MEDICAL MARIJUANA
David Peters
SOC 5810 – Fall, 2012
Michigan Medical Marijuana
Research and Legal Issues:
Past Problems and Future
Directions
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2.
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5.
Five Topics
History of marijuana and medical
marijuana
Legal Issues: The Dispensary Question
Medical Marijuana research
The War on Marijuana Research
My research
-PhD Dissertation- interviews of patients and
caregivers.
-Multi-Center study surveying perceived effects
of different strains of medical marijuana.
I. History of Hemp…….
The use of marijuana likely
predates humanity…
Marijuana is eaten by practically
every mammal…
Mammals have the cannabinoid
receptor
• About 28,000 years ago we finally got
good at growing Marijuana.
• Which means.…Marijuana was probably
the first plant cultivated.
26,000 B.C.- One of the earliest pieces of
agricultural evidence ever discovered
includes a 28,000 year old Hemp cord
imprint on a pottery shard in pre-historic
Taiwan village
So the first use of marijuana
was about the same time
Paleolithic cave art developed
around 28,000-30,000 years
ago.
Is there a connection? You be the
judge.
“It would be wryly interesting if in human
history the cultivation of marihuana led
generally to the invention of agriculture,
and thereby to civilization.”
Which came first:
The weed or the imagination?
It would not be the last time
marijuana sparked up a creative
renaissance…
Egyptian hieroglyphic showing
Pharaoh smoking a strange plant
from 3,000 B.C.
Marijuana as medicine in History
2737 B.C.- Chinese text recommends
marijuana for gout, malaria, eye problems,
pain, and arthritis.
1600 B.C.- Hebrew text recommends
marijuana as a pain killer in child birth.
Herodotus in 480 B.C. reported on
the Scythians communal use of
marijuana.
“They place select tops into a container over
the fire and creep beneath felt booths.
Immediately it releases a vapor such as no
Grecian bath can compare…which causes
the Scyths to howl with joy.”
Marijuana as medicine in the U.S.
Over one hundred articles recommending
cannabis were published between 1840 and
1900 alone (Herer, 2000).
Early 1900’s Ban as a Mexican Immigration Foil.
Before the 1937 Marijuana Stamp Act Marijuana
was commonly recommended by U.S. doctors:
--as a painkiller during childbirth
--for treatment of asthma
--as a palliative for gonorrhea symptoms
--anxiety
--hysteria
among other conditions (Earleywine, 2006).
Later uses of medical marijuana in
the U.S.
--glaucoma,
--chemotherapy induced nausea,
--spastic disorders,
--AIDS wasting syndrome,
--other less severe illnesses such as
chronic pain were later claimed to be
helped by the therapeutic use of marijuana
(Chapkis, 2008).
The Michigan Medical Marijuana Act
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Chronic Pain
AIDS
ALS (Lou Gehrig's Disease)
Severe Nausea
Glaucoma (Impaired Eyesight)
Hepatitis C
Nail Patella
Cachexia or Wasting syndrome
Crohn's Disease
Multiple Sclerosis
Muscle Spasms Epilepsy or Brain Seizures
Cancer
II. Legal Questions………
Dispensaries
• Not mentioned in the referendum because
the issue was not polling well
• A caregiver can register up to 5 patients
and grow and possess 12 plants and 2.5
ounces per patient to whom he is
connected through the caregiver registry
system
Attorney General Bill Schuette claims that
caregivers and patients are supposed to
become “independent” and grow their own
completely within the caregiver registry
system.
But, but, but what about….
• Starting the garden (clones)
• Overages
• Temporary loss of supply
– Bad crop
– Bad harvest
– Bad genetics
– Unreliable caregiver
Even the most competent
Caregiver cannot by himself offer
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varieties of marijuana
counseling
chemical testing
massage oils, tinctures, baked goods,
suckers, etc.
State of Michigan
In the Court of Public Opinion
Non-Profit Dispensary
vs.
Farmer’s Market
Compassion Clubs
Compassion Network
Delivery Service
Appellate courts have ruled that Patient to
Patient transfers are NOT allowed under
the MMMA (for $$).
However at least one Circuit Court judge
has ruled that patient to patient transfers
that do not involve the exchange of money
are allowed.
However…..
