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Mark Kleiman is right about the need for research

Mark Kleiman has a good post about some of the problems that are occurring in the unfortunate federal legal limbo of medical marijuana (like patients losing their jobs over drug tests): Cannabis, medicine, employment, and science

He notes that it won’t be solved unless/until cannabis is legalized at the federal level or a strain of cannabis is FDA approved.

For that to happen, the Federal government has to stop its current policy of obstructing clinical research.

Exactly.

Good stuff. But then he goes on to attempt to describe “our side,” complete with “medical marijuana” in scare quotes:

Many advocates of “medical marijuana” tacitly or explicitly oppose the clinical-research approach, even though that puts them on the same side of the issue as the drug warriors and the Drug Enforcement Administration. They insist that no research is needed because they already know the answer. (To advocates, “data” is just the plural of “anecdote.”) And they fear, quite correctly, that cannabis as a prescription drug would be no cheaper than illicit-market cannabis, and that actual prescriptions wouldn’t be nearly as easy to obtain as California “recommendations.”

Maybe I’ve been too tough on Mark in the past, assuming that he was including me when he talked about legalizers. If he really knows advocates who oppose research, then that’s sad.

None of the drug policy reform advocates that I’ve met fall into that category. I welcome research. I demand it. More information is always better.

Here’s an important point, though. I believe, as do most of us, that there is sufficient research and sufficient knowledge of the properties of cannabis to confidently (and in a scientifically appropriate way) allow its use for a wide variety of medical purposes.
(So if a prohibitionist tells me “They can’t use medical marijuana until there’s more research,” I call bullshit, particularly given the fact that that person generally knows that the government has no intention of following through on research.)

We understand that data is not the plural of anecdote. However, in the case of cannabis, there are plenty of instances, even when levels of research sufficient to result in FDA approval (assuming that’s even a proper standard) have not been conducted, where the knowledge is sufficient for going ahead confidently with medical use. The Institute of Medicine report “Assessing the Science Base” suggested that “n of 1” trials would be a good approach for cannabis, rather than waiting, for example.

There’s also a significant difference between analyzing a drug that’s used for symptom relief and one used for providing a cure.

Broadly using cannabis to cure cancer would require significant study (see laetrile) because allowing the patient to use cannabis instead of other treatments could jeopardize the patient’s treatment options.

However, using cannabis to treat the symptom of nausea from chemotherapy chemicals requires only two things:

  1. Does it work for this patient? This is a simple matter of observation by the patient and his/her doctor.
  2. Is it safe? And we have decades of the lack of bodies to sufficiently demonstrate the safety of cannabis.

In most cases today, medical cannabis is being used for the second example, and therefore the supposed need to wait for additional FDA approval is merely harmful to current sick people. That doesn’t mean that more research shouldn’t be done. It should. Just that it should not prevent medical cannabis use now.

Mark also says

The more sophisticated among them will say explicitly (in private) that “medical marijuana” is the best organizing issue for drug policy reform, and that FDA approval of cannabis as a real, live medicine (just like methamphetamine) would take a lot of the wind out of their sails.

I guess I just must not be very sophisticated.

Sure. I have said (publicly) that medical marijuana (not in quotes) is an excellent organizing issue for drug policy reform. That’s a simple fact. Once people see that medical marijuana exists and the sky doesn’t fall and people don’t turn into axe-wielding zombies, they’ll realize that they’ve been lied to all these years, and it’ll be easier to get them to be open to the truths about full legalization.

But I’m not using medical marijuana patients to further my cause. If the FDA approved a medical marijuana strain so that Julie Falco could get the medicine she needs to get through her day without having to resort to criminal activity, then I’d be absolutely thrilled, and I’d focus on legalizing cannabis and all other currently illicit drugs for recreational purposes.

The ones who use medical marijuana patients in harmful ways are the prohibitionists, who do everything that they can to block medical marijuana, because they also know that medical marijuana will cause people to learn the truth. And they’re willing to harm sick people in order to hide the truth. That’s despicable.

