Journal of the California Cannabis Research Medical
"Marijuana Use Disorders"
The May 5 Journal of the American Medical Association
carried an article entitled “Prevalence of Marijuana Use Disorders
in the United States, 1991-92 and 2201-2002” by an MD named Compton
and four PhDs. Their conclusion: “Despite the stability in the overall
prevalence of marijuana use, more adults in the United States had a
marijuana use disorder in 2001-02 than in 1991-92. Increases in the
prevalence of marijuana use disorders were most notable among young
black men and women and young Hispanic men. [What a coincidence —the
very groups they love to harass!] The results of this study underscore
the need to develop and implement new prevention and intervention programs
targeted at youth, particularly minority youth.”
Most marijuana-use disorders are characterized as “abuse,” which is supposedly
milder than “dependence.” Compton et al define marijuana abuse —relying, of
course, on the Diagnostic and Statistical Manual of Mental Disorders— as “repeated
instances of use under hazardous conditions; repeated, clinically meaningful
impairment in social/occupational/educational functioning, or legal problems
related to marijuana use.” In other words, getting in trouble with the law
or with the authorities at work or school is now defined as a mental disorder!
This is Science with a capital S. Science in the service of the status quo.
And talk about reductionism... Reducing the intricate workings of the human
mind to a three-digit number!
Another point Weil made in his UCLA talk was substantiated by a recent study
in Lancet/ A team led by Dr. John Macleod of the University of Birmingham examined
data from 48 studies in search of evidence that early cannabis use causes psychological
or social problems later in life. But no such link could be found!
Cannabis-using youth tend to leave school earlier and are more likely to use
other illicit drugs, but, as Macleod observed, “This association could have
several explanations,” such as poverty, dysfunctional family, etc. “We are
not saying cannabis is harmless, we are saying the evidence is inconclusive,” MacLeod
told Reuters. —F.G.
California MJ Research Program
Stretches Mandate to Hold "Cannabinoid Therapeutics" Event
By Fred Gardner
Did the directors of the University of California’s Center for Medical Cannabis
Research violate their basic mandate by arranging a one-day conference in Paestum,
The event, entitled “Future Directions in Cannabinoid Therapeutics II: From
the Bench to the Clinic,” was held on June 27, the day after the International
Cannabinoid Research Society’s annual meeting. Participants included many prestigious
scientists —Raphael Mechoulam, Roger Pertwee, Raj Razdan, Alexandros Makriyannis,
Daniele Piomelli, Cecilia Hillard, Vincenzo di Marzo, Ester Fride, Natsuo Ueda,
Jun Fu, George Kunos, Geoffrey Guy, and others— who had no idea, presumably,
that the session was unauthorized by the people of California.
The CMCR was created by the Marijuana Research Act of 1999 and received a total
of $8.7 million from the California legislature between 2000 and 2002. The
CMCR staff solicited proposals and gave grants to 18 scientists to conduct
studies, some of which won’t be completed until 2006. The staff designated
funds to pay themselves and to keep the Center, which is at UC San Diego, in
operation through that year.
Additional funds have been sought from foundations, the federal government,
and private-sector drug companies —as authorized by the Marijuana Research
Act. CMCR co-director Drew Mattison says that no state funds were spent on
the “Cannabinoid Therapeutics” conference in Italy or a previous one that CMCR
arranged after the 2002 ICRS meeting.
The CMCR’s 2004 conference was funded by the U.S. National Institute on Drug
Abuse (NIDA), Health Canada, Solvay (makers of Marinol), Lilly, Merck, Esteve,
Valeant, Indevus, Kadmus, and G.W. Pharmaceuticals.
Mattison contends that the CMCR is mandated to concern itself
with synthetic drugs by a reference in the Marijuana Research Act
to “alternate means of administration.”
Mattison contends that the CMCR is mandated to concern itself with
the development of synthetic drugs —including “antagonist” drugs that
block the cannabinoid receptor system— by a line in the Marijuana Research
Act that refers to “alternate means of administration.”
Wouldn’t most Californians assume the reference was to vaporizers, tinctures,
and other alternatives to smoking —not brand-new molecules?