The Supreme Court of Michigan
has not ruled on this issue or on
CG to Patient transfers
Section 4(e):
“A registered primary caregiver may
receive compensation for costs
associated with assisting a registered
qualifying patient in the medical use of
marihuana. Any such compensation
shall not constitute the sale of
controlled substances.
People vs. Kolanek and King
• Section 4 and section 8 BOTH provide
protections.
• Section 4 requires compliance with 2.5 Oz limit
per patient.
• Section 8 ONLY requires “The patient and the
patient's primary caregiver, if any, were
collectively in possession of a quantity of
marihuana that was not more than was
reasonably necessary to ensure the
uninterrupted availability of marihuana for the
purpose of treating or alleviating the patient's
serious or debilitating medical condition.”
• Limited to the patient OR his “primary caregiver”
and does not appear to protect dispensary
operators or bud-tenders.
III. Medical Marijuana Research
• No placebo controlled clinical research has
EVER been done using medical marijuana
• One recent clinical (but not placebo
controlled) study (Morgan, 2010) used
volunteers who provided their own cannabis
for the study
• They investigated whether higher CBD
marijuana could decrease the effects of
higher THC marijuana (as a way to
decrease the effects of ‘marijuana
addiction’)
• Note how the research questions are
characterized
A few scattered MM findings:
• Weight and BMI gain for AIDS patients
using medical cannabis (Abrams, 2003).
• Mixed results on reduced spasticity for
M.S. patients using synthetic THC (Only
14 total studies on M.S. patients).
• 97% of M.S. patients claim they perceive
reduced spasticity and pain when using
smoked cannabis (Consrue, 1997).
Marijuana as effective as codeine
in reducing pain (Campbell, 2001).
These authors conclude- incredibly- their
results show that marijuana:
-Is not useful for post-operative pain;
-----and-----needs “more research” before use for
other types of chronic pain.
This does not need more
research…
Studies in the 1980’s on the
medicinal benefits of marijuana:
1970’s era studies using NIDA
cannabis
• Inconclusive on Glaucoma pressure.
• Some suggestion of analgesia (reduced
pain sensitivity) in healthy subjects
(Milsein, 1975).
IV.
Federal Prohibition
on medical research
• Research focuses almost exclusively on
the harmful effects of marijuana
• 95% of research uses synthetic
cannibinoids rather than marijuana
(Nabilone, Cesemet, Dronabinol,
Levanatrodol etc.)
A marijuana clinical study requires:
Food and Drug Administration approval on
the safety vs. risk benefits of the study.
• Drug Enforcement Administration
Schedule I Controlled Substances License
(one of several contemporary marijuana
“stamps.”)
• Drug Enforcement Administration approval
for the study
• National Institute of Drug Abuse approval
to supply the research marijuana.
NIDA will only study the harmful effects of
drugs.
NIDA Research Marijuana
1.5% - 8.3% THC
SCHWAG
=
• I have not found any study that uses 8.3% (a
Canadian study used 9.5%).
• Almost all marijuana studies have used 1.5%.
• Dr. Abrams in the 1990’s was the first scientist to
get research marijuana since the early 1980’s.
• I am not sure how many others have been
supplied research marijuana since the early
1980’s- If there are any I am sure all of them
studied the harmful effects of marijuana, not the
medicinal effects.
V. My research
• When there is smoke there is fire.
• The government is hiding something.
• They are deliberately and aggressively
blocking scientific research into the
efficacy of medical marijuana.
• I want to know what they are hiding.
My PhD Dissertation:
“Interviews of Medical Marijuana Patients
and Caregivers”
--8 page interview guide- more than 50
topics.
--1-2 hour interviews
Preliminary Findings 1 of 2
• Average medical marijuana patient is
much older than the common
characterization of teenagers hanging out
at the marijuana club over a hangnail.
• Patients with chronic pain claim the
analgesic effects of marijuana is less than
morphine, more than tylenol, and about
the same as codeine or vicodin.
Preliminary Findings
2 of 2
• Patients consistently claim they are able to
dramatically reduce prescription drug
intake of many types as a result of access
to potent medical marijuana.
• Most patients began using marijuana at a
young age and have used regularly most
of their life.
Quasi-Clinical Study
• My great idea was to research the
perceived effects of Indica and Sativas
using a survey.
• Of course the ancient Sanskrit words
Indica- “Night” and Sativa- “Day” are well
known.
Putting it together:
• Jamie and Kevin operate nonprofit medical
marijuana dispensaries.