Maybe I’m hopelessly naive. Maybe there’s a bunch of drug policy reformers out there with bad motives who oppose research. I just haven’t met them.

Kleiman ends his piece strong:

The real mystery is why the Obama Administration, which has largely dropped drug-war language and ideology and is generally in favor of gathering and using scientific information to make policy, hasn’t changed course on this issue.

Given the overwhelming support for the medical use of cannabis found in every poll and confirmed in several referenda, and given the fact that the DEA’s own administrative law judge ruled in favor of breaking the research-cannabis monopoly and had to be over-ruled by the DEA Administrator, I would have thought the choice to let the science speak for itself would have been a no-brainer. But I would have been wrong.

The fact that policy that not only fits the President’s agenda and also has such popular support can be so easily squelched, just goes to show how profitably entrenched the prohibition lobby is in our government.

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18 comments to Mark Kleiman is right about the need for research

  • Rhayader

    Very good response Pete. Kleiman is all over the place on cannabis policy — sometimes I really like what he’s saying, but other times he flies off the rails. It’s clear that he realizes there are fundamental and extremely harmful flaws in our current approach to cannabis, but the paternalist in him has a very hard time abandoning the idea of heavy-handed government involvement.

    And yeah — where are all of these pro-legalization folks who seek to suppress government-approved cannabis research? I’ve never once met a single person who could be described that way. We all know that the truth shall set us free, and every reform advocate I’ve ever met would say “bring it on.”

    Anyway, I really hope Kleiman takes the time to respond to the points you’ve made here.

  • Every time I need to increase my chi I order one of these! 🙂

    Chinese Cannabis Drink

    Um, except I ask for the version WITHOUT the first ingredient! 😉

    The Chinese are l-o-n-g known for their interest and study of medicine. Although it tends to be from a different slant than Western medicine, i.e. helping the whole person, not just focusing on the mechanics and productivity of the individual factory.

  • Duncan

    I think it’s fine for cancer patients to try the Simpson method but think it should be in addition to conventional medical protocol for cancer treatment. Cannabis just doesn’t have any serious side effects and doesn’t cause a negative reaction. It would be easy enough to tell if the cannabis patients were faring better than the conventional protocol only patients. I won’t be holding my breath while I wait.

    I recall the news frenzy around laetrile back in the 1970s. It was all over every media outlet. I often think of that time when I read something about the indications that cannabis could either inhibit cancer or possibly even cure it outright. I wonder why the media doesn’t care. I suppose it’s possible that the group memory of news reporters recall the laetrile scam and are embarrassed that they fell for it.

  • divadab

    Duncan – I think the media is so overwhelmingly prohibitionist because it’s the corporate party line. We have a controlled media on this country – it’s controlled by the same greedy dominionists who own the federal government.

  • Servetus

    Here’s the latest research from Canada, once again affirming the neuropathic pain relief afforded by smoked cannabis.

    http://www.cmaj.ca/embargo/cmaj091414.pdf

  • ezrydn

    In reading, I get the opinion that any and all testing and reporting PRIOR to Mark’s piece is not to be believed or even read. He’ll only accept data from “today on,” and, as we all know, “today” changes EVERY day!

    Past research be damned, eh, Mark?

  • hangman

    The system is enriching too many operatives in and out of the cannabis trade for them to ever legalize it voluntarily. The US has studied the weed a lot more than we’re being told and they know what a miraculous plant it is.