The CMCR conference was not publicized in advance and as of this writing is
not reported on their website. Your correspondent first heard about it as the
ICRS meeting got underway from Sumner Burstein, a Univesity of Massachusetts
medical school researcher who has developed a synthetic drug, ajulemic acid
(named after his granddaughters) that activates the cannabinoid receptors.
Burstein said that a drug company called Indevus was testing AJA as a treatment
for pain, and that promising results would be reported at “the meeting on Sunday.” (The
ICRS program ran through Saturday.) He said he hoped I would cover it.
Next evening two California doctors, Jeffrey Hergenrather of Sebastopol and
R. Stephen Ellis of San Francisco, were seated at dinner with Mattison, who
revealed that CMCR had organized a meeting on Sunday for companies developing
drugs they hoped to test and market in the U.S. Mattison said it was “by invitation
only,” and he did not extend an invite to the California docs. They, being
gentlemen, did not protest.
The following afternoon I encountered Mattison outside the lecture hall and
told him that Burstein had invited me to the CMCR session. He said that “since
there had been so many complaints,” he’d been forced to “open it up” on a first-come,
first-served basis to 20 more participants. I could get in if I showed up early
I asked Mat-tison if the CMCR might find a way to provide analytical-lab services
so that California patients, doctors and growers could identify the composition
of the plants they were using and begin to duplicate, however crudely, the
G.W. approach to research. “The hills are full of Burbanks,” said I. “If only
they had access to an analytical lab, they could begin to develop strains with
different cannabinoid ratios that patients could use to treat various conditions,
and doctors could monitor the results.”
Mattison exuded impatience and disapproval. Instead of responding, he said “Gerard
might be starting his talk” and scurried into the hall where Gerard Le Fur
of Sanofi was about to describe the effectiveness of a cannabinoid-antagonist
drug in treating obesity. [See related story on page 1.]
The CMCR Sunday conference was held at the Ariston Hotel, same as the ICRS
meeting. Some 20 distinguished scientists sat around tables with nameplates,
microphones, water, gift notepads, etc. Tables had been added for another 20
auditors. Breakfast and lunch were provided.
At least five people from UC San Diego were involved —Mattison and co-director
Igor Grant, staffer Heather Bentley, a grad student and a distraught technician
who kept scurrying along the floor trying to get the mikes to work and/or stop
The talks devoted to antagonist drugs seemed furthest afield from
what the CMCR was created to do.
The program was organized into four sections: “Cannabinoid Agonists,” “Cannabinoid
Antagonists,” “New Trends in Cannabinoid Therapeutics,” and “Cannabinoid
Drug Development.” The talks devoted to antagonist drugs —which work
by blocking the body’s cannabinoid receptors— seemed furthest afield
from what the CMCR was created to do. One paper, by Carl Lupica of
NIDA discussed antagonist drugs as “potential treatment” for food,
alcohol and nicotine cravings. “It is also clear that marijuana craving
may be successfully treated by this drug,” according to Lupica.
Our concern is not that the CMCR honchos used California taxpayers’ money to
organize and stage a “cannabinoid therapeutics” conference in Italy —they say
they didn’t and we’re not going to ask to see anyone’s time cards. Our concern
is that the program itself violated the CMCR’s reason for being, which was
and is to study “marijuana,” not ajulemic acid or any other synthetic cannabinoid,
let alone antagonist drugs.
The Marijuana Research Act of 1999 was drafted explicitly in response
to the passage of Prop 215.
The Marijuana Research Act of 1999 was introduced by State Sen. John
Vasconcellos explicitly in response to the passage of Prop 215. Enacted
as Senate Bill 847, it authorized the UC regents to create a “Marijuana
Research Program... (to) develop and conduct studies intended to ascertain
the general medical safety and efficacy of marijuana and, if found
valuable (sic), shall develop medical guidelines for the appropriate
administration and use of marijuana.”
SB-847 refers to “marijuana” as it was and is being used by Californians under
Prop 215 —in other words, the plant. “The crude plant,” that grows in the crude
soil and that we, the crude people, voted to legalize for medical use. For
example: “Proposals shall contain procedures for outreach to patients with
various medical conditions who may be suitable participants in research on
marijuana...” And “Proposals shall contain protocols suitable for research
on marijuana...” And “Studies conducted pursuant to this section shall include
the greatest amount of new scientific research possible on the medical uses
of, and medical hazards associated with, marijuana...” And “The marijuana studies
shall employ state-of-the-art research methodologies.” And so forth.
