Research Ruckus

When the University of Arizona abruptly fired Assistant Professor Sue Sisley recently, some people decried the move as a major stumbling block for cannabis research.

Sisley, a physician who hopes to study the use of smoked cannabis to treat post-traumatic stress disorder in veterans, wasn’t told why her contract wasn’t renewed, but she was assured that it was not for job performance. She suspects it was because of her public advocacy for marijuana research and has since hired an attorney to try to preserve her job—and her PTSD study.

But her firing (her contract is up this fall) would not be a death knell for cannabis research—even hers. Sisley’s study will likely live on, if not at UA then elsewhere through the Multidisciplinary Association for Psychedelic Studies.

MAPS is a California nonprofit organization at the forefront of marijuana research, or at least behind it pushing fervently. MAPS is the sponsoring organization behind Sisley’s PTSD study. Despite her setback, cannabis research is on the rise, said Brad Burge, MAPS communications director.

“There is a lot of research happening, and that needs to be recognized and it needs to be celebrated,” Burge said.

But almost all of that research has been on isolated components of cannabis, not the whole plant. At least two cannabis-related drugs are on the market today—Sativex and Marinol.

Marinol is synthetic THC. It is used for appetitive stimulant and nausea suppressant (yes, it makes you high, the same way regular THC does). It is manufactured in a laboratory, not extracted from the plant. Sativex is a synthetic cannabinoid drug approved originally for muscle spasms associated with multiple sclerosis, though the manufacturer is studying its use as a pain reliever. Both drugs ignore the “entourage effect” of whole-plant cannabis. Up to now, researchers have been mostly ignoring the collective effects of numerous chemical compounds in cannabis.

“So we’re looking for a specific key, instead of a set of keys,” Burge said.

There are more than 80 cannabinoids in marijuana, including the commonly known ones THC and cannabidiol (CBD). Researchers are beginning to understand that the interactions of these molecules sometimes offer benefits they don’t individually bring.

For example, CBD counteracts the psychoactive effects of THC. That means a patient using Marinol might get very high from the drug, whereas a patient using a similar dose of THC from whole-plant marijuana wouldn’t, if the strain contains a high dose of CBD. There are also more than 100 terpenes in cannabis, and researchers are beginning to see that these chemicals contribute to the entourage effect.

Burge cites two main reasons for this focus on isolates—tradition and money.

Western medicine, for various reasons, has focused almost entirely on extracting specific compounds for specific results. Eastern medicine, which includes a wider use of herbs and other natural remedies, doesn’t. The bigger reason is the almighty dollar, Burge said.

Pharmaceutical companies can’t patent marijuana, but they can patent a process to make synthetic compounds found in marijuana, so that’s where they look, he said.

Ultimately, he believes the PTSD study will happen, and MAPS is looking at ways to help. He called Sisley’s PTSD study a “wedge” that could leverage other whole-plant research. In March, Sisley made national news by getting requisite approval from the Health and Human Services Department. That approval forces the National Institute on Drug Abuse, which grows and dispenses marijuana for research, to supply her. NIDA told Sisley then that it doesn’t yet have the supply of cannabis she needs, Burge said.

It will be January before the marijuana is available, according to Burge, but even if that doesn’t happen, the fight for this study will not be over. MAPS is considering other options, including moving the study to Colorado or finding an alternate investigator.

“Regardless, we’re moving forward,” he said.

This article appears in Jul 10-16, 2014.