Pot Kids
February 17, 2015 5:09 AM   Subscribe

 
Ok, why don't they study it then?
posted by oceanjesse at 5:31 AM on February 17, 2015 [4 favorites]


It's a bit weird for the article's subtitle to include the term "science-free" when the article itself refers to two promising studies:
In a small study of 75 children receiving [cannabidiol]-rich oil and being cared for at [Children’s Hospital Colorado in Denver], researchers report in the study summary that about one-third had a reduction in seizures exceeding 50 percent, the standard threshold for treatment efficacy in epilepsy.
...
British company GW Pharmaceutical launched an FDA-approved a trial of a marijuana-derived CBD drug called Epidiolex. The trial is being conducted at NYU, Massachusetts General Hospital, the University of California, San Francisco (UCSF), and soon, UCLA.

Researchers at NYU, led by Devinksy, and UCSF reported in June that of 27 patients treated with Epidiolex for three months, 13 experienced at least a 50 percent reduction in seizures. Four were seizure-free after 12 weeks.
That, combined with anecdotal reports of specific low-THC strains of CBD oil reducing seizures without the side effects of other anti-seizure drugs, suggests more research, not calling the existing (and nascent) research "science-free".
posted by daveliepmann at 5:37 AM on February 17, 2015 [19 favorites]


There's also a short Vice documentary about this, which is worth watching.
posted by escape from the potato planet at 5:51 AM on February 17, 2015 [1 favorite]


(news report, documentary, whatever)
posted by escape from the potato planet at 5:52 AM on February 17, 2015


Ok, why don't they study it then?

Good luck getting NIH to fund that landmine; can you imagine the congressional hearings?

Rep. Stu, R-Pid: Why does the NIH support providing to children the chemically active component of cannabis, a Schedule 1 drug that has, and I'm quoting the DEA here, "no currently accepted medical use and a high potential for abuse"?
posted by leotrotsky at 5:56 AM on February 17, 2015 [8 favorites]


Significant reduction of seizures in a third of patients is a great outcome, not a "meh". I don't get it.
posted by internet fraud detective squad, station number 9 at 5:57 AM on February 17, 2015 [11 favorites]


I think that the congresscritters might get pulled along by the tide of public opinion, though, leotrotsky. I heard a local NPR show do a segment on this a while back, and the law-and-order local police dude sounded like a big, unconvincing jerk when he tried to debate the parents of desperately sick children who were begging for medical research into what they saw as a promising therapy. And I mean, it's sort of hard to justify the fact that real drugs of abuse like Oxycontin are legal but we can't test marijuana-based treatments that aren't even capable of making anyone high.

I'm far from a pot-head, but part of the reason that you do medical testing is so that you know when things don't work. If this does work, that's fantastic, and if it doesn't work, then parents deserve to know that, too.
posted by ArbitraryAndCapricious at 6:05 AM on February 17, 2015 [8 favorites]


Yeah, article does not match title.

I had to skim because I'm late to work, but it's worth noting that the in-demand marijuana treatment for epilepsy does NOT get children high. It has basically no side-effects, especially when compared to other epilepsy treatments which have heinous side-effects. That combined with the sheer desperation felt by parents of children with refractory epilepsy means that demand will be huge. It forces people with very compelling stories to become political activists, and there's really no good reason to oppose them.
posted by Humanzee at 6:07 AM on February 17, 2015 [4 favorites]


This has been big news here in Georgia, where the conservative Republican legislature and governor have passed a law allowing for more research on cannabis oil. It seems to have been driven mainly by parents and based on anecdotal evidence. A real problem with this kind of policy that arises out of frustration with failures of current medical therapy is that it can be very difficult to do double blinded studies to find out if the treatment works; no one wants to risk getting put in the placebo/standard treatment arm of the study (see also experimental cancer drugs). The fact that the drug in this case is an herbal preparation that is poorly standardized and of uncertain purity further complicates things. The availability of Epidiolex is a huge step in the right direction, but there is still a lot to be done before there is convincing evidence that cannabis derivatives are effective in treating epilepsy.

