SALT LAKE CITY — Initial findings from state-funded research into the medical qualities of marijuana could be presented to lawmakers as early as the legislative session at the start of next year, according to the organization charged with carrying out the study.
"Hopefully there will be some preliminary data that can be shared during the legislative session this year," Ivy Estabrooke, director of the Utah Science Technology and Research Initiative, told the Deseret News.
Estabrooke cautioned that a complete report on the study's findings isn't expected until late spring or early summer of 2018.
That full report should be publicly available in the months leading up to a potential decision by Utah voters on whether or not to legalize marijuana for medical use in the state.
The Utah Patients Coalition, the name of the campaign seeking such legalization, told the Deseret News that organizers are quickly closing in on the signature threshold required to get the issue on the ballot in November 2018.
DJ Schanz, director of the coalition, said he is optimistic that all needed signatures statewide will be collected by January, well before the April 15 ballot initiative deadline.
"We feel that we've done a good job of messaging and bringing this message directly to the people," Schanz said.
So far, the Utah Patients Coalition has gathered about 50,000 signatures, he said. Volunteers are responsible for securing about two-thirds of those, while paid signature gatherers have obtained the rest.
"We (have) an enormous amount of support," Schanz said.
Medical cannabis advocates have contended the ballot initiative is a necessary move in order to get Utahns access to the drug after efforts to legalize it for medical use appeared to stall in the Utah Legislature. State lawmakers introduced two bills in 2016 that would have legalized medicinal use of marijuana to varying extents, but both ultimately failed. No such bills were introduced in 2017.
Schanz said multiple polls have shown the Utah Patients Coalition that support for approving medical cannabis remains strong statewide, with as many as 3 in 4 Utahns being in favor of it.
State requested study
The Utah Science Technology and Research Initiative, an economic development engine organization created by the state in 2006, was appropriated more than $31.8 million for fiscal year 2018. State lawmakers decided earlier this year to appropriate $500,000 toward its budget solely for the study into marijuana's medical properties as it pertains to pain, according to Estabrooke.
That funding will allow for a "randomized placebo controlled clinical trial" of 45 Utahns experiencing chronic pain, Estabrooke said. Deborah Yurgelun-Todd and Perry Renshaw, University of Utah psychiatry professors, were asked by the initiative to lead the study.
Recruiting of subjects is still underway. Those studied will be divided into a group with a placebo treatment, a group that receives cannabis treatment with high concentrations of THC and low CBD, and others who get a dose high in CBD and low in THC, Estabrooke said. THC is the psychoactive ingredient in cannabis, while CBD is not considered to have any psychoactive effects.
The subjects' pain levels will be measured via a cognitive function test, a brain MRI and a self-reported pain scale, throughout five days of treatment, Estabrooke said.
The idea behind the cognitive function test is that "people can't function when they're in a lot of pain, so if the pain is reduced you would expect a lot of improvement on cognitive function tests," she said. She added that the value of the MRI is that it "doesn't rely on self-report."
"I think what it has the potential to show is (whether there is) a benefit for chronic pain … and it will also provide some insight into whether … high THC is more effective than low THC," Estabrooke said.
Is study needed?
Schanz views the state's request for the study with deep skepticism, however, saying there are already "literally thousands of clinically studied reports" throughout the world that examine the medical benefits of cannabis.
"While we are not against studies and research, it needs to be in conjunction with having a legal path forward for patients," he said. "It has to be in conjunction with ending prohibitive policies denying patients access."
Schanz said he questions whether the state may be using the study as "a smokescreen," an "excuse," or "a delay tactic" in its reluctance to open access to medical cannabis for Utahns.
"The idea that Utah's going to be on the forefront of any research is laughable and anything short of giving patients access is unacceptable. … They're starting 20 years — in Israel's case, actually 50 years — late on this," Schanz said.
He was referring to Israel's reputation as an international leader in cannabis research for several decades.
"We would be cautious to see this as anything other than as a (barrier) to giv(ing) patients access," Schanz said. "If research is done in conjunction with access, we're supportive. If it's used as an excuse to continue prohibitive laws … we're not supportive of it."
He added it would be "just foolhardy" to subscribe to the idea that Utah's own research could be the tipping point between knowing or not knowing enough about cannabis in order to make a decision about legalizing it.
But both Yurgelun-Todd and Renshaw say that upon closer examination, additional studies into marijuana as a medicine are critically important, despite the helpfulness of existing cannabis research throughout the world.
"There have been very few high quality placebo controlled trials of substances that are known to have a (consistent) content of THC or (CBD)," Renshaw said.
Yurgelun-Todd agreed, saying, "There are some nice studies, but there are not enough studies, or enough well-controlled studies" in the field of cannabis research. She said the study she and Renshaw are leading has the opportunity to significantly add to the body of work examining the drug.
"We're hoping that we've designed a study that will actually enhance our knowledge base and show the important potential medication benefits of medical marijuana in pain prevention," said Yurgelun-Todd, who is also director of the Cognitive Neuroimaging Laboratory at the U.
She and Renshaw will be examining patients' results on a daily basis and at the conclusion of their treatment to "understand how quickly they might respond to these kind of treatments," she said.
There is a lack of consistency between studies regarding the precise levels of THC and CBD administered, according to both Yurgelun-Todd and Renshaw.
"We reviewed all the literature that's out there … especially with regard to pain," Yurgelun-Todd said. "In order to understand how we might administer medical marijuana, we need more information."
Specifically, Renshaw said, Utah doctors would need more scientifically based recommendations on how much of the drug to give a patient, in what circumstances and in what format for ingestion.
"If you went to a physician and said, 'Good news, you can prescribe marijuana,' the physician is likely to say, 'Great, what formulation? What dose should I use? … What should I advise patients about in terms of side effects?'" he said.
Renshaw belongs to the Cannabinoid Product Board that was created by state lawmakers this year. Asked about Schanz's comments on existing research, Renshaw said one purpose of the board is to make a good faith effort to “be looking at what is the state of the research.”
The group will be presenting their observations on existing research to legislators later this month, he said.
Yergulen-Todd and Renshaw both said federal regulations designating marijuana as a Schedule I drug have been holding back research into its effects. They said gaining the right clearance to carry out the study from federal agencies like the Food and Drug Administration and the Drug Enforcement Administration has taken several months.
"It is very difficult right now to do marijuana research in Utah or anywhere in the United States," Renshaw said.
Estabrooke praised the Utah Legislature for making a push for cannabis research despite the federal roadblocks, saying it appears they are trying to work with the most complete information available.
"I think it's a really positive thing that the Legislature is trying to have the best science they can to make data-driven policy changes in the state, Estabrooke said. "This study is a good example of that technical leadership or that policy leadership from our Legislature of wanting to have scientific evidence informing their policy decisions."