As dispensaries open in NY, UB experts weigh in on medical marijuana

With some dispensaries opening today in New York State, UB researchers say medical benefits exist for medical marijuana, but rigorous testing is needed.

Edward Bednarczyk, chair of the Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, says medical marijuana must be held to the same standard as other drugs.

“This is a call for science,” says Bednarczyk, who has presented on the topic all over the country. “I think just like any other drug product, we shouldn’t rush things to market until the expected standard for safety has been met.

“No one is opposed to the active ingredients in marijuana,” he says. “It just needs to be studied like any other drug. People are advocating for it for less than pure reasons. How about some data? That is what we would expect from any other drug.”

The active ingredients in marijuana have great potential for medical benefits, Bednarczyk notes. But very few studies have been done, he says, as most have been done with synthetic or semi-synthetic forms of the active ingredients.

“Plants have historically been a rich source of human medications, but nowhere else have we settled for using crude plant products instead of the active ingredients,” he says. “We have also used modern techniques to develop drugs that are better suited for human use than the forms found in nature.”

Arie Weinstock, professor of clinical neurology, Jacobs School of Medicine and Biomedical Sciences, agrees that more studies need to be done. Weinstock, medical director, pediatric epilepsy, at Women & Children’s Hospital of Buffalo, is the site principal investigator at the hospital for a multicenter, randomized, double-blind, placebo-controlled study now underway of cannabidiol (CBD) for some forms of severe epilepsy in children.

“There is currently a perception among patients and caregivers that sufficient evidence of safety and efficacy for medical marijuana already exists,” he says. “However, data available today are based only on open label studies often subject to bias and placebo effects; therefore rigorous placebo-controlled, double-blind studies are necessary.

“It is widely accepted among epileptologists that only CBD, the non-psychoactive cannabinoid compound, should be considered in children with refractory epilepsy. CBD would need to be available in a pharmaceutical grade form in those patients.

“There is an inaccurate belief that nature’s products, including medical marijuana, are always safe,” Weinstock continues. “Significant adverse events have been reported with CBD, including somnolence, interactions between CBD and antiepileptic drug medications, and even increased seizure frequency.”

Kenneth Leonard, director of UB’s Research Institute on Addictions, calls the arrival of medical marijuana in New York State a “mostly positive” development, in part because New York’s legislation does an excellent job of “framing marijuana as a medicine, and not as a way to get high.”

Under the law, doctors must get training before prescribing medical marijuana and patients cannot obtain a prescription unless they have severe complications stemming from a highly circumscribed set of disorders, Leonard says.

“The legislation is very carefully crafted to make sure appropriate patients are getting it under appropriate medical supervision,” he says. “We also have strict regulations on naming and advertising that will prevent people from giving fanciful names to their products to help market it.”