• Ken tests marijuana for the dispensaries.
• They were already collecting far superior data
using precise concentrations of THC, CBD, CBN
and more than a dozen others.
• A quantum leap beyond broad categorizations of
indica and sativa!!!
• So forget about Indica and Sativa- go right
to comparing the actual chemical
constituents of the marijuana
---vs---Perceived effects of marijuana
Study Procedure
1. Patients procure MM in the same way
they would normally.
2. Testing Authority picks a sample of the
week for each dispensary.
3. Samples are double blinded- only Ken
and the director know what is in sample.
4. Patient consumes the product at home.
5. Patient fills out online survey on
perceived effects 1-2 hours later.
Certification of Medical Cannabis
Administrable by:
We certify that this cannabis sample has been
prescreened by MTAKB007 on Wednesday, February 01,
2012
for safe medical administration. Our prescreening results
assist in the administration of this cannabis by insuring it is safe from harmful
and possibly deadly contaminants. Our state of the art equipment tests parts
per billion to detect chemical compounds that enable this cannabis to be
administered for specific illnesses and serious conditions.
Med Joint
Wayne State Study
ID:M101
Identification Certificate
Genetic Fingerprint I.D. Card
Bacteria Analysis
Mold
Pass
Fungus
Pass
Pass
Mildew
Potency Analysis
CBD
THC
CBN
Chemical Analysis!
Pesticide Pass
1.0%
9.8%
0.2%
Captured above is this cannabis sample’s unique
Chemical Signature drafted by it’s genome,
environment and farming practices.
Pharmacological Effects Analysis
Qualitative Scale of Effects (1-10) Ten being one of the best.
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Sleep Pain
Diet
HungerNausea
Alzhiem
Immune
Anti-spasm
Inflamation Anti-Cancer
Focus
Pleasure
Awake
Anti-Anxiety
THCV, Delta 8 and other minor
Cannabinoids are added to provide
a total count.
Affects of the detected Medical Compounds found in this sample of cannabis.
MTA uses portable state of the art G.C.- S.A.W. Surface Acoustic Wave technology, along with a scientific low pressure vapor testing
method to detect the terpinoids, flavinoids, and cannabinoids in parts per billion. Our on site testing produces accurate test results in
almost real time, so it can be utilized as a tool in selecting quality medication. Please feel free to call 1-855-751-2500 with any questions .
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Please rate the potency or effectiveness of the test sample on the
OVERALL SEDATING OR "DOWN" EFFECTS.
No Effect
Very Small Effect
Medium Effect
Large Effect
Very Large Effect
One of the strongest I have experienced
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Please rate the potency or effectiveness of the test sample on the
OVERALL EUPHORIA OR "UP" EFFECTS.
No Effect
Very Small Effect
Medium Effect
Large Effect
Very Large Effect
One of the strongest I have experienced
Hypothetical Data
% THC VS. Uplifting Effect
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Uplifting
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% THC
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More Hypothetical Data
% CBD vs. Sedation
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1400 Data points and counting!!
• Once enough data points are collected
with enough samples we should be able to
regress multiple chemical components
Sociology Research Statistics
• Often use THOUSANDS of participants (General
Social Survey)
• Can isolate specific components of behavior and
environment to predict
• For example: Predict- Educational Level
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Race
Parents Income
Parents Profession
2 parent stable family
Religion
Gender etc. etc.
This means we will be able to calculate
the % contribution to “uplifting” (or
“sedating” or “pain relief” etc) from each
component in the medical marijuana.
We are also comparing the perceptions of
samples high in one or more components
with the perceptions of samples high in
other components.
-The sample sizes are to small to compare
individual samples but we can group them
by category (example) :
--Samples 1, 9, and 15 = “high CBD”
--Samples 2, 3, and 12 = “low CBD”
Then compare “pain relief” or “sedation.”
Why do we care?
Informing genetics for growers, patients
and breeders.
Should we propagate that mutant with the
high Limonene??
Can we develop strains for…
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Pain
Depression
Anxiety
Nausea
Inflammation
I think it is possible we could develop
strains full of anti-cancer ingredients for
general prophylactic (prevention of cancer)
use……….
A couple dozen companies have
been given patents to isolate
medicines from whole cannabis
extracts.
Future Directions
With this Research
Supervised use and testing in a clinical lab.