Orrin Hatch supports medical marijuana research

Conceptually I don’t see much difference between medical marijuana and some other prescribed medications. I’ve also never totally understand why Joseph Smith couldn’t drink alcohol as a pain killer (or calming agent) before his bone surgery, but that’s another topic.

However, I’ve asked three different LDS pharmacists what they think of medical marijuana (and not one of them is TBM) and they all think it’s a terrible idea. I don’t know enough to have my own opinion but their opinion leads me to believe that at a minimum more research is necessary and at worst it’s a terrible idea.

I think the debate is healthy. Personally it seems to me a bigger problem in Utah right now is the opioid epidemic. But what I can’t square up is that the church stays silent on that, but issues a press release against MEDICAL marijuana. Heck – we think that Elder James E. Talmage did some of what we today would call “recreational” (or at least “experimentation”) with marijuana. It just doesn’t make sense where the church pokes it’s nose and where it turns a blind eye.

I don’t know enough to have my own opinion but their opinion leads me to believe that at a minimum more research is necessary and at worst it’s a terrible idea.

More research! This is the best thing about the bill.

For most medications, a doctor can determine an initial dose by looking it up in a chart, and (depending on the medication) slowly work up to a dose with the desired therapeutic effect. Everything is standardized and undergoes strict quality control, so it doesn’t matter who the supplier is, where or when it was made, or any of the circumstances surrounding its manufacture.

If I understand correctly, none of those things is true of marijuana. This bill would help us eventually fix that.

Another thing we don’t have much information on because of lack of research is marijuana’s interactions with other medications. For example, how much is safe to take along with a mood stabilizer or a blood thinner? Plenty of people have done this illicitly, but there’s a distinct lack of reliable, publicly available data and analysis.

The issues I mentioned above only scratch the surface. For the curious, here’s a fairly readable, peer-reviewed journal article on the state of things and what it would take to medicalize cannabis:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022003/

I think the debate is healthy. Personally it seems to me a bigger problem in Utah right now is the opioid epidemic. But what I can’t square up is that the church stays silent on that, but issues a press release against MEDICAL marijuana. Heck – we think that Elder James E. Talmage did some of what we today would call “recreational” (or at least “experimentation”) with marijuana. It just doesn’t make sense where the church pokes it’s nose and where it turns a blind eye.

I think they feel a need to tell members what to think in debates that are adjacent to things the Church sees as moral issues. I think most members want that direction, too. Their #1 concern about medical marijuana is probably whether it’s against the Word of Wisdom.

I don’t understand the Church’s statements as being against medical marijuana, just as urging caution.

From Feb. 2016:

We continue to urge legislators to take into account the acknowledged need for scientific research in this matter and to fully address regulatory controls on manufacture and distribution for the health and safety of all Utahns.

From June 2017:

Accordingly, we believe that society is best served by requiring marijuana to go through further research and the FDA approval process that all other drugs must go through before they are prescribed to patients.

This matches what most drug researchers seem to be saying. For example, the article I linked to starts this way:

Is there a pathway that will lead to the return of cannabis to mainstream medicine? The answer is clear, inasmuch as it has already commenced. It follows the same time-honored process that any pharmaceutical must attain to receive regulatory approval: proof of biochemical uniformity and stability along with safety and efficacy as proven by randomized clinical trials (RCT).

What the Church isn’t saying, which makes it possible to understand the statements as being implicitly against, is whether marijuana’s current classification as a schedule I substance, and therefore all of its controls and regulatory red tape, is something that best serves society. If the Church’s position is that this classification is good, it’s basically against medical marijuana, because further research is so difficult to get approved and carry out.

(FWIW, based only on its call for more research, I infer the Church’s position to be against marijuana’s schedule I classification, or at least against the status quo. Hatch’s bill is in line with this; see below.)

It takes at least a year for an institution to get a license from the DEA to study schedule I substances, and the security and handling requirements are so onerous that they can only be met by large, wealthy institutions like Johns Hopkins. Add to that that the DEA is reluctant to give licenses because the licenses enable an institution to keep and handle flippin’ heroin.

After getting a license, every individual study involving a schedule I substance requires DEA approval, which, according to a totally nonrandom and biased Internet sample I just took, seems to take over a year and a half of daily pestering. If you want to run a really good study that involves hospital patients under a doctor’s observation, you’re out of luck. Almost all hospitals can’t meet the requirements. (They don’t have to because they don’t stock schedule I substances, because those substances are defined as having “no currently accepted medical use.”) If you want to do something as simple as observe your study participants as they take the marijuana-derived medicine you give them, you can’t. Apparently, that’s against regulations.

The biggest question is whether marijuana is safe enough and effective enough (often enough) to be used as medicine. The DEA is right about one thing: nobody actually knows. We don’t have enough information. But the DEA’s own rules make it basically impossible to find out! How’s that for a catch-22?

The best way to streamline research is to move marijuana down to schedule II where we find things like Adderall, or to schedule III, where it probably belongs. This has been attempted since 1972 without success. Hatch’s bill doesn’t do that, but streamlines research in a different and hopefully more acceptable way. I don’t know how because I haven’t read the bill. Hopefully it breaks the stalemate researchers and the DEA have been in for almost 50 years.

From my observation, and it is just my biased point of view, much of the medical marijuana push is actually driven not by those who have medical need (although they do join in) but rather by those who want general marijuana use legalized.

As a gateway to legalizing recreational use? That might be right. What’s interesting is that state legalization of recreational use came first, and is starting to drive deregulation. I can think of a few ways: