Starting this fall, the University of Maryland will offer a masters degree in medical cannabis. The university’s School of Pharmacy developed the Medical Cannabis Science and Therapeutics Master of Science program to train medical students to treat medical marijuana patients and conduct research on cannabis.
Benjamin Caplan, MDMasters Degree in Medical Cannabis
Title: Novel approaches in clinical development of cannabinoid drugs
A pamphlet has recently been published that highlights new approaches in the clinical development of cannabinoid-based therapies. The pamphlet begins with a look into how current cannabinoids affect patients based on gender, stress, physiological variations, and also delves into how cannabis works on the body in general.
A novel therapy that features an oral version of tetrahydrocannabinol (THC) and a synthetic activator of cannabinoid-receptor-1 (CB1) is explored in this piece and frames it to be a promising future therapy. The pharmacological properties of these two novel therapies were optimized during development after various analysis techniques, forming medications that the authors hope to see in future clinical trials.
Although the authors remain hopeful that their cannabis-based therapies will reach clinical trials soon, trials featuring cannabinoids are difficult to test in a formal setting because of a dire lack of funding. The federal government still lists cannabis as a Schedule I substance, under the Controlled Substances Act, meaning that the federal government does not support the idea that cannabis has any medical use. Considering the legal status of cannabis, only privately-funded studies are able to take place, and unfortunately, that leaves cannabis research in an area of complete bias and prohibitively underfunded. Considering the massive literature supporting a myriad of novel therapeutic benefits, this is a costly reality to the health and well-being of millions.
In yesterday’s blog post, the discrepancies in the number of medical cannabis users were discussed and the suggestion arose that perhaps medical cannabis use may need stricter regulations. The author of the piece that inspired the letter featured in the post responded, highlighting the possibility that recreational cannabis is being used for medical purposes rather than users obtaining cannabis from more nefarious sources. The author points out that renewing medical licenses can be a hassle and in states where recreational cannabis has been legalized patients may just be obtaining their cannabis, used for medical purposes, from recreational dispensaries. Surveys that delve into this issue are needed to confirm the author’s hypothesis.
Describing the medical process of obtaining a cannabis license as a hassle is, unfortunately, reported by many consumers. State governments are forced to run the regulatory processes, in the absence of federal support, and conservative politicians and opposition groups often create difficulty around opening dispensaries in their districts. On top of the expenses of renewing or obtaining a medical license, it may seem almost less confrontational for people who reside in a state or have access to recreational marijuana (from a state-regulated dispensary) simply to purchase recreational cannabis, rather than take the time to obtain a license.
Of note, Massachusetts is one of the few states that has anticipated this circumstance and has codified protections and advantages of the medical program, into law. In Massachusetts, medical patients are incentivized through robust discounts (totaling greater than $2000 in discounts, and 20% cost reduction because of the absence of state taxation for medical patients.) Further, there are legal protections available only to medical patients, and the opportunity for delivery, which are not available to recreational consumers.
Benjamin Caplan, MDAuthor’s Response to Discrepancies in Medical Cannabis Use
A recent letter to the editor exposes the large discrepancy between the number of registered medical marijuana patients and those who self-reported medical cannabis use. Estimates given by the National Survey on Drug Use and Health (NSDUH) suggest that 2.5% of Americans over the age of 12 used medical cannabis in 2013-2015 but a study from 2016 found that only 641,176 people were licensed to receive medical cannabis, a prevalence of 0.4%. If the numbers published by the NSDUH are accurate then states may need to delve into how so many people are accessing medical cannabis without proper licensing in order to better regulate the supply. If the numbers are extrapolated to 2019 and include all states where medical cannabis use in legal then more than 6.2 million people should be licensed but may not be.
Medical cannabis can be difficult to acquire due to its cost, post-legalization. Although medical cannabis in Massachusetts is readily available with a large number of dispensaries across the state, the cost of obtaining a doctor’s recommendation, complying with state fees, and then paying for the cannabis at a dispensary can be too much for some patients. Although MA will soon be waving the state fee, to obtaining a license, clinicians are still expensive and without the support of the federal government allowing national insurance companies to cover medical cannabis the costs still add up quickly. Fortunately, some dispensaries are designed to cater to those who need financial support.