Abstract
If someone had told you a decade ago that children would become the driving force behind the medical marijuana movement, you’d likely think they were high. Yet in 2015, we witnessed 15 states—including conservative bastions like Alabama and Texas—pass legislation designed primarily to give seriously ill minors access to cannabis. It has become one of the most fascinating developments as the concept of legalization becomes normalized, and it shows no signs of slowing down.
As marijuana moves into the mainstream, so too do growing techniques. For decades, underground black market cultivators have bred for high amounts of tetrahydrocannabinol (THC) that provide the strongest high, whether that be a sedative body effect or a racing mental buzz. If something didn’t get you “stoned,” that would be the end of the line for that particular plant. Enter high-end testing laboratories with the onset of medical marijuana. Suddenly, scientists were finding cannabinoids (chemical compounds in weed) that were much more interesting than THC. The biggest cash cow in the industry was suddenly cannabidiol, or CBD, which showed a diverse range of medical applications as an antiemetic and anticonvulsant, among others. The only problem: it doesn’t get you high. Growers had been axing the best medical marijuana plants for years.
A label for Stanley Brothers/CW Botanicals’ Charlotte’s Web tincture.
What came next amounted to an arms race. With plants taking around four months from seed to smoke, finding CBD-rich strains of marijuana became paramount for those looking to jump into the emerging market. Some began tapping the industrial hemp market to find the compound, while others simply began testing their existing supply. One of the fastest to market, however, was Charlotte’s Web, a type of marijuana named after the popular book as well as Charlotte Figi, a now 8-year-old girl who suffers from Dravet syndrome. It quickly became one of the most controversial.
In a nutshell, Dravet syndrome is characterized by a large number of epileptic seizures starting at about six months of age. Charlotte’s parents heard of another child using medical marijuana to treat the symptoms and soon wound up working with Realm of Caring (ROC), a nonprofit based in Colorado that has a proprietary strain of high-CBD cannabis. They immediately noticed a dramatic decrease in the frequency of her seizures and improvement in her quality of life without the euphoria traditionally associated with weed. Soon, parents across the country were clamoring for similar strains to help their children. With limited supplies and communication issues at ROC, these recent transplants grew frustrated.
Other strains—with names like Cannatonic and Harlequin—began popping up, but few companies had the marketing resources and constant media attention to make them household names like Charlotte’s Web. Families without access to or knowledge of these strains soon began lobbying for medical marijuana laws in their own state, but under a different guise than many: bills that would allow for CBD oil and not strains high in THC. The legislation, heralded by some, was decried by others as insufficient for many patients.
Dubbed “the entourage effect”, advocates argue that we don’t fully understand the interaction between various cannabinoids, including CBD and THC. Championed by Israeli researcher Raphael Mechoulam, this approach favors whole plant medicine as opposed to isolated cannabinoids. Take, for instance, Marinol, the FDA approved synthetic THC. While raw marijuana has never been directly attributed as a cause of death, Marinol has. Four times, in fact. Scientists believe there’s a synergistic effect that isolated CBD alone cannot provide and CBD-only laws are a disservice to those who need medical cannabis.
That hasn’t stopped the market from producing a wide variety of CBD products, many offering to ship across the nation because they claim to be derived from hemp. This remains a violation of the Controlled Substances Act, but patients with no other recourse are willing to take the risk, driving up prices for the limited supply. These companies are also in a bind as to how they can market their lines, with several receiving a February 2015 letter from the FDA warning about making claims of efficacy. “Consumers should beware purchasing and using any such products,” the FDA noted. Of the product lines they tested, most came back with fractions of a percent of CBD. Patients were purchasing the equivalent of snake oil.
Moving forward, whole plant cannabis laws, including industrial hemp, are the only way to pave the road to the future. Otherwise, patients will continue to flock to legal states where they’re left without a support system or resources. Will someone please think of the children?
As with any nascent industry, there will be growing pains. New extraction methods, coupled with breeding projects, should help accelerate the process of finding medically appropriate strains for patients. For now, those in states with CBD-only legislation may find treatment insufficient and give up on marijuana altogether. Moving forward, whole plant cannabis laws, including industrial hemp, are the only way to pave the road to the future. Otherwise, patients will continue to flock to legal states where they’re left without a support system or resources. Will someone please think of the children?