I'm all for legalization of recreational pot, and think the federal government really needs to back down on its anti-marijuana stance for both casual use and research; this sort of thing should help on both counts. Later today I will be working with a pediatric neurologist; I'll see what her take is on this.
posted by TedW at 6:10 AM on February 17, 2015 [2 favorites]


Good luck getting NIH to fund that landmine; can you imagine the congressional hearings?

That would be stupid, but you can blame sensationalized reporting like this Time article ("let's use a green-lit family photo hurf durf" and talk about "kids on pot"--wtf). We're talking about the extraction and use of a single simple oil from a plant with other, more famous, uses, and has only the "good" effects without the "bad." It's like everyone wants this to become politicized.

tl;dr won't someone think of the children?
posted by resurrexit at 6:44 AM on February 17, 2015 [4 favorites]


We have a weird situation in Louisiana. We have legal medical marijuana, but no legal framework to sell or distribute it. Last year the legislature tried to fix that and the LEO lobby went apeshit and shouted it down with threats of BOOGA BOOGA LAW ENFORCEMENT NIGHTMARE. They got their way and it was dumped, but it's coming up again and I sense a growing perception even in this very conservative state that stomping on sick people by comparing them to drug kingpins is kind of stupid and tacky, and nobody's really buying it.
posted by localroger at 6:44 AM on February 17, 2015 [3 favorites]


I'm all for legalization of recreational pot, and think the federal government really needs to back down on its anti-marijuana stance for both casual use and research; this sort of thing should help on both counts.

I don't disagree, but I think this is part of the problem for the medicinal people: they get lumped in and used as a benefit of "legalization for recreational and medicinal purposes," when there really isn't necessarily a lot of overlap between those groups. As this very dumb article shows, it tarnishes legitimate research aims because, hippies.
posted by resurrexit at 6:45 AM on February 17, 2015 [1 favorite]


I guess the article doesn't mention that a UK company has patented nabiximols which is essentially a tincture with equal parts THC and CBD, and is available in several European countries to treat MS symptoms.

But there's no science! Nope! Not until it's in pill form and available in the US!
posted by RobotVoodooPower at 6:56 AM on February 17, 2015 [4 favorites]


I don't disagree, but I think this is part of the problem for the medicinal people: they get lumped in and used as a benefit of "legalization for recreational and medicinal purposes," when there really isn't necessarily a lot of overlap between those groups. As this very dumb article shows, it tarnishes legitimate research aims because, hippies.

I concur that blurring of the lines between medical and recreational use harms the case of people who want medical marijuana, but disagree that there is not a lot of overlap between the two groups. The conditions for which it is prescribed are pretty inclusive and it seems that in many places anyone who wants it can get a medical marijuana prescription. If marijuana is to become truly accepted as a medical treatment, the appropriate bioactive compounds will need to be isolated, charaterized in terms of effects and side effects, and purified or synthesized as has been done with opium. It is hard to find many who will admit it, but it seems to me that medical marijuana is in many instances a way to get a foot in the door for more general legalization. As far as pot being a drug for hippies, that perception is definitely there for some people, but I know far too many upper class white folks who smoke/have smoked pot over the years for that characterization to be anything like unanimous. I think that as long as poor black kids bear the brunt of pot being illegal there are a lot of pot smokers who aren't highly motivated to support legalization for recreational use. These are the same folks who would have no problem getting a prescription for medical use, just as they can get Adderall, or Oxycontin, or whatever else they want prescribed.
posted by TedW at 7:05 AM on February 17, 2015 [1 favorite]


Related observation, hopefully not too much of a derail: early in the documentary Super High Me, and there is an interesting remark from a doctor who is giving advice to the comedian who will spend an entire month high. The doctor says something like, "look, pot should be utterly legal, it's pretty safe as far as these things go, I've enjoyed it myself, blah blah blah. But, I don't believe in medical marijuana per se. I would never prescribe marijuana, at least not in its natural state. I'm not going to prescribe somebody to take hits off of a plant, when marijuana plants themselves can vary wildly, when marijuana can have very different effects on people, when different methods of intake can produce such different results, and so on. I think 'medical marijuana' as a concept basically exists only as a back door to proper legalization, which is why I would rather just have it be legalized properly and have that be that."

