The Energy and Commerce Subcommittee on Health today held the first legislative hearing on cannabis in 2020, and it’s clear that lawmakers are particularly frustrated by the state of cannabis research.
While dozens of states have legalized cannabis for medical or adult use, federal prohibition poses a number of hurdles for researchers hoping to understand the implications of cannabis use on individuals, and of legalization on Americans, as well as the therapeutic potential of the plant’s compounds, called cannabinoids.
The hearing, entitled “Cannabis Policies for the New Decade,” called on the following people to answer questions and provide testimonies: Nora Volkow, director of the National Institute on Drug Abuse; Matthew Strait, a senior policy advisor with the Drug Enforcement Administration; and Douglas Throckmorton, deputy director for regulatory programs at the Food and Drug Administration’s Center for Drug Evaluation and Research.
A total of six bills were under consideration, including two that would federally legalize cannabis, but much of the nearly three and a half hours was spent specifically discussing research, including existing literature, the need for more, and the barriers that investigators face.
While it’s unlikely that many of the cannabis bills discussed will see traction in Congress this year, these hearings provide an opportunity for discussion about existing evidence on cannabis, and policy gaps.
Strait, from the DEA, said that the agency is actively working on legislation that would pave the way for additional federally-approved suppliers of cannabis for research. This could solve one major issue facing researchers: the cannabis they use to conduct studies comes from one federally-approved cannabis farm, at the University of Mississippi.
“This poses a legitimate public health challenge as it impedes the ability for researchers to truly understand the impact of products regularly used by consumers and prevents us from advancing sound science,” New Jersey Rep. Frank Pallone said during the hearing.
While the DEA increased the aggregate production quota for cannabis by 575% between 2017 and 2020, the cannabis from the federal farm is indeed a far cry from the flower, edibles, and vapes currently available through licensed, state-legal shops. (When this reporter visited the federal cultivation center at Ole Miss, the cannabis looked like dry shake, filled with seeds and stems.)
The DEA already put out a call for applications in 2016, but they have been in limbo. That might be changing, according to Strait.
“We actually have a draft regulation in place,” Strait said, adding that it has been submitted for review by the White House Office of Management and Budget, and that on Thursday, “many of us will be getting on a call to talk through it.”
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Massachusetts Rep. Joe Kennedy, who said at Wednesday’s hearing that he was “initially hesitant to support legalization,” alluded to another upcoming hearing on cannabis that he pushed for because Wednesday’s hearing didn’t include important stakeholders, like “those whose lives have been directly touched by our broken marijuana policies, people unjustly incarcerated, patients who rely on medical cannabis, researchers with expertise who are yearning to learn more, small business owners trying to find fair footing in a new industry.”
As states started to legalize, including the state that Kennedy represents, he sought answers from doctors, families, experts, advocates, and regulators, he said.
“That’s where you start to get frustrated, that as a federal legislator, my hands are tied because our federal policy still rested on Richard Nixon’s decision to put marijuana in the same category as heroin,” Kennedy said.
“Meanwhile, millions of Americans, mostly black and brown, have been locked up for nonviolent drug offenses. Meanwhile, desperate parents are forced to turn to a black market with no concern for patient safety to get their children the relief they need. Meanwhile, our cities and states are trying, at times stumbling, to put in place thoughtful and thorough regulatory frameworks with zero support from federal partners,” Kennedy said. “And meanwhile, a brand new corporate industry is rising up, rife with predictable economic injustices that spring up whenever government fails to regulate.”
Virginia Rep. Morgan Griffith told a personal story that heavily influenced his decision, even as a self-described Conservative Republican, to “champion” cannabis law reform.
“When I was a young man in the 1980s, some of my friends were smuggling marijuana into the hospital in our community,” Griffith said, “because there was an individual whom I did not know who was dying of cancer. But he wanted to spend every day he could with his son, who was about 2 at the time.”
Chairwoman Rep. Anna Eshoo, of California, responded, “There’s nothing like a real life story.”
Another concern that came up several times is that the FDA expects it will take three to five years to finalize CBD regulations. And until then, the sprawling CBD industry, which now includes everything from CBD-infused pillows to CBD treatments for pets, will grow in a gray area.
Florida Rep. Kathy Castor said that “when it comes to CBD, it’s like the cat is already out of the bag. It is amazing the marketing for CBD. What would you advise the public about the efficacy of the products on the market today?”
Throckmorton, of the FDA, said, “We do not know. We don’t know whether the various claims being made are accurate to the standard that I would expect for a drug product being developed. And we don’t know well enough what’s found in those products that are being sold under a variety of state initiatives.”
Throckmorton highlighted that the FDA continues to believe that the best path forward for new medicines, including those derived from cannabis, is the drug approval process.
The Farm Bill “explicitly” gives the FDA authority over any products that come from hemp, like CBD. “These products must still meet any applicable FDA requirements and standards just like any other FDA regulated product,” Throckmorton said. “FDA understands the broad interest in making these compounds more available to the public and is considering the possibilities of new legal pathways for CBD products. However, it is important to maintain adequate incentives for drug development as we do so.”
Throckmorton pointed out previous FDA concerns, including the risks associated with CBD use in animals that are used as food for humans. (Cannabis Wire covered that topic here.)
“FDA’s biggest concern is the marketing of CBD products that put consumers at risk, such as by making unsubstantiated therapeutic claims to prevent, diagnose, mitigate, treat, or cure serious diseases, but that have not obtained new drug approvals,” Throckmorton said. The FDA issued 15 warning letters to CBD companies in November, which Cannabis Wire covered here. Specifically, Throckmorton noted, the FDA is aware of CBD products claiming to cure cancer or Alzheimer’s disease, and the concern is that people will turn to CBD instead of other safer treatments for serious illnesses.
Nora Volkow used her testimony to explain how cannabis works in the body, and to highlight two main concerns: cannabis use by pregnant people, and youth use. These topics have also been covered by the U.S. Surgeon General Jerome Adams, who issued an advisory last year.
Cannabis use during pregnancy is linked to lower birth weight and preterm deliveries, Volkow said.
“In adolescence, cannabis use has been consistently associated with lower academic achievement, higher risk of dropping out of school, lower IQ, disruptions in brain connectivity and structure as the brain transitions into adulthood,” Volkow said. Other areas of concern are cannabis use and the risk of psychosis, driving while ability impaired by cannabis, increased emergency room admissions after legalization, and hyperemesis, or cyclical vomiting caused by heavy cannabis use, she said.
“However, our understanding of the adverse effects of cannabis is incomplete. This was made clearly evident by the outbreak” of vaping-related lung injuries, Volkow said.
Volkow was asked several times about whether cannabis was a gateway drug, to which Volkow responded, “It increases the likelihood that you are sensitive to the addictive effects of other drugs.”
Volkow also highlighted that NIDA is creating a “unit” of cannabis that can be used for consistency across research, and expects that standard dose to be available within a year.