  • one need only look at how even hemp is banned. HEMP! I haven’t heard much these days on the hemp front… at least the cops aren’t saying we’ll be hiding our ganja in the hemp and asking how they can be expected to tell the difference… and as to our boy Mark… safety is addressed by the simple act of comparing LD-50s of cannabis w/ any other substance. Basically we’ve had a large enough portion of our adult population smoking ganja regularly for two generations that were any of the concerns so often expressed about cannabis’ supposed harms that we would have bodies somewhere – except that we don’t. Where are the cannabis cancer deaths? Where are the tens and hundreds of thousands that have suffered increased mental health problems? Where the millions with respiratory problems? And if harm is to be used as a scale for cannabis’ worthiness then it must be compared to all other medicines/intoxicants/activities. More people die from vehicle accidents in the US (and 1/2 of those involve alcohol) than ALL illegal drugs. One need not be a professional wonk or a doctor-of-whatever to figure this stuff out. It’s not rocket science Mark! I mean I have yet to meet a black jazz or blues musician that was once a white youth that smoked a reefer and *POOF!* suddenly had darker skin and rhythmic inclinations…

  • vicky vampire

    I totally agree with you Allan 420,I’m so exhausted of this drug war yes cars are far more dangerous, these paternal psychopaths that control peoples freedom from medicine that helps me incredibly in so many ways, I see the light at end of tunnel getting biggerbut we are not there yet.

  • does Mark ever touch the topic of cannabis history? What part of this racist policy fraud are you failing to grasp Mark? You do realize we as humans have had cannabis longer than we’ve had written language, right?

    I’m sorry Mark but there is a universal grandfather clause about such things… but you can’t access it until you either consume cannabis or become an empathetic friend o’ weed. And Mark… the proper word is CANNABIS. You know, for when you get serious.

  • Just me.

    I DEMAND RESEARCH ! Thats the whole point, prove beyond doubt that cannabis shouldnt be prohibited, give government NO wiggle room.

    How many of you have lossed family and friends to cancer or other deseases and want testing done? How many would like to know what the government doesnt want us to know?

  • Dean Smith

    We need more research on even more powerful strains; that way people smoke less and are healthier, and we have a psychotropic that will effectively alleviate the most troubling aspects of living in a fundamentalist corporate culture, that values the invisible hand over the suffering heart…

  • TrebleBass

    His argument, I guess, is: what if they find out that it doesn’t work, or what if they make a pill form of it (better than marinol, that also has cbd), that works better than the plant itself (or something resembling an asthma inhaler that’s a vaporizer)? He thinks that that would hamper the efforts for legalization. What he fails to realize is that we like marijuana. We want research to be done, and we like any little gadget that they might create to consume it. And we’re hopeful of marijuana being proven to treat all sorts of diseases; we’re eager for all necessary research.

  • Samantha

    Pro marijuana forces question every study, government or university, that shows any negative effects of marijuana, so I’m sure you would welcome government studies, but only if they showed some benefits of marijuana. You have already concluded that marijuana is safe without the requisite studies. The problem is that you would have to take the good news with the bad. The overwhelming number of studies show that marijuana has numerous side effects and risks, but you either downplay, ignore, dismiss, or dispute those studies, as shown above. Dean Smith then mentions smoking. Does that mean someone might think smoking is not that healthy? You would be open to a medicine in pill form? Because I don’t see the FDA approving smoking as a medicine any time soon.

  • Samantha,

    We welcome all studies. Keep in mind that we’ve been operating under a regime for some years where all marijuana studies from the government are funded by NIDA, which publicly stated that they are only interested in funding studies which are likely to find negatives. And the studies must get their marijuana with permission from the DEA, which is also only interested in supporting studies where the intent is to find something negative.

    This skews the entire research field right now, so naturally we carefully analyze every study that shows a negative (too many unethical researchers know what side their bread is buttered on, and will imply unsupported conclusions to fit NIDA’s interest).

    However, when a good research study shows something negative about marijuana, we’re happy to acknowledge it, such as the fact that heavy smoking over the course of years, while not a factor in head, neck, or lung cancers, can be a factor in other lung diseases like bronchitis. That’s why we push for more research on vaporizers, which can be a healthful alternative for heavy smokers — research which, by the way, has been blocked by the federal government.

    You have already concluded that marijuana is safe without the requisite studies.

    Wrong. What are the “requisite” studies for safety? Approval from a political entity like the FDA? Approval from Congress? (after all, they’re the ones who decided it wasn’t safe to begin with) Or science?

