In 1996, California became the first state to legalize medical marijuana. Eleven years ago, Vermont followed suit. But doctors still know surprisingly little about the pharmacology of cannabis. And a Vermont-based think-tank is hoping to transform the industry by applying new scientific rigor to an old drug.
When you feel a headache coming on, or that sore back starts to act up, choosing a medical intervention is a pretty straightforward affair.
“When you actually go to a pharmacy and you buy an aspirin or you buy ibuprofen, you know exactly the number of milligrams that you’re going to get from that pill every single time,” says Willy Cats-Baril, an associate professor at the University of Vermont’s Grossman School of Business.
Cats-Baril, who specializes in health economics, among other things, is a member of an organization named the Phytoscience Institute. And this think-tank, as its five founders refer to it, is hoping to bring to medical marijuana the same kind of scientific scrutiny that regulatory agencies, like the FDA, have long provided for conventional drugs.
“And so what we hope to do here in Vermont is to develop new technologies that are at the forefront of making sure that the products that are created are not only consumer-safe, high quality, but absolutely reproducible time and time again,” Cats-Baril says.
Doctors have long known about the medical properties of the plant and its extracts. The fact that it’s classified as a Schedule 1 narcotic by the federal government has, to say the least, hampered its scientific exploration.
“When you lose federal approval, you lose the EPA, you lose the FDA and you lose the USDA, so the industry has had to start self-regulating itself,” says Monique McHenry, another member of the Phytoscience Institute.
McHenry is a PhD-trained plant geneticist who has been developing strains of cannabis and hemp at a nonprofit medical marijuana dispensary in Montpelier.
McHenry says one thing is abundantly clear: ingesting cannabis offers profound symptom relief to patients suffering from cancer, multiple sclerosis, and other chronic conditions that make people legally eligible to use medical marijuana in Vermont.
Less apparent, according to McHenry, are what elements of the drug, and at what dosages, are best for treating the specific symptoms for which patients are seeking relief.
“Is it the percentage that you find in weight? Or is the amount of THC in relation to other cannabinoids, such as [cannabidiol]? Or does it involve other plant compounds, like terpenes? And we’re just not really sure of those answers right now,” McHenry says.
Dr. Kalev Freeman says Vermont could become the epicenter for the research and development that would provide those answers. Freeman is an emergency room doctor at the University of Vermont Medical Center. He’s also a member of the Phystoscience Institute, and heads up the lab-testing company, called Nutraceuticals Sciences Laboratory, that has emerged as one of its first projects.
“And in that capacity, over the past three years, I’ve tried to work with a nonprofit medical marijuana dispensary to help ensure the safety and quality of the product, and to help them conduct research that could lead to improved patient outcomes,” says Freeman, who also happens to be McHenry’s husband.
Freeman is especially interested in exploring cannabis as a tool for pain management.
“Patients [of the dispensary] have reported to us that, with access to high-grade medical marijuana, they’ve eliminated the need for opioids as part of their pain regimen. This was fascinating to us. I hadn’t seen much in the literature on this, so we’ve started doing clinical trials to see which strains of marijuana help people get off opioids,” Freeman says.
“I’m an emergency room physician. I work in the emergency room. I staff the ER Friday and Saturday nights. And I have been seeing for years, people come in with opioid overdoses. And we have to ask ourselves – are there better options to treat pain?”
Freeman, however, says testing protocols and research standards nationally for medical cannabis are inconsistent and unregimented, by the lofty standards of medicine especially.
Last week, members of the Phytoscience Institute released a 34-page white paper. In it, they recommend testing and regulatory guidelines they think Vermont lawmakers should adopt for medical marijuana.
They say elected officials should mandate the same protocols for cannabis sold for recreational use, if lawmakers approve pending legislation that would legalize recreational use of the drug.
“We need to know what we’re providing them,” Freeman says.
The Phytoscience Institute is a business. But Cats-Baril, McHenry and Freeman say the mission isn’t purely a moneymaking one. The “PSI,” as they refer to it, was formed as a benefit corporation, which means its owners must take into account “general public benefit,” and not just profit.
Cats-Baril says the vision of PSI is to develop locally the intellectual property needed to advance the medical cannabis field, and then export those advances to other states and countries.
“What drives us is the passion … to understand this plant better and how we can use it to help people lead better lives,” Cats-Baril says.
In addition to research-and-development and quality assurance, the Phytoscience Institute has a third mission: education.
The University of Vermont recently enlisted Freeman and McHenry to deliver classroom instruction. UVM says two courses – including a free, five-part, online course called, “The Cannabis Lecture Series” – will be the first medical cannabis courses in the nation to be offered by a college or university.
“I’m hoping that this will be a platform for future research and future investigations that will come up with novel therapeutic medical uses for cannabinoids,” says Dr. Mark Nelson, the chairman of the Department of Pharmacology at the UVM College of Medicine.
A majority of states now have some form of medical marijuana law, but the science surrounding the drug remains in relative infancy.
“So I think there’s a lot to learn,” Nelson says. “And our goal in this course is really to cover the history, the chemistry, and what’s known and not known, and teach people how to evaluate the current literature.”
Like Freeman, Nelson says he’s particularly interested in the use of cannabis to ease pain.
“To be able to manage pain, or even have one new way of managing pain, would be a fantastic accomplishment,” Nelson says.
Tom and Robin Grace, owners of the food-allergen testing company Bia Diagnostics, are also members of the Phytoscience Institute. Freeman says their “internationally recognized” expertise could fuel new breakthroughs in cannabis testing.
“What we hope PSI will do not only statewide but nationally is that we will develop an expertise on medical cannabis that will be recognized worldwide,” Cats-Baril says. “That’s what we hope to do.”
This post was edited at 10:25 a.m. Nov. 18, 2015 to correct the name of the Phytoscience Institute.