I'm not saying I agree with the doctor about medical marijuana as a category, but I thought it was an interesting perspective nonetheless.
posted by Sticherbeast at 7:14 AM on February 17, 2015 [6 favorites]


in many places anyone who wants it can get a medical marijuana prescription.

While the first part is true in many places, the second is not, and is a common misconception. No one receives a prescription for medical marijuana; patients receive a physician's recommendation to be able to legally grow or acquire marijuana. "Prescription" implies a level of specificity regarding exact chemical components, dosage, etc., that is not part of that process.

Of course, the roadblock to converting the cannabis plant to actual, prescribe-able medicines is government in its various facets, so the irony of medical-marijuana-as-backdoor-legalization (ironic because, as a medicine, it can be tremendously efficacious, as TFA points out) is entirely self-created by the entities who continue to pretend that society will collapse if a relatively benign soft intoxicant with shockingly promising medical applications is ever simply made legal.

Marijuana prohibition is beyond stupid at this point, especially prohibitions on medical research, so I just don't care if various medical marijuana laws are routes to backdoor legalization or not (they are, but they also are making helpful treatments for illness available--it's a con and the truth!) because the madness of prohibition just needs to stop.
posted by LooseFilter at 7:31 AM on February 17, 2015 [2 favorites]


I'm not going to prescribe somebody to take hits off of a plant, when marijuana plants themselves can vary wildly, when marijuana can have very different effects on people, when different methods of intake can produce such different results, and so on.

Yet all these things can be controlled by agricultural means, especially when those means are legal. Nobody worries that most caffeine users get their fix from a natural product that isn't purified in a pill factory, and most people figure out what they can handle and how the different delivery methods such natural coffee vs energy drinks or pills work for them.
posted by localroger at 7:34 AM on February 17, 2015 [4 favorites]


CANNABIS BAD

OPIUM GOOD
posted by Sys Rq at 7:51 AM on February 17, 2015 [1 favorite]


Yet all these things can be controlled by agricultural means, especially when those means are legal. Nobody worries that most caffeine users get their fix from a natural product that isn't purified in a pill factory, and most people figure out what they can handle and how the different delivery methods such natural coffee vs energy drinks or pills work for them.

The doctor was specifically talking about prescribing marijuana as medicine. He said that pot should be legal - just as coffee, energy drinks, etc. are all perfectly legal. However, I have never been prescribed coffee, energy drinks, etc. as medicine. To the extent that doctors prescribe pep pills for medical purposes, they prescribe rigidly controlled, synthesized formulations.

I agree that one could control marijuana through agriculture, but I don't know enough on the topic to say whether you could control it enough to allay that particular doctor's concerns. He wasn't just concerned about the nature of each individual plant.

Either way, I don't know enough to share that doctor's beliefs.
posted by Sticherbeast at 8:03 AM on February 17, 2015


I think, though, that what's being asked for here is rigidly-controlled medication. The parents here will resort to less-regulated versions if that's all they have access to, but they would rather have real, regulated drugs. It's clearly true that a lot of people want to use medical marijuana as a wedge to legalize all pot, but I don't think that these folks are in that camp.
posted by ArbitraryAndCapricious at 8:07 AM on February 17, 2015


A big strike against the agrucultrization of recreation pot (to me) is how much it then opens the door to having all manner of stuff being added to it. We think of cigarets as being tobacco, but really as everyone actual knows there's a lot more in a cig then just tobacco, by no mean is tobacco good for you, but with all the added stuff it seems like they made a kinda bad thing into a god-awful-fuck-that thing. I worry just a bit about what will eventually end up in commercial marijuana.

Medical marijuana? Can't happen soon enough and regardless of my feelings on recreation pot, frankly I've been more than a little peeved at the subset of folks who are trying to get there by pushing medical marijuana as a wedge.
posted by edgeways at 8:27 AM on February 17, 2015


Sys Rq: CANNABIS BAD

OPIUM GOOD
I agree, but that's because THC aggravates my anxiety issues. YMMV; enjoy as you see fit.

