A bipartisan group of members of Congress is pushing the Trump administration to consider medical marijuana as a safer alternative to opioids.
“As you know, our country is grappling with an opioid epidemic that is now taking 91 lives every single day,” the lawmakers wrote in a letter to Acting Health and Human Services Secretary (HHS) Eric D. Hargan. “Recent studies published by qualified academic researchers suggest that marijuana may prove to be a useful alternative treatment for chronic pain instead of harmful, addictive prescription opioids, and that marijuana may reduce the overall number of opioid overdose deaths.”
After citing a number of studies demonstrating cannabis’s efficacy and that legal marijuana access is associated with reduced opioid issues, the House members lay out a series of questions they want answered:
The evidence that marijuana may have a positive therapeutic warrants additional attention from the federal government. We request that you provide answers to the following questions:
1. Please describe in detail what the Department of Health and Human Services (HHS) is doing to fill the gap in our knowledge about the use, uptake, and effectiveness of medical marijuana as an alternative to opioids for pain treatment in states where it is legal.
a. Please describe in detail any federal efforts to conduct research the impact of state medical and recreational marijuana laws on opioid overdose deaths.
b. Please also describe in detail efforts by other federal agencies under the jurisdiction of HHS.
2. Please describe in detail what HHS and other federal agencies are doing to work with states that have implemented medical marijuana laws to collect data on the impact of these laws on opioid overdose deaths.
3. Is HHS committed to implementing evidence-based policies regarding the use of medical marijuana as an alternative pain treatment in an effort to promote public health?
4. Is HHS committed to making any research on the therapeutic benefits of marijuana available to states including as a more benign alternative to opioids for pain management, so that they can implement evidence-based policies to address the opioid epidemic?
5. Please describe in detail any ongoing efforts to share this research on marijuana’s potential as an alternative pain treatment to addictive and dangerous prescription medications with other federal agencies, including but not limited to the Office of National Drug Control Policy, the Drug Enforcement Administration, and the Department of Justice.
“We should not ignore any information that suggests there may be a tool available to fight the opioid epidemic that we are not using to the fullest extent,” the legislators conclude in the letter, which is dated Tuesday. “While it is clear that more research is necessary, it is equally clear that medical marijuana is an alternative pain treatment that merits the attention of the federal government.”
Congresswoman Tulsi Gabbard (D-HI) posted a series of tweets about the issue on Thursday evening.
As the opioid epidemic continues to ravage communities across the country, we must pursue every available path to prevent, treat, and ultimately end America’s reliance on these highly addictive drugs.
— Rep. Tulsi Gabbard (@TulsiPress) December 7, 2017
With 91 lives lost every single day to the opioid epidemic, Acting Secretary Hargan should immediately authorize additional research into medical marijuana as an alternative treatment to urgently address this opioid crisis.
— Rep. Tulsi Gabbard (@TulsiPress) December 7, 2017
The letter comes amid increasingly prominent discussion about marijuana’s potential to reduce opioid overdoses. The federal government’s top health research official was asked about the topic in two separate Senate hearings this week.
Last week, Sen. Elizabeth Warren (D-MA) sent questions about marijuana and opioids to Alex Azar, President Trump’s nominee for HHS secretary.
See the full text of the House lawmakers’ new letter below:
Feds Award $3 Million In Grants To Study Marijuana Ingredients As Alternatives To Opioids
The federal government has awarded $3 million in grants for research into the therapeutic benefits of ingredients in marijuana other than THC, emphasizing their potential as alternatives to prescription opioids.
In a notice published on Thursday, the National Institutes of Health (NIH) explained why the studies were necessary and listed grant recipients and the subjects they will investigate. That includes research into the use of CBD for arthritis pain, which will be led by New York University School of Medicine.
“The treatment of chronic pain has relied heavily on opioids, despite their potential for addiction and overdose and the fact that they often don’t work well when used on a long-term basis,” Helene Langevin, director of the National Center for Complementary and Integrative Health (NCCIH), said in a press release. “There’s an urgent need for more effective and safer options.”
