Cannabis Research Review Board Meeting – September
The Department of Health and Human Services’ Cannabis Research and Review Board (CRRB) held their monthly meeting last Tuesday (Sept. 13). The meeting was held virtually only, but was open to the public and lasted the full two hours it was scheduled for.
The Board consists of the following members:
Katherine Carlson, M.D., M.S. (Board Chair)
Perry G. Fine, M.D. (Previous Board Chair)
Matthew S. McIff, M.D. (Vice Chair)
Michael Moss, M.D.
Jennifer L. Norris, M.D.
Misty D. Smith, Ph.D.
Brian Keith Zehnder, M.D.
At the outset of the meeting, Board Chair Dr. Carlson, stated the purpose of the board and meeting, which is to “review the available research literature and assist the Utah Department of Health and Human Services (UDHHS) and Center for Medical Cannabis in their efforts to provide useful treatment recommendations to qualified medical providers regarding the use of cannabis and cannabinoid products for treatment of certain medical conditions as ‘qualifying medical conditions’.”
Approval of Updated Bylaws
After approval of the minutes, the Board discussed some of the updated bylaws, specifically Section 5 of Article IV (Duties of the Board), which states: (5) Guidelines that the Board develops under this section may not limit the availability of cannabis, cannabinoid products, or expanded cannabinoid products permitted under Title 4, Chapter 41a, Cannabis Production Establishments, or Title 26, Chapter 61a, Utah Medical Cannabis Act.
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It was pointed out by Dr. Fine, who characterized this section as “superfluous,” really serves no purpose since it basically states that any guidelines the board develops will not necessarily affect the availability of cannabis and cannabinoid products available in the state, since their role is more advisory. After some discussion about rewording this section, it was decided and voted by the Board to completely eliminate this section of the bylaws.
Highway Safety Committee Update - Dr. Moss
Next, Dr. Moss provided an update on what is known about the effects of driving under the influence of cannabis. Dr. Moss conceded determining how impaired a driver is on cannabis is much harder to determine than alcohol. There are a number of variables that affect a driver’s level of impairment, such as a person’s tolerance and whether alcohol was also involved. It was suggested by Dr. Fine to get in touch with the Utah Medical Association (UMA) to discuss and develop some guidelines or educational materials for medical cannabis patients and the relative risks of driving.
Living Systematic Review on Cannabis for Chronic Pain– Lauren Heath
Next, Lauren Heath of the University of Utah College of Pharmacy discussed the findings of a study done on the effects of cannabinoids and other plant-based compounds to treat chronic pain.
Results of the study showed:
· Comparable THC to CBD ratio oral spray is probably associated with small improvements in pain severity and overall function, but there may be a large increased risk of dizziness and sedation and a moderate increased risk of nausea.
· Synthetic THC (high-THC to CBD) may be associated with moderate improvement in pain severity with no effect on overall function and increased risk of sedation, and large increased risk of nausea and dizziness.
· Extracted whole-plant high-THC to CBD ratio products may be associated with large increases in risk of study withdrawal due to adverse events and dizziness.
· Evidence on whole-plant cannabis (including patient’s choice of products), low-THC to CBD ratio products (topical CBD), other cannabinoids (cannabidivarin), and comparisons with other active interventions was insufficient to draw conclusions.
Public Health Outreach Efforts - Danielle Conlon
Danielle Conlon, Outreach Specialist at Utah Center for Medical Cannabis, discussed a number of issues regarding the safe use of cannabis during pregnancy, the health effects of medical cannabis, and how to safely store your medical cannabis. The slides used during her presentation can be viewed here:
· Cannabis Use During Pregnancy and Breastfeeding
· Health Effects of Using Medical Cannabis
· Safe Storage of Medical Cannabis
Public Comments
Approximately 20 minutes before the end of the meeting, public comments were allowed. Comments were limited to three minutes.
Zac Newel King, a medical cannabis patient, explained how he suffers from chronic pain as a result of a paintball injury a few years ago. He said cannabis has helped his pain like no pharmaceutical ever could. He sadly lamented on the death of his wife, who overdosed on Ambien, a commonly prescribed sleep medication. Unfortunately, the cost of medical cannabis in Utah is so high, he cannot afford the four ounces of flower he needs each month.
Christine Stenquist (TRUCE) would like to see more engagement with “pro-cannabis” organizations and experts, such as Dr. Ethan Russo and Dr. Bonnie Goldstein, who have more experience and expertise on medical cannabis than the state’s QMPs, which she pointed out only have to complete 4 hours of training—something anyone could do.
Jill Marriot, a medical cannabis patient for chronic pain, thought the board has focused too much on the negative side-effects of cannabis (such as dizziness) compared to pharmaceuticals, which have far worse side-effects.
Zach Chase (advocate for TRUCE) praised the benefits of cannabis for him. It has helped him get off alcohol, helped with an eating disorder, in addition to surviving a heroin overdose. Zach feels there is too much emphasis on the negative aspects of cannabis, while not enough on the positive, in addition to the patients’ needs not being adequately addressed.
Finally, Nathan Kizerian, who lost his wife to cancer, emphasized the importance of every advocate getting in their say of two minutes. Unfortunately, the 2-hour mark had been reached and the meeting was then adjourned.
An audio recording and handouts used during the meeting can be found here.
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