Or were you being sarcastic? ;)
posted by IAmBroom at 8:33 AM on February 17, 2015 [1 favorite]


Here's a good article on the quest to get Sativex (the brand name of the cannabis-derived mouth spray) approved in the U.S.
posted by RobotVoodooPower at 8:36 AM on February 17, 2015


I don't suppose this is part of an attempt to re-demonize pot by tying it to children?

Or do I?
posted by Twang at 9:02 AM on February 17, 2015 [1 favorite]


Sorry, allow me to rephrase:

CANNABIS BAD

OPIUM GOOD

HAMBURGER
posted by Sys Rq at 9:02 AM on February 17, 2015 [1 favorite]


I don't suppose this is part of an attempt to re-demonize pot by tying it to children?

"Won't someone think of the children!?"

"We are. This helps them to not suffer."

"Won't someone think of the children!?"

*facepalm*
posted by Sys Rq at 9:12 AM on February 17, 2015 [1 favorite]


A big strike against the agrucultrization of recreation pot (to me) is how much it then opens the door to having all manner of stuff being added to it.

Ironically, this is due to the industrialization of agriculture. Cigarettes are the horror that they are precisely because tobacco companies regard them clinically as "nicotine delivery systems." While it is possible to pick coffee beans, roast them in your oven, and grind them to make your own coffee, most of our coffee goes through a very scientific grading process to ensure its consistency (although mostly without the kind of tampering tobacco gets).

While purity and standardization are good for some purposes, they are demonstrably bad for others; refined sugar is a horror compared to any of the foods we extract it from, for example. People who have tried both consistently report that pure THC is markedly different from MJ and there may be cofactors in there whose activity we don't understand.

It wasn't all that long ago that tinctures and essential oils were a regular staple of the pharmacist. Insisting on molecular purity seems to be to be more about control than any sort of medical necessity. If a plant makes us demonstrably more well, why shouldn't we use it even if we can't explain exactly why by the action of specific molecules?
posted by localroger at 9:18 AM on February 17, 2015 [3 favorites]


tl;dr won't someone think of the children?

Haha. That only works if 'thinking of the children' means you get to bust skulls, shame sluts, or take money from someone indiscriminately. If actual 'thinking of the children' were happening, schools, orphanages, and child-protective services would be adequately funded.
posted by eclectist at 9:30 AM on February 17, 2015 [3 favorites]


localroger: People who have tried both consistently report that pure THC is markedly different from MJ and there may be cofactors in there whose activity we don't understand.
"People who have tried both consistently report" that Nessie exists; anecdotes are not medical data. I can tell you caffeine pills are different from coffee, but that doesn't mean diddly about whether or not they affect my insulin receptors and GABA levels differently.

From a medical POV, handwaving "cofactors" are just maddening increases in uncertainty about side effects, efficacy, and so on. That's what scientific tests do: they attempt to isolate cause and effect.
posted by IAmBroom at 10:51 AM on February 17, 2015


"Ok, why don't they study it then?"

They are.

Take a look at Epidiolex, for example. All this is being done by a publicly-traded British company to create a pure, standard-dosage form of CBD, and the FDA is apparently helping them to find uses for it. There is serious research going on, and its in phase 3 trials.

It's actually a *very* promising company, with a lot of potential for treating *many* illnesses, but some of the testing done so far isn't as promising as one would hope. Obviously, though, their results will vary by which problem they are treating.

Some of the critics of Epidiolex are actually within the pro-marijuana community, which view prescription CBD as a threat to medical marijuana, and to those who enjoy the high of THC. They counter that marijuana oil and Epidiolex are not the same thing, as a lot of the compounds in marijuana oil that are working for patients aren't present in more refined forms of CBD oil.

Which begs the question... are there other active compounds that are missing that might help with patient outcomes, or do patients just do better with their pain when they're high?
posted by markkraft at 10:58 AM on February 17, 2015 [1 favorite]


Virginia's highly conservative General Assembly has just passed a bill legalizing cannabis oil this past week, 37-1 in the Senate and 92-1 in the House of Delegates. There has been a lot of press about a family who had to take their daughter to Colorado to get treatment, they came back home to speak before the Senate subcommittee and the 3 year old girl had one of her seizures right in front of the legislators.