A total of nine grants were issued, with NIH stating that the funds will help identify alternative treatment options for pain and provide information about the impact of consuming cannabis compounds such as CBD and other lesser-known cannabinoids as well as terpenes found in the plant.
“The cannabis plant contains more than 110 cannabinoids and 120 terpenes, but the only compound that’s been studied extensively is THC,” the press release said.
But while THC is known to treat certain forms of pain, NIH is concerned that its intoxicating effects limit its medical applicability.
“THC may help relieve pain, but its value as an analgesic is limited by its psychoactive effects and abuse potential,” David Shurtleff, deputy director of NCCIH, said. “These new projects will investigate substances from cannabis that don’t have THC’s disadvantages, looking at their basic biological activity and their potential mechanisms of action as pain relievers.”
Just released: Nine new research awards, funded by our Center, will investigate the potential pain-relieving properties and mechanisms of actions of the diverse phytochemicals in cannabis, including both minor cannabinoids and terpenes. https://t.co/03MxrycfFa
— NIH NCCIH (@NIH_NCCIH) September 19, 2019
NIH first announced that it would be issuing grants for studies into minor cannabinoids and terpenes last year.
Federal health agencies aren’t the only institutions interested in learning about marijuana compounds other than THC. On Wednesday, a Senate committee issued a spending report that called for research into CBD and CBG while also criticizing the federal drug scheduling system for inhibiting such research.
Read descriptions of the federal cannabinoid and terpene research grant awards below:
Mechanism and Optimization of CBD-Mediated Analgesic Effects; Boston Children’s Hospital, Boston,; Zhigang He, Ph.D., B.M., and Juan Hong Wang, Ph.D. This project will investigate how the pain-relieving effects of cannabidiol (CBD) and other minor cannabinoids may be modulated by the activity of potassium-chloride cotransporter 2 (KCC2), a chloride extruder expressed in most neurons. (Grant 1R01AT010779)
Neuroimmune Mechanisms of Minor Cannabinoids in Inflammatory and Neuropathic Pain; University of California, San Francisco; Judith Hellman, M.D., and Mark A. Schumacher, M.D., Ph.D. This project will explore the effects of minor cannabinoids on inflammatory and neuropathic pain in vitro and in vivo, focusing on the interactions of the cannabinoids with the peripheral receptor called TRPV1 and a cannabinoid receptor, CB1R. (Grant 1R01AT010757)
Minor Cannabinoids and Terpenes: Preclinical Evaluation as Analgesics; Research Triangle Institute, Research Triangle Park, North Carolina; Jenny L. Wiley, Ph.D. This project will evaluate purified biosynthesized minor cannabinoids and selected terpenes alone and in planned combinations to determine their potential efficacy as pain relievers against acute thermal, inflammatory, neuropathic, and visceral pain. (Grant 1R01AT010773)
Identifying the Mechanisms of Action for CBD on Chronic Arthritis Pain; New York University School of Medicine, New York City; Yu-Shin Ding, Ph.D. This project will use neuroimaging studies and behavioral assessments to investigate the mechanisms of action of CBD in the modulation of chronic pain associated with osteoarthritis in a mouse model. (Grant 1R21AT010771)
Synthetic Biology for the Chemogenetic Manipulation of Pain Pathways; University of Texas, Austin; Andrew Ellington, Ph.D. This project will use a novel method to evolve individual variants of cannabinoid receptor type 2 (CB2) that interact with high affinity with minor cannabinoids and evaluate the new variants in a mouse model of pain. (Grant 1R21AT010777)
Exploring the Mechanisms Underlying the Analgesic Effect of Cannabidiol Using Proton Magnetic Resonance Spectroscopy; University of Utah, Salt Lake City; Deborah A. Yurgelun-Todd, Ph.D. This project will use proton magnetic resonance spectroscopy (1H-MRS) to evaluate changes in brain chemistry in critical pain-processing regions after short-term administration of a cannabis extract enriched in CBD. (Grant 1R21AT010736)
Mechanistic Studies of Analgesic Effects of Terpene Enriched Extracts from Hops; Emory University, Atlanta; Cassandra L. Quave, Ph.D. This project will take a multidisciplinary approach to investigate the analgesic effects of terpenes from Humulus lupulus (hops), a plant that is closely related to cannabis and has a very similar terpene profile. (Grant 1R21AT010774)
Systematic Investigation of Rare Cannabinoids With Pain Receptors; University of Illinois at Urbana-Champaign; David Sarlah, Ph.D. This project involves synthesizing several classes of rare phytocannabinoids, systematically evaluating their anti-inflammatory potential, and examining the effects of the compounds with the strongest anti-inflammatory potential on the major receptors involved in pain sensation. (Grant 1R21AT010761)
Analgesic efficacy of single and combined minor cannabinoids and terpenes; Temple University, Philadelphia; Sara J. Ward, Ph.D. This project will use rodent models of pain to evaluate the effects of four biologically active components of cannabis that may act synergistically to protect against pain development and to assess the interactions of these four substances with morphine. (Grant 1R01AT010778)
Beto O’Rourke Proposes Drug War Reparations Funded By Marijuana Taxes
Marijuana would not only be legalized under a plan proposed on Thursday by Democratic presidential candidate Beto O’Rourke, but cannabis tax revenue would be used to directly repay formerly incarcerated people through a new “Drug War Justice Grant” program.
