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Lawmakers voted down a proposal that would make medical marijuana more available in North Carolina, saying they didn’t think the bill was strong enough and that they didn’t know enough about the effects of cannabis. We take a quick look at the science on medical marijuana.

By Rose Hoban

After 45 minutes of testimonies Wednesday afternoon from medicinal marijuana users that were at times emotional and tear laden, a legislative judiciary committee hearing a bill to legalize the medical use of cannabis and cannabis extracts voted the bill down.

Jamie Hargitt, co-founder of Republicans Against Marijuana Prohibition, testified at the House Judiciary III meeting Wednesday morning in favor of legalizing medical marijuana use. Photo credit: Rose Hoban

Choking back tears, Jamie Hargitt from the North Carolina chapter of Republicans Against Marijuana Prohibition told committee members of how medical cannabis has helped her husband, an Army veteran with multiple deployments to Iraq before being diagnosed with Parkinson’s disease in 2008.

“Medical cannabis needs to be available so where he can function and we can keep our family intact,” Hargitt said through tears. “I know that medical cannabis for [my husband] makes him a much better father.”

Hargitt was followed by Christine Bacon, another military spouse, who started her testimony by depositing a Ziploc bag filled with medicine bottles on a committee table. She told the committee that doctors at Womack Army Medical Center suggested medical cannabis might help her husband’s problems with traumatic brain injury, chronic pain and the gastrointestinal side effects of taking multiple pain medications.

And they were both preceded by Perry Parks, a former chief warrant officer who retired a decade ago and found medical marijuana helped him cope with chronic pain and problems sleeping.

But despite these and other testimonies, and the fact that at least three of the committee members in the room had served in the military, the committee did not debate the bill before unanimously voting to give it an unfavorable report.

For this legislative session, the bill is effectively dead.

And although legislators said they were moved by the stories they heard, and some said that they might even be amenable to medical marijuana legalization, they said there were problems with the bill and the amount of information available on the effects of medical cannabis.

Moved to tears

The bill would have allowed people in North Carolina to obtain a prescription to use medical cannabis for a laundry list of acute and chronic medical conditions, from cancer to Lou Gehrig’s disease to arthritis. HB 78 would require that users register and buy the substance from a state-licensed distributor who would limit the amount of cannabis that a user could buy at any one time. It also would have created a system for production, regulation, taxation and sale of medical cannabis and directed the UNC system to research the substance.

“Many of the testimonies that you have heard from people, they haven’t talked about smoked cannabis,” said bill sponsor Rep. Kelly Alexander (D-Charlotte). “They’ve talked about cannabis oil and using it in ways other than the stereotypical notion that you may have when you think about the old Cheech and Chong movies, or Harold and Kumar.”

“That is not what this is about,” he said.

Lawmakers on the committee expressed misgivings that the regulatory regimen was not strict enough.

“Some of those stories, they moved me to tears,” said Rep. Grier Martin (D-Raleigh), an Iraq and Afghanistan veteran. “I know people like that; I served with people like that. I get it.”

But Martin said the bill, as presented Wednesday, was not rigorous enough in regulating medical cannabis, even as he said that he’s come to believe “we need to find a way to make marijuana usable for medicinal purposes in North Carolina.”

Map of U.S. jurisdictions with cannabis laws (light purple), U.S. jurisdictions with medical cannabis laws only (light blue), jurisdictions with marijuana decriminalization laws only (dark purple), jurisdictions with both decriminalization and medical cannabis laws (green) and jurisdictions with both medical marijuana laws and legalized recreational cannabis. Some Indian reservations and cities have laws that are different from the states. Currently, 23 states and the District of Columbia allow some measure of access to marijuana. According to N.C. General Statute § 90-95 (b)(2), a person possessing less than 5 grams of marijuana is subject to a misdemeanor without jail. Map by Lokal_Profil. Image courtesy Wikimedia Commons

“This is a drug with intoxicating properties and needs to be taken seriously,” he said. “We need to give it the same look as we do for drugs that are not as intoxicating. This bill didn’t have that.”

