic nature of this non-psychoactive compound. These claims include positive effects on diseases such as arthritis, epilepsy, and even terminal diseases, like cancer, AIDS, tumor, etc.
Regrettably, most of these health claims lack high-quality, science-backed evidence that show medical marijuana is both safe and effective.
What little evidence exists is unreliable, failing to represent the purpose for which medical marijuana is considered. Dosage standardization, overall effectiveness, drug interactions, contraindications and long-term risks associated with using marijuana as a medicine, are not well understood. The best evidence suggests that marijuana can be used as a medicine only if it meets the same standards of safety, quality and effectiveness of any other prescription drug. That standard has not yet been met.
Reasons for the lack of scientific evidence to support marijuana as a medicine
The research efforts for cannabis are stymied by the following primary barriers:
Regulatory barriers and slow process of certifying scientists
In the U.S., for example, medical researchers conducting clinical research on cannabis must first get FDA approval for their proposed study. Then, the investigator may contact the National Institute on Drug Abuse (NIDA) to obtain an administrative letter of authorization (LOA), which describes the manufacturer’s facilities, as well as the availability and characteristics of the desired cannabis product.
To safeguard against the gaining cannabis-for-non-research-purposes, investigators must also apply for a DEA (Federal Drug Enforcement Administration) registration and site licensure. Meeting the DEA laboratory requirements is a costly and lengthy process. Gaining approvals for new studies can take up to a year. Only eight researchers managed the Mississippi contract in 2010; though the number increased to 20 in 2017, according to NIDA.
Lack of funding
Due to inadequate funding support, cannabis research is unable to inform public health practice or keep pace with changes in cannabis policy and the ways cannabis is used. In 2015, the National Institutes of Health (NIH) spent a total of $111,275,219 on all cannabinoid research, of which the NIDA accounted for 59.3 percent on cannabinoid research. However, NIDA spent only 16.5 percent on investigating therapeutic properties of cannabis.
Investing in the health effects of cannabis on a diverse range of conditions such as metabolic syndrome, cardiovascular disease, cancer, Alzheimer's disease, obesity and sedentary behavior, requires a broader research agenda. However, it is unrealistic to expect that NIDA has the resources to fund this agenda.
Inferior products available for research
The University of Mississippi is the only research facility in the U.S., authorized to grow and test cannabis for medical research. But this effort is stymied, as scientists don’t even have products that match marijuana products that have recently been rolled out in the consumer market.
In 2016, the DEA proposed an expansion of the supply of high-quality cannabis for scientists. Unfortunately, then-Attorney General Jeff Sessions withheld the final approval.
The Future of Medical Cannabis Research
Addressing the issue of supply, the DEA recently approved Tilray Inc., a Canada-based importer, to ship a cannabinoid study drug for a clinical trial at the University of California San Diego (UC San Diego) Center for Medicinal Cannabis Research (CMCR). This positive step shows a commitment to research regarding the benefits of cannabis. Hopefully, the DEA’s resilience and support on this topic will eventually lead to a resolution on the issue of high-quality cannabis supply for certified researchers.
As demand in the consumer market and legalization increase, more pharmaceutical companies are diverting funds to studies. The continuous increase in knowledge, along with evolving social attitudes towards cannabis, will ensure that funding will continue to increase.
Though the classification of cannabis as Schedule I is certainly the biggest obstacle in R&D, we can expect a boom for medical cannabis in the near future given the support of scientific data seen in recent years. With the possibility of increased funding for research, this is even more likely.