Unlike other contenders who have come around to supporting marijuana legalization in just the past couple of years, the former Texas congressman has long called for ending prohibition—and his new plan in many respects goes further than those rolled out by other campaigns.
(Marijuana Moment’s editor provides some content to Forbes via a temporary exclusive publishing license arrangement.)
Support Grows For Marijuana Legalization Bill In Colombia
Colombia’s legislature will soon take up a bill to legalize and regulate the production and consumption of marijuana for adults.
The legislation, which is being filed by Sen. Gustavo Bolivar of the opposition Colombia Humana party, seeks to end prohibition as a means of curtailing crime and supporting a public health-focused approach to drug policy.
Bolivar, an author who has written several books centered on drug trafficking, has characterized the bill as being about “regularization, not legalization,” but it would provide for legal sales to adults with restrictions similar to those imposed for tobacco and alcohol. There would be penalties for selling to underage individuals and smoking wouldn’t be permitted in public spaces.
The senator pointed to Uruguay, Canada and states in the U.S. as regulatory models for legalization.
“It has been proven that crime levels are lowered and public health is improved,” he said, according to Colombia Reports.
Sen. Alberto Castilla Salazar of the leftist Polo Democrático party said that his coalition supports the reform measure.
Colombia debe superar el prohibicionismo y romper los vínculos de los grupos ilegales con el control del Cannabis, para que sea el Estado quien regule, defina las formas y entienda el consumo como problema de salud pública. Como @PoloDemocratico respaldamos está iniciativa. pic.twitter.com/YBDHqojENJ
— Alberto Castilla Salazar (@CastillaSenador) September 17, 2019
“Colombia must overcome prohibitionism and break the ties of illegal groups with the control of cannabis, so that it is the State that regulates, defines the forms and understands consumption as a public health problem,” he said on Tuesday.
Sen. Julián Gallo Cubillos of the FARC party said his coalition supports the legislation and that it represents “a new way to fight the scourge of drug trafficking.”
— Senado Colombia (@SenadoGovCo) September 18, 2019
The proposal has also garnered the support of former President Juan Manuel Santos, who has been an outspoken advocate for ending the war on drugs. His Liberal party could make or break the legislation depending on where members fall.
While left and center-left lawmakers seem largely united around legalizing marijuana, the issue will likely face resistance from President Ivan Duque, who last year signed a decree banning low-level possession of cannabis and cocaine despite court rulings that such activity is permissible.
As Colombia Reports noted, however, Duque’s far-right Democratic Center party is in the minority.
“We’ll have to see how many senators are left to former president Juan Manuel Santos and see how public opinion receives the idea that marijuana can be consumed in public spaces,” Sen. Paloma Valencia, a member of the president’s party, said.
If the country does opt to pursue a regulated cannabis program, it will join Mexico, where lawmakers are readying legislation to legalize marijuana for adult use following a Supreme Court ruling establishing that a ban on possession and cultivation for personal use is unconstitutional.
Photo courtesy of Brian Shamblen.