The momentum behind medical marijuana


As the apothecary movement of dispensaries proves the market and merit of medical marijuana, the industry and its consumers find themselves in a grey area. The federal government promises to keep their nose out of state affairs, especially when it comes to the medical side of cannabis, but before landmark federal endorsement can come, the drug will be subject to the regulatory structures of the United States Food and Drug Administration (FDA), including medical trials and pharmaceutical regulation.

There are small permissions for medical marijuana at the federal level, like last week when Congress passed language to stop the Obama Administration’s Department of Justice from spending money to block the implementation of state medical marijuana laws. The language is a benchmark in the legalization of medical marijuana, signaling a major shift in drug policy as the reigns on prohibition loosen.

But while the language appeases some of the stress between the states and Washington D.C. over medical marijuana, it is not a definitive end of prohibition. Rather it is a passé indication that the federal budget ought not concern itself with the matter. The new amendment, slipped into a nearly 2,000- page, must-pass spending bill, almost comes as an afterthought.

Before there can be more enthusiastic endorsements of medical marijuana, the drug must overcome its lack of peer reviewed research — a deficiency that is driving a chasm between medical marijuana products sold in state licensed dispensaries and the medicine derived from the cannabis plant by pharmaceutical companies. Small markets may not need FDA approval now, but the larger pharmaceutical industries are after bigger markets that depend on such backing.

In recent years, public and private research organizations performed studies that are filling that gap and paving the way for marijuana to emerge as a legitimate subject of political debate.

A 2014 National Institute of Health Study found an association between cannabis and reductions in post-traumatic stress disorder symptoms in some patients. Although it lacked a placebo controlled confirmation, the study spurred medical marijuana activists to seek the Veterans Administration (VA) to allow veterans to use medical marijuana as prescribed by VA doctors, which it did in November with the passing of the FY 2016 Military Construction and Veterans Affairs Appropriations Bill.

In June and July 2015, The Journal of American Medicine Association published a slew of reports on medical cannabis studies. The most prominent found high-quality evidence to support the use of marijuana for chronic pain and spasticity and moderate-quality evidence showing that cannabinoids were associated with improvements in nausea and vomiting under certain umbrella diagnoses.

The forward movement in research is not without complication — marijuana is still listed as a Schedule I Substance by the Drug Enforcement Administration (DEA), which does not acknowledge lawful cannabis producers. But the DEA has and continues to make room for pharmaceutical companies to begin research of medical marijuana by way of flexible scheduling — allowing these companies to administer trials on the basis that they would be classified as Schedule II or III drugs in market. The DEA released a notice earlier this month indicating that the federal government issued Catalent Pharma Solutions, a New Jersey drug development company, permission to begin importing various forms of cannabis into the United States to be administered to patients in clinical trials. Major drug manufacturers are paying Catalent to help engineer commercial medical marijuana products in a manner that will garner expeditious approval from the U.S. government.

According to the Marijuana Business Daily, the medical marijuana industry could reach $10 billion by 2018, even without a federal endorsement. In anticipation of that growing market, pharmaceutical companies are slipping around the law with a flexibility never granted to state level dispensaries.

So while it is exciting to see the progress in national policy and public opinion in regard to medical marijuana, it is also becoming clear that the real progress is being driven behind the scenes by large pharmaceutical companies as they prepare to take over the mom and pop apothecary network that paved the way.