The federal government's most disputed marijuana policy decision may come down to funding — for research.
Under the Controlled Substances Act, the feds consider marijuana to have no medical value, classifying pot under the harshest possible classification — a schedule 1 drug. The government argues this is justified because there have been no large-scale clinical trials proving pot has medical value.
Maybe so. But a new analysis by News21, a Carnegie-Knight national student reporting project based at Arizona State University, suggests the federal government is part of the reason this research isn't happening.
Out of $1.4 billion the National Institutes of Health spent on marijuana research from 2008 to 2014, just $297 million went to studying marijuana's effects on the brain and potential medicinal benefits. The rest went to studying pot abuse and addiction. To put marijuana's non-abuse research funding in perspective, the feds spent about two times as much on non-abuse research for opiates, a much more established drug type.
This matters. The government plays a big role in funding all research — the NIH estimates that it spends $30.3 billion each year on medical research. And the feds tightly regulate the use of marijuana for studies, since it's illegal.
So the funding numbers aren't good. They play into medical marijuana advocates' belief that the feds are only interested in proving marijuana is bad — hence all the studies dedicated to abuse and addiction. And they show the federal government isn't very interested in finding out if its classification of marijuana is legit.
Moreover, this plays a big role in both medicine and policy. One of the major potential benefits of medical marijuana is its ability to treat pain. With thousands of people dying each year from opioid-based prescription painkillers, medical marijuana could be a healthier alternative — but federal policy will have to acknowledge that pot is a legit medical substitute first before it's nationally accepted.
There's good evidence that marijuana could substitute for deadly opioid painkillers
Since the late 1990s, the number of people dying from opioid painkiller overdoses has steadily risen — with more than 16,000 deaths reported in 2013. What's worse, one study in JAMA Psychiatry found opioid painkiller use has contributed to the rising use of heroin, which is deadlier and more addictive than painkillers. And a 2015 analysis by the Centers for Disease Control and Prevention found people who are addicted to prescription painkillers are 40 times more likely to be addicted to heroin.
But these concerning numbers come into conflict with another public health issue: Approximately 100 million US adults suffer from chronic pain, according to a 2011 report from the Institute of Medicine. And although there's no good evidence that opioid painkillers can treat chronic pain, they can help with acute pain and are commonly prescribed for long-term issues.
If marijuana can relieve pain, it can substitute opioid painkillers with none of these problems. No one has ever reportedly died from a marijuana overdose. And pot isn't an opioid, so dependence — which does happen with marijuana, but at much lower rates than opioid addiction — can't lead to an addiction to heroin.
IF MARIJUANA CAN RELIEVE PAIN, IT CAN SUBSTITUTE OPIOID PAINKILLERS WITH NONE OF THEIR PROBLEMS
A review of the research, published in JAMA, found good evidence that marijuana can treat chronic pain and muscle stiffness, but not much evidence for other conditions. Another study published in JAMA found that medical marijuana legalization may reduce opioid overdose deaths. And a recent study from RAND Corporation and UC Irvine researchers similarly found that states with legal medical marijuana dispensaries have less opioid abuse and fewer opioid deaths.
While the researchers involved in all of these studies say that more research needs to be done on the potential benefits of medical marijuana, their findings are very promising. For all the hoopla about whether medical marijuana is just a back door to legalization, we're beginning to see pretty good evidence that it is medicine and it might be better medicine in some cases than some of the fully legal drugs. The positive findings for chronic pain in particular stand in stark contrast to the findings for opioid painkillers, for which, again, no good evidence exists to suggest they can treat chronic pain.
So marijuana could play a big medical role. It's just a matter of getting the federal government behind it. And while there are some signs the government is changing, the research funding figures show that change is coming very slowly.