Pubdate: Wed, 24 Feb 2016
Source: Honolulu Star-Advertiser (HI)
Copyright: 2016 Star Advertiser
Authors: Sue Sisley and Peter P. Rudlowski
Note: Susan Sisley, M.D., president of Scottsdale Research Institute 
and chief medical officer for Manoa Botanicals, is principal 
investigator for the FDA-approved randomized controlled trial using 
whole-plant medical cannabis. Peter P. Rudlowski, M.D., Hina Mauka 
Substance Abuse Treatment Center associate medical director, is on 
the medical advisory board for Manoa Botanicals (which has applied 
for a Hawaii medical marijuana dispensary license).


As a growing number of states recognize the importance of providing 
legal access to patients who benefit from medical marijuana, it 
becomes even more implausible that research is so uniquely - and 
unfairly - restricted.

Patients with conditions such as PTSD (post-traumatic stress 
disorder), epilepsy, chronic pain and migraines deserve research that 
can determine the optimum medication content and procedure.

Even with research that has been approved by the Food and Drug 
Administration (FDA), federal policies require a redundant, 
multi-agency review process that creates unnecessary red tape and 
wasteful government spending.

Unlike studies done for other federal Schedule I drugs, only cannabis 
research must pass an additional review process before the Drug 
Enforcement Agency (DEA)/National Institute on Drug Abuse (NIDA) will 
release the research material. By law, NIDA is the sole, monopolistic 
supplier of all cannabis to be used for research studies.

NIDA administers this additional review process and has a fundamental 
conflict of interest in deciding which studies it will allow. The 
agency's 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 
inferior and radically more expensive cannabis than is readily 
available from state-regulated dispensaries.

A case in point is PTSD, especially critical given the suicide rate 
among veterans. The U.S. Veterans Administration estimates that in 
2012, about 22 former members of the armed forces, on average, 
committed suicide every day. One in five, or nearly 300,000 veterans 
of the Iraq and Afghanistan wars, are diagnosed with PTSD. Treatment 
has cost the U.S. more than $2 billion so far.

Antidepressants such as Zoloft and Paxil, along with other pills that 
have been shown to have risky side effects, have been the traditional 
treatment in doctors' arsenals, but in many cases these pills have 
been ineffective.

The use of medical marijuana to treat patients with 
treatment-resistant PTSD is supported by a number of sources, 
including research in lab animals, fMRI (functional MRI) imaging in 
humans and anecdotal reports from countless health practitioners, 
patients and patients' families. Additionally, clinical research in 
Israel evaluating medical marijuana as treatment for PTSD has been promising.

Yet, the government has been slow to act. A study approved by FDA in 
April 2011, and the U.S. Public Health Service in 2014, is still 
awaiting DEA/NIDA approval. This study will be the first randomized 
controlled crossover clinical trial in the United States testing the 
therapeutic potential of marijuana for PTSD. The research is intended 
to address some of the unanswered questions surrounding medical 
marijuana, particularly the proper dosage for patients.

Other medical conditions deserve the same study, and more rapidly. 
Hawaii has an opportunity to make considerable progress. Our plan is 
to leverage research such as the PTSD study and conduct pilot studies 
with dispensary patients to identify strains that are effective for 
specific disorders. Our agricultural research team can then begin 
work on discovering the optimum growing conditions and breeding 
programs for identified strains. Hawaii can be a leader in removing 
some of the mystery and uncertainty surrounding medical marijuana and 
contributing to a more defined healing program.

To put patients front and center, we must expand cannabis research. 
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.
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MAP posted-by: Jay Bergstrom