The pair, along with pain specialist Dr. Anthony Reeve, presented their research on how enrollment in the New Mexico Medical Cannabis Program has affected prescription opioid use in patients with chronic pain on Friday at UNM.
Vigil said the Medical Cannabis Program is unprecedented because patients manage their own care, since doctors can’t prescribe doses of cannabis, only authorize patients to obtain it.
He said it’s difficult to obtain federal funding for research on medical cannabis use and New Mexico is a great place to do research on it now, because recreational use is not currently legal.
The study compared prescription opioid use in Reeve’s patients who were enrolled in the medical cannabis program and his patients who were not enrolled over an 18 month period, Stith said.
New Mexico keeps track of prescription opioid use, allowing them to check whether patients who reported a reduction in opioid use were telling the truth, she said.
Their research found a 31 percent reduction in opioid use after 18 months in the medical cannabis patients and a slight increase in opioid use in the control group, she said.
The trend for cannabis users was clear, while the control group’s trend was less definite. But their research defies the popular gateway hypothesis, that cannabis use will lead to the use of more dangerous drugs, Vigil said.
Stith said it was difficult to even begin the study as Vigil spent two years getting the “little pilot study” approved through the institutional review board.
“I don’t have tenure yet. I wouldn’t have been able to spend those two years,” Stith said. “Basically (Vigil) got tenure and was able to invest the time and so it really is restrictive, especially when you don’t have tenure to even begin to start on these types of studies because it’s just too long of a timeline.”
One of the other challenges is quality assurance, Stith said.
“You can go to one dispensary and buy something called “purple firefly” or something and you go to another dispensary, it’s called the same thing but it’s actually a totally different plant,” she said. “There’s a lot of inconsistencies and that makes it hard to study in a medical sense.”
Stith said the biggest challenge to doing research is cannabis’ status as a Schedule 1 drug.
“We cannot give patients cannabis or we’re drug dealers — so we have to figure out how to observe them in a way so that we’re not intervening with them,” she said. “We couldn’t say, ‘take this before you go to bed and tell us how it works.’ We can’t do that. So that’s the biggest hurdle, the Schedule 1 aspect of it, and Schedule 1 means literally no therapeutic potential for the medication or substance.”
But despite all of the challenges, they are excited to continue in this “really exciting” area of research, she said.
“One benefit of the fact they haven’t allowed us to do research for so long, is there’s a lot of questions waiting to be answered,” Stith said. “It’s not hard to find research to do in this area — especially now that we’ve been able to develop this more observational approach as opposed to an interventionist approach.”
The two plan to continue their research on medical cannabis use and expand the scope of their research, she said.
“We want to look across different states. Different types of cannabis programs, how those work,” Stith said, adding that one of the next things they will look at is the indirect effect of cannibis on sedatives.
“It appears that these patients are not just reducing their opioid use, they’re also reducing their sedative use,” she said. “We’re going to look at some of the polypharmaceutical aspects. We want to get into some of the economic questions, cost effectiveness.”
Now that they have completed the pilot study, Stith said she believes future studies will be easier to begin, especially after going “back and forth and back and forth” with the IRB to get everything approved.
“So all that’s been worked out,” she said. “How the patients consent, when they consent, all that stuff. So a lot of legwork’s been done on that.”
Medical cannabis patient and community advocate Jason Barker said he thought the presentation was excellent and is excited to see research being done on medical cannabis.
“This is research that should have started back in 2014 when they first initially tried to do this,” he said. “Now they’ve got it under way, this is exciting because opioids kill more people in the state than any other thing we have.”
Cathy Cook is a news reporter at the Daily Lobo. She can be reached at firstname.lastname@example.org or on Twitter @Cathy_Daily.
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