He also bemoaned the fact that federal inaction has left the issue to states to work out the issue on their own.

There may be some help on that front. A federal bill was introduced in the US Senate earlier this month by New Jersey Democrat Cory Booker and co-sponsored by Kentucky Republican Rand Paul, among others.

The Compassionate Access, Research Expansion and Respect States Act would move marijuana from a highly restricted Schedule I drug, similar to heroin and cocaine, to a Schedule II drug, similar to opiods such as morphine and oxycodone. The bill would also make it easier for researchers to study the medicinal and psychoactive effects of marijuana.

Research gaps

Freeing up the ability to research would go a long way to allowing scientists to speak more knowledgeably about marijuana, said David Kroll, a Triangle-based pharmacologist and researcher who writes about drug development and drugs derived from nature for Forbes.com.

Kroll said the federal bill would make it easier to research marijuana.

“It’s hard for people to do real research,” he said. “Even at the University of Colorado (in a state where marijuana use is legal), you can’t do your own marijuana research. You can’t go to a dispensary and buy retail marijuana; you have to have specific federal grants.”

He said the only marijuana allowed for research is specific strains grown at the University of Mississippi and distributed to researchers from there. Those strains are different from the ones that have been hybridized by black market growers, which tend to be higher in tetrahydrocannabinol, or THC, the psychoactive substance in marijuana.

“This is why we’ve got limited data in the U.S. on what marijuana does in clinical trials,” Kroll said.

Helen Monroe, an 85-year-old Chatham County resident, told the committee that marijuana has provided relief from arthritis. Photo credit: Rose Hoban

Several European countries and Canada now allow the use of some forms of medical cannabis oils and medications that have been synthesized from other strains of marijuana. One such drug is made from strains with less THC and more cannabidiol, which is not psychoactive. The drug is used to relieve the muscle spasticity that’s a problem for people with multiple sclerosis.

Kroll said some of the research has looked at marijuana’s use as an adjunct to allow patients with chronic pain to use it alongside opiods, reducing their dependence on the narcotics.

“I really want to see that study, because that could be really significant,” he said. “But it was a small study and it wasn’t using the marijuana that we have here for research.”

Wake Forest University researcher Allyn Howlett has been studying how cannabis affects the brain since the 1980s. She was one of the scientists who identified what’s known as the CB1, or cannabinoid 1, receptor, the place on human cells targeted by THC. Other cannabinoid-sensitive receptors have been identified since.

“These receptors weren’t put there in the body to smoke pot, they were put there because they modulate the way different cells in the body function,” Howlett said.

She said the problem with smoking pot or ingesting cannabis oil is that it acts on all of the cannabinoid receptors in the body, not just in the organs with disease. Howlett pointed to a British company, GW Pharmaceuticals, that is making a drug to treat multiple sclerosis. She said the company’s cautious go-slow approach is the “right way” to create a cannabis-based drug that will avoid what she called “bad effects.”

“People are looking now to see if they can make drugs that would be more selective, maybe only working on different tissues at different circumstances,” she said. Howlett praised pharma companies’ drug-development process as being safer and more predictable than just smoking leaves or using them in order to extract an oil.

But she admitted that pharmaceutical companies are only going to work on medications that might have a big market.

“[Pharma companies] put a lot of thought and effort into drug development. It’s expensive to go through clinical trials,” she said, “and they could be liable for any of the side effects. So a big drug company has to be careful.”

Howlett also bemoaned the fact that Marinol, the first drug based on a synthetic form of THC, was not very effective at relieving the nausea and vomiting that people often smoke marijuana for. But she also said there’s little quality control with much of the marijuana that people buy in leaf form.

“We’ve protected ourselves from things that could go wrong, things that are inadvertently put inside a product, like insecticide or molds that might have been grown in a plant,” she said. “Most people are not growing their own plants. They get it from someone else and they don’t know what’s in that baggie.”

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