Most of the original CMCR study protocols involved smoked marijuana. How did
it come to pass that research into the safety and efficacy of smoked marijuana
got transmuted into studies involving synthetics?
A key step was the selection of UC San Diego, where the influence of the medical
marijuana movement was almost nil, to be the headquarters, and Igor Grant —a
major recipient of NIDA funding throughout his career— to be the director.
Whereas SB-847 had called for “Marijuana Research,” the UC center changed its
name to ‘Cannabis’ (Latin being so much classier than Mexican). The launch
was accompanied by a self-congratulatory mission statement that seemed more
concerned with fellow bureaucrats than the people of California:
“The Center for Medicinal Cannabis Research will conduct high quality scientific
studies intended to ascertain the general medical safety and efficacy of cannabis
and cannabis products and examine alternative forms of cannabis administration.
The center will be seen as a model resource for health policy planning by virtue
of its close collaboration with federal, state, and academic entities.”
Who is better positioned than the CMCR to collect data on the
conditions that Californians have been treating with cannabis?
Had the CMCR been based at UC San Francisco, its operation might have
been monitored by doctors and cannabis-using patients who want and
need studies relevant to their own situation. Who is better positioned
than the CMCR to collect data on the conditions that Californians have
been treating with cannabis? Who is better positioned to analyze and
provide data on the strains being used in the here and now? A director
whose ambitions were on the clinical rather than the research side
of medicine would have promoted such studies.
Instead we have Igor Grant and Drew Mattison “bringing together the major stakeholders
in the development of cannabinoid therapeutics,” as their conference abstract
book put it, “to survey the laboratory compounds that are most promising for
testing in human trials, confront potential stumbling blocks to testing and
development of these compounds, and identify opportunities for progressing
(sic) new compounds to clinical readiness.”
Another factor that might make “new compounds” seem more amenable to study
than smoked marijuana is the difficulty that CMCR researchers encountered recruiting
human subjects. In one egregious case, a study designed for 56 patients had
signed up only one after almost a year of trying. Given that high-grade cannabis
is available to patients in California under Prop 215, why would AIDS and cancer
patients volunteer for studies in which they receive low-THC cannabis from
NIDA, or —even worse— a placebo?
Although the Marijuana Research Act directs CMCR to conduct studies with federally
grown marijuana, it provides a loophole. “If federal agencies fail to provide
a supply of adequate quality and quantity... the [state] Attorney General shall
provide an adequate supply pursuant to Section 11478.”
The federal agencies have indeed failed to provide marijuana of adequate quality —which
is why CMCR studies couldn’t entice enough test subjects—but Mattison and Grant
never asked the state attorney general to supply medicine comparable to what
Californians are growing in their own gardens.
Mattison rejects the notion that the quality of NIDA’s marijuana
has dissuaded people from enrolling in CMCR’s clinical trials.
Mattison rejects the notion that the quality of NIDA’s marijuana has
dissuaded people from enrolling in CMCR’s clinical trials. “Our participants
have never held that belief,” he said in a post-conference interview. “Our
participants have not complained about potency except about it being
too potent. Some experienced psychoactive effects before they experienced
Mattison and CMCR Project Manager Heather Bentley have visited the farm in
Mississippi where NIDA-licensed marijuana is grown, and report that sticks
and seeds are now being removed on a conveyor belt. Mattison says that NIDA”can
provide marijuana blended for increased potency,” and did so for at least one
CMCR study. He adamantly defends his efforts to build alliances with federal
agencies and pharmaceutical companies.
Bentley also had an answer to our complaint about CMCR’s failure to track which
conditions Californians are actually using cannabis to treat. “We didn’t have
any applications for such a study,” she said.
But surely if they can take the initiative to arrange a “Cannabinoid Therapeutics” conference
in Italy, they could suggest that a California researcher get the basic facts
on medical marijuana use in the state. Or the CMCR staff could do it themselves,
as an-in house project, while they’re holding the fort through 2006.