Experts delved into the current state of policy, research and health issues regarding recreational and medical marijuana. Offering key insights and solutions, panelists made their case for this rapidly emerging industry.
“Recreational Marijuana and CBD: Public Attitudes, Science, and the Law” was moderated by Paul Demko, Cannabis Editor, POLITICO. He was joined by panelists Bob Blendon, Professor of Health Policy and Political Analysis, Harvard T.H. Chan School of Public Health and Harvard Kennedy School; Andrew Freedman, Co-Founder and Partner, Freedman & Koski; former Director of Marijuana Coordination for the State of Colorado; Staci Gruber Director, Cognitive and Clinical Neuroimaging Core, Director, Marijuana Investigations for Neuroscientific Discovery (MIND) Program at McLean Hospital; Associate Professor of Psychiatry, Harvard Medical School; and David Grelotti, Medical Director, Center for Medicinal Cannabis Research at University of California San Diego School of Medicine, and Associate Clinical Professor of Psychiatry.
With so many applications, formats, legalities, opinions and unknowns -- there wasn’t a shortage of material to comb over during the live webcast. The experts discussed everything from regulations, to studies, to vaping to misinformation.
“We’re living in some very interesting times. We now have 33 states that have either legal recreational or medicinal markets, and it’s literally changing everyday,” said Demko. “On Sunday, we saw the first recreational or adult-use sales in Michigan begin.”
Indeed, dozens of states have legalized marijuana for medical or recreational use and American farmers can grow hemp on an industrial scale. Cannabidiol (CBD) is derived from cannabis but does not produce a “high” like marijuana.
“In 2018, congress passed the Farm Bill that legalized hemp,” said Demko. “What we’ve seen in the last year is this massive growth of hemp-derived CBD products in lotions, tinctures, foods and beverages that is just exploding in popularity and people are taking for everything from insomnia to cancer.” Indeed, consumers say CBD has helped with insomnia, pain, anxiety, libido and so more. But the evidence and attitudes toward CBD are still evolving.
Attitudes reach new highs
The panel examined a newly-released poll that looked at public attitudes toward CBD and recreational marijuana.
“There’s been very broad changes in the beliefs and values from the average general public around marijuana and the legalization for recreational purposes and how CBD is seen,” said Blendon, referencing the recent poll commissioned by Politico and Harvard.
The poll found that slightly more than half of American adults (54%) are familiar with CBD products, and one in seven adults (15%) say they personally use CBD products. Few US adults who are familiar with CBD products believe they are very harmful to the people who use them (5%), and those familiar with CBD generally think such products should be available widely.
The poll asked what future role the FDA should play in regulating the safety and effectiveness of CBD products. When it comes to safety, just over half (51%) of those familiar with such products believe that CBD products should be allowed to be sold to the public only if they have been shown to be safe by the FDA, like prescription drugs are; 45% believe consumers should be able to buy CBD products in the same way they can buy vitamins and dietary supplements – without being shown by the FDA to be safe.
When asked about the FDA’s role in monitoring effectiveness, a majority (55%) of those familiar with CBD products say consumers should be able to buy such products in the same way they can buy vitamins and dietary supplements – if they think they are effective for them, without first being shown to be effective by the FDA. In contrast, 43% think CBD products should be allowed to be sold to the public only if they have been shown to be effective by the FDA, like prescription drugs are.
Walking in dietary supplements’ footsteps
On CBD, Blendon asked, “Should it be available if it’s shown not to be effective? The bottom line is yes. Yes by the general public and yes overwhelmingly by the people who use it. This is exactly the same finding we reported 15 years ago on dietary supplements.”
The poll also asked US adults their views about regulation of marijuana for recreational use. A majority (62%) favors legalizing marijuana for recreational use by adults nationally. However, they also favor a number of regulations on the sale and use of recreational marijuana. In contrast to CBD products, where most adults familiar with such products favor their sale widely, about two-thirds (69%) favor limiting sales of marijuana for recreational use only to licensed stores in their state. Only 32% favor allowing use in public spaces in their neighborhood.
It’s worth noting that CBD products and marijuana for recreational use are seen as less harmful to the people who use them than tobacco cigarettes, e-cigarettes, and alcohol. About half (53%) favor allowing licensed stores selling marijuana for recreational use to open in their neighborhood.
“Would you think since we filled jails for years with people for selling marijuana for recreational purposes, that it’s seen as less harmful than alcohol?” asked Blendon, who helped commission the poll along with POLITICO.
“Public sentiment has been shifting for a long time on cannabis, and the federal government has not. There was a buildup of political support that essentially just bubbled into state referendums, which asked us to defy federal government,” said Freedman.
“I think it’s one of the most extraordinary political phenomenons of this generation. It’s certainly the most striking form of direct democracy and political populism that we’ve seen in American democracy in the modern age.”
Whatever one might call it, the CBD and cannabis world has become the wild wild west. And industry experts are urging the FDA to take swift action.
“Heightened consumer confusion”
According to a separate survey published by the Grocery Manufacturers Association, over 75% of Americans assume that commercial CBD products are regulated by the FDA. The FDA has approved only one CBD product, a prescription drug product to treat two rare, severe forms of epilepsy.
Freedman said there needs to be a way of educating consumers as well as “enforcing a regulatory system that ensures not just efficacy, but safety of the products. It is going to be an extremely difficult challenge in this policy space, but one that will probably ultimately fall on public health specialists.”
Grelotti agrees that more education and tools are needed. “People are going into the dispensary and they’re getting information on treating conditions from what are called ‘budtenders.’”
“There’s a paralysis with marijuana, that until we know everything we should govern nothing. I hope that public health specialists start to come through with framework both for recreational and medicinal that we can use in the interim between when the science actually does catch up,” said Freedman.
If you lead, they will follow
Freedman compelled the FDA step up and set guidelines for cannabinoids as as soon as possible. He said that once they do, the industry will follow.
In addition to more oversight, Gruber said research is lacking. “Nearly all of what we know about the impact of marijuana comes from studies of recreational consumers. Despite the fact that legalized medical cannabis has been around since 1996 in this country.”
“It’s important to remember that ‘one size does not always fit all’ when it comes to marijuana. And we need continued research on medical and recreational cannabis use in order to maximize therapeutic potential and mitigate risk and harm.”
Gruber highlighted pronounced alterations in adolescents as well as older populations, as well as rising potency over the last two decades as major concerns. She also cautioned that we have to be mindful of the fastest growing group of cannabis and cannabinoids based products: consumers 50 and up.
Echoing the need for more research, Grelotti said, “We need the controlled studies for CBD, we need to try CBD with other derivatives of cannabis to see if there’s combinations that work best. We also want to look at the different ways of administering it. Is inhalation better than taking it orally? I mean heck, there are even people trying suppositories out there.”
Grelotti and his team have several CBD trials underway that will study how CBD impacts things like lower back pain, tremors, and neuropathic pain. He said science is the key.
“For three thousand years cannabis was a medicine. It was really like a 100 years ago that it was taken off largely for political reasons. We’re now putting it back in, those were the dark ages and we’re merging into this renaissance. For all the questions that we’ve pondered today, science is the candle in the dark.”
Gruber, added, “It’s like rock n roll in the old days, it’s not going anywhere, it’s here to stay.”