Saturday, February 24, 2018

Pay It Forward in Supporting the UNM Medical Cannabis Research Fund

The Medical Cannabis Research Fund (MCRF) is comprised of faculty and researchers from a variety of disciplines at the University of New Mexico that are focused on conducting scientifically valid and unbiased research on medical Cannabis across all areas of social and biomedical sciences. Donations made to the MCRF support the direct costs of studies intending to measure the safety and efficacy of using medical Cannabis as a pharmacological agent. Findings from these multi-disciplinary investigations are intended to generate basic and clinical knowledge, educate patients, scientists, and physicians, and help inform regulation and use of medical Cannabis.

UNM Scientist and Private Physician Write the First Medical Cannabis Research Bill.
In February, 2015, UNM scientist, Dr. Jacob M. Vigil, and clinical pain specialist, Dr. Anthony Reeve wrote the first Medical Cannabis Research Bill to mandate that the New Mexico Medical Cannabis Program direct a consistent proportion of revenue produced by the Program to local research on medical Cannabis. Supported in the Senate by Senator Jerry Ortiz (SB 516) and in the Congress by Representative Armstrong (HB 466), while gaining much traction in both houses of congress, failed to get the final approval before the end of the legislative session. The Bill continues to be proposed each legislative session and is expected to pass into law in the near future.

UNM Scientists Help Direct Federal Medical Cannabis Policy.

In July, 2016 the Director of the Division of Extramural Research for the National Institute on Drug Abuse (NIDA), Dr. Susan Weiss, cited a recent article published one month earlier by UNM scientists, Drs. Sarah Stith and Jacob Vigil, in her testimony to the U.S. Senate to justify medical Cannabis research reform. Soon after, the Drug Enforcement Agency (DEA) "announced a policy change designed to foster research by expanding the number of DEA- registered marijuana manufacturers. This change should provide researchers with a more varied and robust supply of marijuana." Further, "...the U.S. Department of Agriculture (USDA), in consultation with DEA and the FDA, also released a statement of principles concerning provisions of the Agricultural Act of 2014 relating to the legalized growing and cultivating of industrial hemp for research purposes under certain conditions, such as in states where growth and cultivation are legal under state law." Sadly, these changes do not minimize the need for the MCRF to help fund scientifically valid and unbiased research on the true safety and efficacy of using medical Cannabis as a pharmacological agent in our present society.

Study Finds Medical Cannabis Is Effective At Reducing Opioid Addiction.
A new study conducted by researchers at The University of New Mexico, involving medical cannabis and prescription opioid use among chronic pain patients, found a distinct connection between having the legal ability to use cannabis and significant reductions in opioid use.

The study titled, “Associations between Medical Cannabis and Prescription Opioid Use in Chronic Pain Patients: A Preliminary Cohort Study,” and published in the open access journal PLOS ONE, was conducted by Drs. Jacob Miguel Vigil, associate professor, Department of Psychology and Sarah See Stith, assistant professor, Department of Economics. The results from this preliminary study showed a strong correlation between enrollment in the New Mexico Medical Cannabis Program (MCP) and cessation or reduction of opioid use, and that whole, natural Cannabis sativa and extracts made from the plant may serve as an alternative to opioid-based medications for treating chronic pain.

UNM Economics Assistant Professor Sarah See Stith and Psychology Associate Professor Jacob Vigil.

Today, opioid-related drug overdoses are the leading cause of preventable deaths in the United States killing approximately 100 Americans every day. Conventional pharmaceutical medications for treating opioid addiction, such as methadone and buprenorphine-tapering, can be similarly dangerous due to substantial risks of lethal drug interactions and overdose.

“Current levels and dangers of opioid use in the U.S. warrant the investigation of harm-reducing treatment alternatives,” said Vigil, who led the study. “Our results highlight the necessity of more extensive research into the possible uses of cannabis as a substitute for opioid painkillers, especially in the form of placebo-based, randomized controlled trials and larger sample observational studies.”

Cannabis has been investigated as a potential treatment for a wide range of medical conditions from post-traumatic stress disorder to cancer, with the most consistent support for the treatment of chronic pain, epilepsy and spasticity. In the U.S., states, including New Mexico, have enacted MCPs in part for people with chronic, debilitating pain who cannot be adequately or safely treated with conventional pharmaceutical medications.

Like other states, New Mexico only permits medical cannabis use for patients with certain debilitating medical conditions. All the patients in the study had a diagnosis of “severe chronic pain,” annually validated by two independent physicians, including a board-certified specialist.