    We have concluded that marijuana is safe precisely because we have seen the requisite studies that conclusively demonstrate that fact.

    Of course we would be open to medicine in a pill form, but Marinol, which is THC in a pill form, is an unacceptable alternative to whole marijuana. It’s fine for some people, but it doesn’t have the medical value of the full plant.

    Sativex is a very promising whole plant extract from GW Pharmaceuticals that has been demonstrated in detailed studies over the course of years to not only be effective in a variety of medical uses, but also to be safe. We’d love to have that available here. Gee, I wonder why we don’t have it yet — it’s already approved for use in the UK and Canada. Certainly GW would love to market it in the states — we have a very lucrative medicinal market here. Maybe it’s because the FDA isn’t interested in science.

  • darkcycle

    Samantha? 4000 years of human use? How safe does a medicine have to be? Not a single overdose fatalaty. No cancer deaths attributed to it….
    The standard held for pharmacueticals is so far from the standard applied to medical marijuana it’s a joke! ANY old chemical poison can slide right through the FDA system. Ever read the side effects for these drugs? Alot of them list death as a side effect, and in fact routinely kill one out of ten thousand or so people who take them. FDA does a great job of protecting you. But they do a better job protecting big pharma.

  • Maria

    I have precious little respect for the ability or desire of the FDA to tell me what’s Safe compared to telling me what’s “eh, safe enough” in its context of a vast cornucopia of consumable industry products.

    I do have a small amount of respect for it as a large government agency with vast reach. One that, when motivated, can catch nasty violations of safety procedures and production, one that still does keep consumers safe when negligence takes a company over. (usually people have gotten sick by that point, but hey, it swiftly sends out recalls.) However, that respect is dwindling as budget cuts occur and it becomes increasingly clear that the priority of consumer safety is at odds with… other things.

    The FDA does some good for public safety, however it is being pulled apart and consumed by multiple industries and apathy. This isn’t new, all industries have reasons to hamstring regulatory bodies; it’s a constant push and pull of competing interests. The the agency let it’s guard down and the government let it’s guard down.

    In an ideal world, the FDA would at least get around to inspecting the food facilities squarely under it’s own (and state) jurisdiction. This year, if it gets around to even visiting half of them, or even reinspecting some serious violators, I’ll be pleasantly surprised. Despite all the promises of rehires, they are still operating with a literal handfuls of inspectors per state, for thousands of sites.

    I’m more worried about the safety of our eggs, milk and salad mix then I am concerned about the FDAs ability to defend or shoot down the lies and rhetoric around legalizing and regulating cannabis and industrial hemp.

    Yeah, hemp, thanks allan420 for reminding me about that, the arguments against oilseed and fiber hemp are just so absurd that even the prohibs won’t touch them unless cornered.

    Hell, I’m frankly more worried about the dangers of the nations crumbling dams and bridges then I am about the dangers of potential side effects of dry mouth, dry eyes, increased appetite, increased saliva production, cough, mental agitation, or gods forbid, euphoria. But I guess all the money that goes into the war on drugs wouldn’t be spent on fixing the dams anyways. Yeah, I’m just juggling unrelated oranges and apples….

  • more importantly, every alleged “danger” of using marijuana is blown way the hell out of any reasonable proportion.

    the core of the matter is that our government kills people to “protect” them from whatever minimal harms they may choose to risk upon themselves.

    so when various “studies” imply an increased risk of (fill in the blank) from using marijuana, if they would provide the actual scale of the alleged “danger” it would be immediately obvious that there really is no pertinent concern.

    the reality is a very simple one: pot is as close to “harmless” as anything you can identify in our world. and it is several orders of magnitude less dangerous than the gun wielding zealots trying to stop people from using it. who i might add, at times are actually killing completely innocent people in the name of their insane drug war.

    the more you learn about it, the most disgusted you should become. and ultimately, everyone needs to come to terms with the simple reality that what you choose to do to yourself is well beyond the reach of legitimate law.

    today, it’s the “druggies” — you are next.