It's a bit crazy that this went through and is awaiting the Governor's signature, seeing as how several other bills, including pot for epilepsy, general medicinal cannabis, and a decriminalization measure, failed to even make it out of committee.
posted by daHIFI at 11:36 AM on February 17, 2015 [1 favorite]


"People who have tried both consistently report" that Nessie exists

There's no need to be an ass about this. Really.

anecdotes are not medical data. I can tell you caffeine pills are different from coffee, but that doesn't mean diddly about whether or not they affect my insulin receptors and GABA levels differently.

You can probably tell whether the caffeine pills are affecting you differently from coffee by, oh, how they make you feel. As for your insulin receptors test strips are $1. So there are ways to clarify things.
posted by localroger at 1:50 PM on February 17, 2015 [1 favorite]


What is really dumb about this is that any particular antidepressant only helps about 1/3 of people. And any particular antidepressant also has the chance of doing significant harm to some, even spurring suicide. We recognize, though, that the chance of great benefit is worth the chance of risk because depression itself can kill and often disables.

CBD, however, is not psychoactive itself and has been taken as part of a plant for thousands of years without a single overdose death and with zero evidence it causes any type of harm.

And the seizures these kids have can also be fatal if uncontrolled.

The idea that there's not enough science for a parent to try the stuff under those risk/benefit conditions— especially given the side effect profiles of the approved epilepsy drugs— is absurd.

If your kid has previously uncontrollable seizures and is one of the 1/3 for whom it works, it's absolutely a miracle drug and it is only stupid drug war politics that pushes the publication of articles like this and makes people unable to realize how absurd it sounds.

it's like arguing that people shouldn't try herbal tea that might have a 1 in 3 chance of working and zero chance of harm— no one would say don't try it (even those who are strong supporters of evidence-based medicine like me) and lots of people would argue for further research funding to see if it's more than placebo if it does work.
posted by Maias at 3:59 PM on February 17, 2015 [8 favorites]


localroger: You can probably tell whether the caffeine pills are affecting you differently from coffee by, oh, how they make you feel.
"How they make you feel" is within the realm of possible placebo effect. One purpose of medical research (which you disparage as both inadequate and unnecessary, in turns) is to rule out the placebo effect.
As for your insulin receptors test strips are $1.
It sounds like you think diabetic insulin strips test cellular insulin receptors - which is like saying a voltmeter can test ignition plug gap distances somehow. Sorry to be "an ass", but you are spouting nonsense, and digging deeper as you go.
posted by IAmBroom at 6:50 AM on February 18, 2015 [2 favorites]


IAmBroom you are putting words in my mouth. I did not say medical research was inadequate or unnecessary. I said that it is not always necessary. The reason people take caffeine is to achieve a subjective conscious state, and whether or not the placebo effect is involved personal experience is actually the determining factor in whether a caffeine source is being effective.

Similarly, the most common reasons for taking medical marijuana are to manage pain and to stimulate appetite (especially for cancer patients on chemo). Those are things that either work or don't work based on the personal experience of individual patients. Even after you run a controlled study that shows X dose benefits Y percent so, individual patient responses will have to be evaluated. Variations in the supply are just one variable in a large equation you can't solve anyway without individual testing. It's simply not like, say, blood pressure meds where there's a nice hard number you can measure and physiological responses tend to be consistent across the population.

As for the insulin receptors, no you can't tell everything about your insulin receptors from quickie blood sugar tests, but you can tell more than you probably realize. I once had a long discussion about how I started eating to the meter with a doctor who had entered his field specifically to work on life extension, and who was doing a lot of personal bloodwork to characterize his own glucose metabolism. When I told him how I was using the test strips to identify particular problem foods -- for example some supposedly low-GI foods spike my sugar, others don't -- and also how high and long my sugar levels overshoot in the hours after a bolus, he said, "My God, I'm doing lab blood tests every day and you're getting better data than I am."
posted by localroger at 7:30 AM on February 18, 2015


« Older When sex won't work   |   "If you can move at a slow shamble, we can use you... Newer »


This thread has been archived and is closed to new comments