Advocating medical marijuana research for public health

A brief overview of the 3rd Annual Hash Bash Panel Series

The Hash Bash panel series, held the day after Hash Bash (4/7/19) at the University of Michigan Law School, quickly filled the lecture hall to standing room only, necessitating a larger room next year. Sponsored by the Michigan Cannabis Industry Association and Students for Sensible Drug Policy, the panel series began with a scientific perspective, followed by a government interlude, before finishing with a public health focus.

Full Spectrum Medicinal Cannabis vs Synthetically Derived Cannabinoids

The first panel, a fascinating, rather quick yet technical dive into the chemistry, drug toxicity and biology of cannabis, was presented by two U-M professors, Dr. Gus Rosania and Dr. Kevin Boehnke, along with the Medical Director of Om of Medicine, Dr. Evan Litinas. Speaking of these technicalities in a Q&A style discussion, some highlights follow:

Rosania, a chemist and drug toxicity expert, explained in detail the differences of natural versus synthetic cannabis as well as the multitude of contextual influencing variables, including ingestion methods. Cannabis (THC/CBD) is generally safe and nonlethal, unlike opiates’ serious side effects. Rosania has worked to improve medical curriculum at the undergrad level, offering the first cannabis class at U-M (PharmSci 420), to update the current training and to enlighten future populations of students going into the medical field with evidence based information to integrate medical cannabis into patient treatments, advancing health and science together.

An anesthesiologist, Dr. Boehnke explained that this debate (natural vs. synthetic) is due to the fact that cannabis holds hundreds of different compounds, so the synergism/antagonism often creates more varied effects than perhaps an isolated (synthetic) source. This has not yet been demonstrated in human studies, so it remains a compelling theory until laws become less restrictive so that we can test this empirically. Boehnke astutely pointed out the need to persistently and patiently change the culture, combating decades of demonization of cannabis. To do so he advocates providing doctors with the latest information on medical cannabis.

Dr. Litinas reinforced how safe and effective cannabis is for chronic pain patients, stressing, however, that it’s necessary to educate patients to administer the medicine in a systematic and precise way. Litinas advocates education on what you put into your body, however due to marijuana’s status federally, doctors are limited, creating more problems and denying policy shifts.

The Director for the Bureau of Marijuana Regulation, Andrew Brisbo, represented the State, providing the latest Michigan efforts to enact recent recreational legislation. Mr. Brisbo reported that the state will likely be ready before December 2019, while reminding the audience that the State is only one part of the process. Municipalities as well as the US Department of Treasury present added hurdles. An audience question that resonated was the concern of patients being injured on the job and to allow the law to take effect whether or not they would be covered by workmen’s compensation if they test positive for medical marijuana. Brisbo explained that the law is written supporting drug testing by employers, reinforced by the Supreme Court ruling also backing employers.

Current Cannabis Research

The final panel presented cutting edge information on the latest medical cannabis research, from U-M’s Dr. Daniel Kruger and Dr. Sue Sisley, a principal investigator at the only FDA-approved randomized controlled trial in the world to examine the use of marijuana as treatment for combat veterans with PTSD. The panel closed with Emma Chasen, a patient educator and advocate from Portland, OR explaining the need for education to explain the scientific research to patients.

Re-Integrating Cannabis into Public Health

Dr. Kruger presented on three studies conducted during recent Hash Bashes. Survey results indicate there are strong reasons for using cannabis, supporting the beliefs that cannabis is much more effective, lower in addictiveness, somewhat lower in cost, lower in side effects and safer than opioids or other pharmaceuticals. In short, people like cannabis better and found it to be an effective substitute for pharmaceutical drugs. More research is needed on medical efficacy, dosages, strains, cannabinoid differentiation, integration and customized medical regimes. Both Kruger and Chasen reiterated that the purpose of public health is to protect people through a harm reduction model, not to perpetuate the historical preoccupation of abstinence when addressing cannabis.

Advocate for Medical Marijuana Research

Panelists suggested that citizens contact US Senator Debbie Dingell (and local representatives) in support of medical cannabis research and removing its Schedule 1 federal status. Dr. Sisley pointed out that citizens must hold the DEA accountable to their 2016 promise to approve other sites than the University of Missouri to provide medical cannabis for research. Taxpayer dollars should fund research on cannabis grown locally, yet currently the US is one of a few countries prohibiting growers from providing cannabis for research. Michigan’s marijuana law includes a set aside fund specifically for research. It would behoove everyone to advocate for these policy changes so that our local economies, educational institutions and communities can competitively partake in the quickly growing production and research of medical cannabis both domestically and worldwide.

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