This week I want to highlight two articles both about the use of cannabis. The first article is about the differences between marijuana and hemp and the confusion it causes. The second article is a report that covers the experiences of individuals using cannabis to treat their PTSD. Below you’ll find these articles and my thoughts on their implications.
Disclaimer: The views and opinions expressed below are those of Mark Pew, Senior Vice President of Product Development and Marketing, and do not necessarily reflect the views of Preferred Medical.
Texas passed a bill in June making hemp products legal. However, marijuana remained not legal, just like at the Federal level. This has resulted in many Texas prosecutors dropping marijuana possession charges. Because hemp and marijuana are similar in their makeup, telling the difference requires lab testing to determine whether the possession in question is legal hemp or illegal marijuana. This different testing requires more time and money so over the objections of the state government some prosecutors are taking the most expedient route by treating everything as if it is legal. That’s not exactly what they had in mind.
More confusion about cannabis, this time in Texas on how to differentiate hemp (legal) and marijuana (still not legal). Prosecutors dropping cases, or not even pursuing charges, comes down to testing per this article. “Before the legislation went into effect, laboratories had to identify hairs on marijuana flowers and test for the presence of cannabinoids, a process that required just a few minutes and a test strip that turned purple when it was positive. Because the new law distinguishes between hemp and illicit marijuana, prosecutors say labs would now be required to determine the concentration of THC in the seized substance. Dr. Stout said he has been able to identify only two labs in the country that can make the fine distinction necessary and that are accredited in Texas. Both of them are private. Prosecutors would need to pay the labs to run the tests — sometimes hundreds of dollars for each sample — and to testify about the results at trial. Sending all of the state’s suspected marijuana to a small number of labs would likely overwhelm them, prosecutors have said, and would result in severe backlogs.” Texas is obviously not the only state dealing with this dilemma (in addition to differentiating between presence and impairment). This is the definition of “unintended consequences.”
In 2014, Minnesota became the 22nd state to create a medical cannabis program. Since that time they have added more qualifying conditions, including PTSD in 2017. This article reports on the experiences individuals with PTSD had during the first five months of the program.
Very interesting results from the Minnesota Department of Health about the use of cannabis for PTSD. For those that argue there isn’t enough scientific evidence for efficacy, this data can be a conversation starter. I suggest you read the entire report, but here are some highlights:
- 751 patients listed PTSD as their qualifying condition
- 96% completed a PCL-5 (developed by the U. S. Department of Veteran Affairs) survey at enrollment and 51% completed the same survey 3 months after their initial purchase
- 45% of all products purchased were Very High THC:CBD vaporization oil
- “Between 50% and 71% (depending on whether a reduction of 20 points or 10 points is used) of respondents saw a clinically meaningful improvement in PTSD symptoms.”
- “On a scale from 1 (no benefit) to 7 (great deal of benefit) … 76% indicated a benefit rating of 6 or 7 … 4% gave a rating of 1, 2, or 3.”
- “The proportion of patients with at least one physical or mental adverse effect varied from 11% in the PSE data to 21% in HCP surveys to 26% in patient surveys.”
Does this prove marijuana can treat PTSD? Your answer probably depends upon your bias. I can understand the argument that this data does not fit the gold standard of a random controlled trial (there is no control group). I can also understand the argument of selection bias in that participants decided to try marijuana on their own so they were likely already biased towards/hoping for it being medicine. So, this study (analysis of results is probably a better term) is not perfect—and likely wouldn’t qualify per FDA standards. That’s why I said “conversation starter” and not “conversation ender.” But at what point does overwhelming “anecdotal” (personal experience) results become “evidence” (that some insist upon before agreeing cannabis is medicinal)? As more results are reported we will all find out what that tipping point may be.
To read everything on my mind this past week, please visit me on LinkedIn at https://www.linkedin.com/pulse/marks-musings-july-29-mark-rxprofessor-pew/.
Until Next Week,