New Mexico, Vigil notes, is among the U.S. states hardest hit by the current opioid epidemic, although the number of opioid-related overdose deaths appears to have fallen in recent years, perhaps the result of increased enrollment in the NM MCP, which currently includes more than 48,000 patients.

“MCPs are unique, not only because they allow patients to self-manage their cannabis treatment, but because they operate in conflict with U.S. federal law, making it challenging for researchers to utilize conventional research designs to measure their efficacy,” Vigil said.

The purpose of the researchers’ preliminary, cohort study was to help examine the association between enrollment in a MCP and opioid prescription use. The study observed 37 habitual opioid using, chronic pain patients that chose to enroll in the MCP between 2010 and 2015, compared to 29 patients with similar health conditions that were also given the option, but ultimately chose not to enroll in the MCP.

“Using informal surveys of patients enrolled in the MCP, we discovered a significant proportion of chronic pain patients reporting to have substituted their opioid prescriptions with cannabis for treating their chronic pain,” said Vigil.

The researchers used Prescription Monitoring Program opioid records over a 21-month observation period (first three months prior to enrollment for the MCP patients) to more objectively measure opioid cessation – defined as the absence of opioid prescriptions activity during the last three months of observation, with use calculated in average daily intravenous [IV] morphine dosages. MCP patient-reported benefits and side effects of using cannabis one year after enrollment were also collected.

By the end of the observation period, the data showed MCP enrollment was associated with a 17 times higher age- and gender-adjusted odds of ceasing opioid prescriptions, a 5 times higher odds of reducing daily prescription opioid dosages, and a 47 percentage point reduction in daily opioid dosages relative to a mean change of positive 10 percentage points in the non-enrolled patient group.

Survey responses indicated improvements in pain reduction, quality of life, social life, activity levels, and concentration, and few negative side effects from using cannabis one year after enrollment in the MCP.

The researchers’ findings, which provide clinically and statistically significant evidence of an association between MCP enrollment and opioid prescription cessation and reductions and improved quality of life warrant further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.

According to Stith, “The economic impact of cannabis treatment should also be considered given the current burden of opioid prescriptions on healthcare systems, which have been forced to implement costly modifications to general patient care practices, including prescription monitoring programs, drug screening, more frequent doctor-patient interactions, treatment of drug abuse and dependence, and legal products and services associated with limiting opioid-related liability.”

“If cannabis can serve as an alternative to prescription opioids for at least some patients, legislators and the medical community may want to consider medical cannabis programs as a potential tool for combating the current opioid epidemic,” Vigil said.

As part of our mission, the MCRF aims to not only conduct pioneering research in all areas of medical Cannabis, but to also train the future leaders in medical Cannabis research. To learn more about the training and collaborative opportunities for medical Cannabis researchers, please contact Dr. Jacob Miguel Vigil here.

You can see the important medical Cannabis research projects that the MCRF is currently supporting here.

If you want to participant in a medical Cannabis research study in New Mexico, click here.

Information for current and future social and biomedical Cannabis researchers can be found here.

Today the New Mexico Medical Cannabis Program has over 50,000 registered participants (most all of whom are voters) with 35 licensed non-profit producers or LNPP’s now growing 14,550 medical cannabis plants, as the program hits the end of its 10th year. The Medical Cannabis Program (MCP) was created in 2007, as the Lynn and Erin Compassionate Use Act, under chapter 210 Senate Bill 523. New Mexico’s medical cannabis history started in 1978, after public hearings the legislature enacted H.B. 329, the nation’s first law recognizing the medical value of cannabis…the first law.

Advancements in Science

Vigil, J. M., Stith, S. S., Reeve, A. P. (2018). Accuracy of patient opioid use reporting at the time of medical cannabis license renewal. Pain Research and Management. Article ID 5704128, 4 pages, 2018. doi:10.1155/2018/5704128

Stith, S. S., Vigil, J. M., Adams, I. M., & Reeve, A. P. (2018). Effects of legal access to cannabis on Scheduled II-V Drug Prescriptions. Journal of the American Medical Directors Association, 19, 59-64.e1.

Vigil, J. M., Stith, S. S., Adams, I. M., & Reeve, A. P. (2017). Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study. PLoS ONE. 12(11): e0187795.

Stith, S. S., & Vigil, J. M. V. (2016). Federal barriers to Cannabis research. Science. 352(6290), 1182.

Filbey F. M., Aslan S., Calhoun V.D., Spence J.S., Damaraju E., Caprihan A., & Segall J. (2014). Long-term effects of marijuana use on the brain. Proc Natl Acad Sci U S A. 111(47):16913-8.