Dr. Sue Sisley. Photo by Erik Verduzco

Legal Cannabis Makes Gains But Roadblocks Remain

Medicinal promise and public opinion are driving legislative changes

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By Shermakaye Bass

03/14/2019

SXSWorld




From long-time marijuana legalization advocates like Willie Nelson to more recent arrivals like former U.S. House Speaker (and SXSW 2019 Convergence Keynote speaker) John Boehner, diverse voices are proclaiming that the time for legal cannabis has arrived. At ballot boxes and statehouses around the country, 2018 was already a bust-out year for legalization, and proponents believe 2019 will be even more weed-forward.

“Too many people in this country want it, and, with respect to medicinal cannabis, unfortunately, too many people need it.”

Currently, 10 states and the District of Columbia have legalized recreational marijuana, while 33 have approved medical cannabis. Even stalwart conservative states such as Oklahoma and Utah have recently green-lighted medical marijuana.

Yet, while American legislators recently approved the 2018 Farm Bill, legalizing hemp as a crop (but not marijuana itself), the country still doesn’t have a cohesive federal policy. That impedes not only health research and criminal-justice reform, but also essentially hands over a white-hot multibillion-dollar industry to countries like Canada, which legalized marijuana last year.

“The United States has been a leader in so many different things, but today, sadly the U.S. is so woefully behind in its compassion and care with cannabis,” says Kevin Murphy, CEO of Acreage Holdings, the largest U.S. cannabis operator, who will join Speaker Boehner for their Keynote Conversation.

John Boehner. Courtesy Dupont Photographers

John Boehner. Courtesy Dupont Photographers

 

However, Murphy adds: “I believe, sooner, rather than later, legalization in the US is coming. I believe that it's going to take place through the STATES Act. Too many people in this country want it, and, with respect to medicinal cannabis, unfortunately, too many people need it."

What does all this mean for the United States? Several developments are coming to the forefront.

The latest research, much of it conducted outside the U.S. by legal necessity, indicates that “whole plant” cannabis (not isolated-cannabinoid products such as CBD) can be more effective for pain than even the strongest opioid compounds, such as fentanyl.

Dr. Sue Sisley, Principal Investigator at Arizona’s Scottsdale Research Institute, is an internist, psychiatrist and leading cannabis researcher. She says that she was surprised at these recent findings.

“Only now are we starting to see early data—not randomized, controlled trials yet, but early survey data and now observational studies, especially looking at cannabis as a substitute for opioids,” says Sisley, who oversees the only FDA-approved randomized controlled trial, which examines the safety and efficacy of whole-plant marijuana to treat post-traumatic stress disorder (PTSD) in combat veterans. She is also studying cannabis to relieve breakthrough pain in cancer patients.

“We just completed a study with the University of Michigan for the last couple of years looking at chronic-pain patients,” she explains. “And we were querying (participants) about how they use cannabis and what were they substituting, and it wasn’t just opioids, but sleep aids and anti-anxiety meds like Ambien and Xanax.”

Sisley also cites another recently-completed pilot study: “My team conducted a small trial in Montreal, where (participants) smoked (marijuana) flower for breakthrough pain in late-stage cancer patients, and compared fentanyl to the smoked flower. And flower was much better.”

Kevin Murphy

Kevin Murphy

 

Sisley explains that fentanyl takes about a half-hour for the patient to feel its effects, while marijuana, when either smoked or vaped, brings almost immediate relief. Not only that, she observed that cannabis doesn’t dull the senses like fentanyl.

The opioid, she found, “made patients so sedated, they just had a really poor quality of life … whereas the people on smoked flower were interactive, and they were kind of chill—more optimistic and their families were bolstered by that … I thought we were insane for trying to go head to head with Fentanyl. But it turned out to be a really good choice,” Sisley concludes—adding that she does not have “any confidence” in CBD or other isolated cannabinoids, until there are controlled clinical trials confirming their efficacy.

The irony to anyone exposed to the fear-mongering and criminalization of the past 80 years is that the humble cannabis bud could provide a solution to the current opioid epidemic. Yet, national pot policy is still based on outmoded beliefs perpetuated by donors who often benefit financially from pot’s illegality. Big money from the pharmaceutical, law enforcement and private-prison sectors has consistently swayed federal agencies and lawmakers to keep prohibition in place. Meanwhile, patients with cancer, epilepsy, glaucoma, PTSD, neuro-spastic disorders like Multiple Sclerosis, and many other medical conditions have been denied potentially effective treatment.

“There are still elected officials that are hanging onto these antiquated notions about cannabis being highly dangerous and addictive,” Sisley says. “But the public has already realized that the government has been lying to them for decades now, and that’s why the laws by voter initiative are changing much faster than formal science can keep pace with.”

Convergence Keynote: Kevin Murphy and John Boehner will be Friday, March 15. Sus Sisley’s Cannabis Research Shackled by Politics Since 1968 presentation, part of the Cannabusiness Track, presented by Leafly, is on Thursday, March 14.

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