Medication, behavioral support systems are needed to treat addiction, says Dr. Nora Volkow, director of the National Institute on Drug Abuse. USA TODAY
New York’s recreational marijuana battle sits on the front line of a generational war over American cannabis laws. As debate heats up, USA TODAY Network New York is compiling answers to key questions about legalized cannabis. The findings will be updated each Monday as New York considers joining the 10 states that allow adults to use marijuana.
Gaps in cannabis research have muddied politically charged fights over the fate of marijuana legalization across the country.
Yet many breakthrough studies underway, like one at Montefiore Health System in New York on medical marijuana’s impact on opioid use for pain, are poised to provide much-needed clarity.
Similarly, researchers are investigating high-potency pot in legal cannabis states like Colorado and abroad. A recent study from London, for instance, raised concerns about psychosis risks among daily users, according to USA TODAY Network.
Much of the analysis stateside is scrambling to address mounting public-health issues because many state laws already allow medical and/or recreational marijuana.
The research was stifled for decades by federal law that continues to designate marijuana alongside heroin and other drugs deemed to have no medical use.
What follows are takeaways from ongoing efforts to improve cannabis research, including information from the National Institute on Drug Abuse and Colorado Department of Public Health and Environment.
Studying marijuana
Colorado exemplifies the cannabis learning curve as it tries to monitor health concerns in real time.
In other words, people using legal marijuana there are test subjects in many of the first large-scale studies of the drug’s risks.
The state’s public-health agency, for instance, listed 11 broad categories where marijuana research gaps exist, touching on everything from secondhand smoke and reproductive health to cancer and cardiovascular effects.
Each scientific data problem is accompanied by plans to fix it, such as standardizing medical records and gathering more specific information from marijuana users.
Several research gaps involved the differences between smoking, eating and vaping marijuana, which underscored the push to get fundamental answers about cannabis-based drugs.
Much of the research push stemmed from a state health committee tasked with guiding Colorado’s marijuana regulations and issuing regular public reports.
“The committee strongly recommends Colorado continue to support research to fill these important gaps in public health knowledge,” a recent report said.
Promoting the unknown
Dr. Thomas Madejski, president of the Medical Society of the State of New York, as well as presidents of New Jersey, Connecticut and Delaware medical societies, recently took a joint stance in opposition to their respective states’ marijuana legalization plans.
“We have serious concerns about the lack of scientific evidence that supports recreational marijuana use by adults and young adults,” they said, referencing many of the above research gaps.
“Most importantly, not enough research has been done to prove marijuana is safe,” they said.
Yet the medical leaders noted they support changing marijuana from a Schedule I drug to a Schedule II classification under federal law, a proposal that has been debated in various forms since 2016.
The move would place marijuana in the category of drugs with federally designated medical uses like methadone, instead of street drugs like heroin.
As a Schedule II drug, government funding can be sought for necessary research that clearly defines the positive and negative elements of marijuana use, the medical leaders said.
“When we have the science, we can make qualified and quantified decisions about legalization,” they added.
Marijuana and opioids
National Institute on Drug Abuse Director Nora Volkow also recently said there’s no evidence that marijuana weans people from opioid addiction – and promoting such treatment might deny people a chance at recovery, USA TODAY Network reported.
The nation’s research agency on drug use wants to assess cannabis ingredients as possible treatments for more than 2 million Americans with opioid-use disorder, Volkow said. But there’s not any evidence that marijuana works for opioid addiction, she said.
New York, New Jersey, Pennsylvania and Illinois allow marijuana as a treatment for addiction to opioids such as heroin, fentanyl and OxyContin.
Volkow said she worries people who substitute marijuana for the Food and Drug Administration-approved medications buprenorphine, methadone and naltrexone might be more likely to relapse.
“If you don’t treat it properly, your risk of dying is quite high,” Volkow said. “My main concern is by basically misinforming potential patients about the supposedly beneficial effects of cannabis, they may forgo a treatment that is lifesaving.”
Meanwhile, a high-profile National Institutes of Health grant was awarded to researchers at Albert Einstein College of Medicine and Montefiore Health System in the Bronx in 2017.
The five-year, $3.8 million grant is for the first long-term study to test whether medical marijuana reduces opioid use among adults with chronic pain, including those with HIV, the health system said.
“This study reflects Montefiore and Einstein’s commitment to exploring all safe and effective therapeutic options to cure illnesses and relieve symptoms for our patients,” said Arielle Sklar.
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