In this article, Dr Igor Grant explores the work of the Center for Medicinal Cannabis Research.
When the Center for Medicinal Cannabis Research at UC San Diego was established in 2000, our initial work had to do with exploring whether THC might be useful in treating neuropathic pain: our first six trials related to different kinds of neuropathic pain; and we did find a benefit in the short term from all of those.
We also conducted a small study into multiple sclerosis patients suffering from muscle spasticity; and again we found THC to be beneficial. This next phase of our work will focus more broadly on some other conditions, including one study exploring the effects of cannabidiol (delivered as Epidiolex) on children with severe autism; and another investigating the application of cannabidiol to treat patients with schizophrenia, particularly in the early stages of the disease. Another study, to be conducted at UCLA, will look at cannabinoids as a potential treatment for rheumatoid arthritis.
Cannabis in the US
Because cannabis is a Schedule 1 drug in the US, placing it in the same category as substances like heroin and LSD, research is very difficult – it is nigh impossible to meet all the regulatory hurdles associated with research into Schedule 1 drugs. The supply of cannabis for medical research is limited to a single source – a federal government-licensed facility at the University of Mississippi – and while supplies are obtainable, now that there is a lot more interest in this type of research there is a backlog.
The range of products available is not reflective of the variety of ways people can ingest cannabis now or the wide range of extracts and concentrations on the market; and it is important for us to be able to conduct research on the products people are actually using, not just the ones which are immediately available to us. Although many states in this country have legalised medical or adult use cannabis, that does not mean an investigator like me can administer it to a patient: the cannabis-based medical products used in trials must be approved at a federal level by the Food and Drug Administration.
Progressive cannabis legislation
California has been very progressive on cannabis legislation: the Center for Medicinal Cannabis Research was established by the state of California; we are funded by the state of California through Proposition 64, which legalised cannabis in the state; and California is extremely supportive. The problem comes in the conflict with federal law. There are strict regulations here governing what people can legally buy; there are mandated laboratory tests for the constituents of products.
In California it is possible to pass a law by popular vote: that is how cannabis was legalised in the state. When that proposition was put to a vote, there were compromises added in order to get it passed; one of which was the provision that towns and cities would be able to opt out of allowing licensed dispensaries – and as it turned out, a lot of jurisdictions around California opted out.
This meant that, as tax projections were based on the premise that cannabis would be legal statewide, the tax revenue from the legal sale of cannabis was significantly lower than projected. The other unintended consequence is that there continues to be a flourishing black market, whereas one of the intents of the law was to drive the black market out.
Dr Igor Grant
Center for Medicinal Cannabis Research
UC San Diego