By Edward M. Bednarczyk
In his State of the State address, Gov. Andrew M. Cuomo invoked the Controlled Substances Therapeutic Research Act of 1980, a law that provided for the medical use of cannabis a full 16 years before medical marijuana was approved by the California legislature. New York’s legislation provides for carefully controlled distribution and study of marijuana for medical purposes.
Unfortunately, this has reignited the call for broader legalization of medical marijuana in New York, perpetuating several myths. One is that the active ingredients in marijuana (collectively called cannabinoids) are unavailable to patients. In fact, two products (dronabinol and nabilone) containing the primary active ingredient in marijuana, THC, have been approved by the FDA. An oral spray currently approved in Canada and the European Union is being tested in clinical trials in the United States. This product contains two cannabinoids (THC and cannabidiol) in carefully controlled proportions.
Another myth is that medical marijuana has been proven safe and effective in numerous conditions. In fact, rigorous data is lacking, and many of the claims for medical marijuana are based on research done with FDA-approved medications containing THC. To be sure, medical marijuana has shown benefit in some conditions, including neuropathic pain experienced by patients with HIV, but no studies have met the standards that the FDA requires of prescription medications.
Recently, claims have been made for the treatment of serious seizure disorders using a strain of cannabis that is said to contain a high percentage of cannabidiol, a cannabinoid believed to lack the euphoric effects of THC. These reports should serve as a call for immediate, careful research rather than uncontrolled experimentation on children already suffering from severe and in some cases life-threatening conditions.
Many useful drugs start from naturally occurring plant or animal sources, and nature will remain an important discovery ground for medications. This doesn’t mean we should advocate for using unrefined, non-standardized products with ingredients of unproven safety. Let’s stick to the standards for safe and effective medications set by the Food and Drug Administration and endorsed by the Institute of Medicine.
If we wish to legalize the use of recreational marijuana, we should undertake that as a separate discussion. New York should first exhaust the limits of the existing legislation before seeking an expansion that would serve only to move toward legalization of recreational marijuana without bringing the benefits of careful research to patients.
Edward M. Bednarczyk is chairman and clinical associate professor in the Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, at the University at Buffalo.