by Jenny Hong
Cannabis and CBDs are purported to be useful for treating many medical conditions and can help people replace traditional pharmaceuticals. Yet, their efficacy, risks, and contraindications with other medications are backed up by little research. A large population of Americans can use medical marijuana legally in their states; the number is close to 270,000 people in the state of Michigan, according to a 2018 Statista survey, making Michigan only second to California for the highest number of medical marijuana patients in a state.
High regulatory barriers, low funds and incentive
Doctors and budtenders have access to little formal training about prescribing cannabis to treat specific health conditions, as training on this expertise is not readily available. With the deregulation of hemp-derived products like CBDs, it is even harder to ensure consistent regulation and quality of cannabis products that are easily obtainable by consumers. Dr. Gus Rosania, who researches cannabis at the University of Michigan and teaches PharmSci 420: Medicinal Cannabis, shares that as a Schedule 1 Drug, research into cannabis-derived products in academic institutions is prohibited by the federal government if the institutions were to obtain grant funding. Furthermore, Dr. Rosania continues, federal prohibition extends to banks and financial institutions, so any cannabis-related clinical trial in the States would have to be financed in cash. With hemp deregulated and CBD widely available, Rosania believes that there will be even less financial incentive for companies to invest tens of millions of dollars necessary to conduct clinical trials on hemp-derived brand-name products.
What Research and Support are Out There?
NIDA Drug Supply Program is one source of support for cannabis research. Their mission is to “advance science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health.” Some private companies do invest in cannabis research, but may not publish their findings in peer-reviewed studies because of federal restrictions, keeping that valuable information from being publicly available for doctors and patients. Dr. Rosania explains that the only company he is aware of that does Cannabis-related studies is GW Pharmaceuticals, which was originally based in the UK and already has a cannabis-derived, FDA-approved prescription drug, Epidiolex, on the market. Northern Michigan University was the first university to offer a four-year degree in Medicinal Plant Chemistry in 2017, but medical cannabis has yet to make its way into standard medical practice.
Contraindications of Cannabis with Other Drugs
Before this important gap is bridged, people using CBDs and other cannabis-derived products are recommended to seek different professional consultants to understand appropriate dosages and how it might interact with other medications and health conditions. There is some evidence to suggest that cannabis can decrease insulin resistance, improving the metabolic process and blood sugar control. Few studies look specifically at how individual cannabinoids interact with other drugs, but it’s possible that cannabis can work favorably with other drugs. Another feature of the THC component of Cannabis is the simultaneous activation of the CB1 and CB2 cannabinoid receptors, which induces a cardiovascular stress response that elevates cardiac oxygen consumption while reducing blood flow in coronary arteries. Reports of adverse effects are relatively rare, but patients who take blood pressure medication should be aware of these compounding effects of cannabis. Marijuana is also likely to enhance the effects of similar sedating drugs. In general, patients should discuss not only health concerns but also possible interaction of cannabis with other drugs when consulting health providers.