The August 11, 2013 premiere of Dr. Sanjay Gupta’s documentary, “Weed,” prominently featured elderly people in Israel and a young man in Denver experiencing remarkable medical recovery thanks to medical marijuana. However, the one patient who captured nation’s imagination was little Charlotte Figi, the girl with the intractable epilepsy called Dravet Syndrome that seems to be nearly cured by the high-cannabidiol (CBD) extract from the Charlotte’s Web variety of cannabis.
While nobody with a heart and brain would deny Charlotte her medicine, or deny that CBD is profoundly medical, what has happened since the public has grown aware of this treatment is a bifurcation of medical marijuana as an issue. We now have “Alepsia,” the name lawmakers in Utah have coined for the high-CBD extract Charlotte uses, versus “medical marijuana,” that sticky crude raw plant that still contains the nasty delta-9 tetrahydrocannabinol (THC) that gets you high.
You can hear it in the defense of providing this Alepsia in states where medical marijuana is forbidden. “It has less THC in it than hemp milk in a grocery store,” goes the common refrain, “so it can’t possibly get the patient high.” While this is something parents of epileptic kids are happy to hear, the AIDS, cancer, Crohn’s, cachexia, PTSD, and other patients who require the medicinal value of THC are probably cringing at the re-demonization of the other half of medical marijuana.
When medical marijuana began, proponents of legalization accepted it as a “baby step” necessary to open the public’s mind to acceptance of marijuana. Once folks saw it help patients with little impact to society, the strategy went, they’d open up to legalizing recreational use. That seems to have been the case, as the first states to legalize and the next ones expected to legalize all have medical marijuana laws.
But as time marches on, medical marijuana’s baby steps keep getting smaller. California’s wide open “any condition” medical marijuana became “qualifying condition lists” and “patient registries” in the next ten medical marijuana states through 2010, and then became “strict condition lists” and “no home grow” in the nine medical marijuana states since 2010. Baby steps are supposed to eventually evolve to walking and running; they’re not supposed to devolve back to crawling.
Now medical marijuana is threatening to become “CBD-only.” Lawmakers in Florida, Pennsylvania, Alabama, and Kentucky who had introduced medical marijuana bills in the past are now abandoning those plans and introducing bills that only legalize “Alepsia”-style medical marijuana. Oddly, medical marijuana advocates who are quick to accuse legalizers of “throwing patients under the bus” with legalization bills are silent on the THC-needing patients thrown under the bus in these four states. Apparently, a legalization bill has to be perfect to get some medical marijuana advocates’ support, but there’s no limit to how compromised a medical marijuana bill can be and earn their support.
In a sense, the strategy of leveraging compassion for the sick is backfiring against us. In the beginning, we would put the cancer patient front and center and ask, “How could you not support medical marijuana to alleviate this person’s suffering?” People who might have hated pot were forced to hate cancer more and support medical marijuana. Now the epileptic child is front and center and medical marijuana supporters are asked, “How could you not support a CBD-only medical marijuana law to alleviate this child’s suffering?” We’re forced to support medical marijuana that won’t benefit most of the patients that need it and support for THC is now being equated with support for getting high.
Meanwhile, GW Pharmaceuticals, the drug maker behind the whole-plant extract Sativex spray intended to be a replacement for medical marijuana, is busy preparing to introduce Epidiolex, a CBD-extract to mimic Alepsia, for testing and trials. Sativex is in its Phase III clinical trials and may be ready for US distribution before the 2016 election. Epidiolex is sure to be fast-tracked for approval by the FDA in response to the overwhelming reaction to Charlotte Figi and migration of hundreds of sick kids’ families to Colorado. How will the dispensary-only medical marijuana systems defend stocking cannabis plant products when there are legit pharmaceuticals of reliable dose and equal or better efficacy, approved by the federal government, prescribed by physicians, and paid for by insurance? How will home grow states defend allowing patients to harvest a plant that can get non-patients high and is a black-market commodity, especially in Washington where that would be competition for the legal market?
In the next ten years, the path of medical marijuana leads to pharmaceuticals. Those who wish to defend medical use of the whole plant, THC and all, need to recognize that legalization is now the only path that gets you there. Without legalization, medical marijuana must become more restrictive and eventually pharmaceuticalized to filter out the “stoners” looking to get high. If you want your THC for medicine, you’re going to have to join those of us fighting for THC to get high.