by Willie J. McKinney, Jr., Ph.D., D.A.B.T
When I hear the term “medical marijuana,” I think of an epigram delivered by George S. Patton. “If everyone is thinking alike, then somebody isn’t thinking.” Most people adding medical to marijuana are not thinking about the arduous process required to support the medical designation by the U.S. Food and Drug Administration (FDA) of a product or device.
What is Medical Marijuana?
The term medical marijuana refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions. In other words, your doctor gives you a pass to purchase unprocessed marijuana for your ailments.
The “medical” classification usually gives us a level of comfort that the product has passed carefully conducted studies in hundreds to thousands of human subjects to determine its benefits and risks. We don’t have that warm fuzzy feeling with medical marijuana because the FDA has not recognized or approved the marijuana plant as medicine.
Is it Safe and Effective?
Clearly, the ingredients added to the plant and the burning of the marijuana plant have not passed the hurdle of safe and effective. I doubt that burned marijuana will ever meet that standard. However, some chemicals in the marijuana plant (cannabinoids) have been deemed safe and effective.
Tetrahydrocannabinol (THC) is a chemical in the marijuana plant that makes people “high.”
- Dronabinol (Marinol, Syndros) and Nabilone (Cesamet) are used to nausea and to increase appetite in very sick patients
Cannabidiol (CBD) is a chemical in the marijuana plant that doesn’t make people “high.”
- Epidiolex treats seizures that are associated with some severe but rare forms of epilepsy.
It’s likely that we’ll see other marijuana-related pharmaceuticals approved by the FDA over the next few decades as the scope of research studies broadens from exploring recreational use and public attitudes and expands into more in vitro studies and clinical trials. There are hints of promising results for THC and other cannabinoids in the treatment of pain, HIV, addictions and other health conditions.
Because the marijuana plant contains chemicals that may help treat a range of illnesses and symptoms, many people argue that it should be legal for medical purposes. In fact, a growing number of states have legalized marijuana for medical use with and without a physician’s prescription. Marijuana dispensaries, such as those in California, often have the air of a medical clinic, with employees (sometimes in white lab coats) making symptom-specific recommendations of their products.
But remember that the marijuana plant as a whole is not approved by the FDA as a safe and effective treatment for anything! So far, only those two chemical compounds are approved for limited use. Think willow bark vs. aspirin; bread mold vs. penicillin; yew tree vs. Taxol.
To be considered for FDA approval, new medicines need not only in vitro studies but also carefully conducted clinical trials involving hundreds or even thousands of human subjects. The current clinical trials for a SARS-CoV2 vaccine to prevent COVID is an example of the type of work that must be put into such an application as a way of demonstrating both the effectiveness and the risks across a broad spectrum of people.
So far, researchers haven’t conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its individual cannabinoids) outweigh its risks in patients it’s meant to treat.
Jump-Starting the Cannabis Industry
That’s why it’s critical for cannabis companies that are interested in health-related uses for their products to begin research studies and clinical trials now, spurring the evolution of the industry. The products most likely, based on current data, to receive FDA approval as “medical” are chemical components of the plant; combustible products are unlikely to be authorized as “medical”.
So don’t be fooled by the “medical” marijuana moniker.