A statewide, state-funded initiative to rigorously study the safety and efficacy of medicinal cannabis to treat certain diseases is being established at the University of California. The Center for Medicinal Cannabis Research (CMCR), headquartered at UCSD, will be a collaboration between UCSD and UCSF, two of the UC system's leading biomedical research campuses.
The CMCR will administer $3 million in first-year funding to support and coordinate scientific research at universities and research centers throughout California, assessing the use of cannabis as an alternative for treating specific medical conditions.
Funding of the CMCR is the result of SB847 (Vasconcellos), passed by the State Legislature and signed into law by Governor Gray Davis in October 1999. The legislation calls for a three-year program overseeing objective, high quality medical research that will "...enhance understanding of the efficacy and adverse effects of marijuana as a pharmacological agent," stressing that the project "should not be construed as encouraging or sanctioning the social or recreational use of marijuana."
Data from these studies will be used to develop guidelines for appropriate pharmaceutical use of medicinal cannabis. California voters approved such use in 1996, but exactly what role the substance should play in patient care, and how it should be administered as a pharmaceutical agent, is ambiguous because of the lack of definitive research, said Igor Grant, M.D., professor of psychiatry at UCSD and director of the CMCR. Grant is also executive vice chair of the department of psychiatry and director of UCSD's HIV Neurobehavioral Research Center.
Co-directors of the CMCR are Donald Abrams, M.D., professor of medicine at UCSF; and J. Hampton Atkinson, M.D., professor of psychiatry, and Andrew Mattison, Ph.D., associate clinical professor of psychiatry and family and preventive medicine, both of UCSD.
The CMCR plans to solicit applications this fall, to be reviewed by an independent Scientific Review Board of national experts. Funding will be awarded to support research focusing on diseases and conditions as defined in a report by the National Academy of Sciences/Institute of Medicine, and by a National Institutes of Health expert panel, according to Grant.
"The politics of medical marijuana are behind us as we begin the important work of researching the safety and efficacy of medical marijuana," said Senator John Vasconcellos (D-Santa Clara). "The National Institutes of Health and the Institute of Medicine of the National Academy of Sciences have independently called for further studies. Now, because of the vision of the Legislature, the Governor and the University of California, the issue of medical marijuana is properly in the hands of physicians and researchers."
The symptoms and conditions for which cannabis might be a useful treatment option include:
* Severe appetite suppression, weight loss and cachexia due to HIV infection and other medical conditions;
* Chronic pain resulting from certain types of injuries and diseases such as AIDS;
* Nausea associated with cancer and its treatment; and
* Severe muscle spasticity caused by diseases such as multiple sclerosis.
"This is an important opportunity to continue to evaluate the therapeutic potential of cannabis," said Abrams, a UCSF oncologist and AIDS expert who has just completed the first clinical trial of inhaled marijuana in patients with HIV infection. "The findings from our initial safety trial suggest that studies of the possible effectiveness of marijuana should be launched now. This state funding will allow that to happen quickly so that we may finally get some needed answers."
Support will be awarded on a competitive basis to those studies determined to be of the highest scientific quality, with studies anticipated to begin as early as January 2001. Most of the studies are anticipated to be patient trials, said Grant, though there is also interest in funding some basic research that has direct relevance to understanding safety, efficacy, and mechanisms of action of cannabis chemicals for the conditions in question.
The cannabis to be used in the studies will be obtained from the National Institute on Drug Abuse in accordance with procedures developed by the Public Health Service. Studies may also utilize alternative, non-smoked preparations of cannabis, as these become available through pharmaceutical research and are approved for clinical trials by the appropriate regulatory bodies.
In addition to the Scientific Review Board that will provide independent review of research proposals, the CMCR leadership is appointing an Advisory Board to provide input on how the CMCR can meet its objectives in the most scientifically sound, responsible and timely manner.
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