Cannabis—Bridging gaps between science and policy to embrace cannabis in modern medicine​

In a special themed issue of Clinical Therapeutics, published by Elsevier, experts review multiple issues at the intersection of cannabis research and regulation with the goal of shining a spotlight on its therapeutic potential. Cannabis is currently the most used psychoactive substance under international control with an estimated 209 million users as of 2020 according to The United Nations Office on Drugs and Crime. Its pervasiveness worldwide presents unique challenges to regulators, researchers, and clinicians.

Guest-edited by Julie K. Johnson, PhD, Director of Research, and Alexander Colby, Research Analyst, from the Massachusetts Cannabis Control Commission (Commission), this special issue taps into the expertise of scientists and policymakers across the world and discusses critical opportunities of cannabis legalization to maximize benefits, minimize risks, and potentially lead to cannabis-based medicines for the treatment of medical conditions that remain challenges for 21st-century medicine. Those conditions range from chronic pain, spasticity, cancer, and seizure disorders, to nausea, anorexia, and infectious diseases.

Cannabis has been used for its therapeutic properties from ancient to modern-day civilizations, but its controversial history makes it a contested option for medicinal purposes today despite the advancement of scientific knowledge on it in recent years. To date, approximately 30 countries and 38 states of 50 in the United States have legalized the use of cannabis for either medical or recreational uses. This proliferation of cannabis legalization has led to a spectrum of different policies and healthcare practice(s) across jurisdictions and cultures worldwide, warranting assessment of the learned and hypothesized health effects in order to enact evidence-based policies.

In a commentary on the history of the therapeutic use of cannabis, Dr. Johnson outlines the history of medical use and the discoveries of the endocannabinoid system and key cannabinoids along the way. She also highlights the need for increased dialogue between researchers and regulators to ensure sound policies that protect and maximize the health of users and citizens alike. “Irrespective of what side of the debate people are on, cannabis legalization and the increased interest in cannabis’ therapeutic use are growing worldwide,” Dr. Johnson notes. “To maximize benefits and minimize risks of legalization, it is imperative to expand cannabis research and bridge the silos between policy and science, to encourage stakeholders to work together to guide best practices.”

This issue of Clinical Therapeutics identifies and discusses several key issues for researchers and regulators, including:

• Endocannabinoid system and potential for therapeutic use
• Preserving existing medical cannabis programs in the era of recreational use policies
• Prescribing guidance to inform clinical decision-making around medical cannabis
• Adolescent cannabis use and neurodevelopment
• Veterans’ health and cannabis use
• Cannabis ‘social clubs’ and the future of social consumption
• War on Drugs and social equity implications in legalization

Dr. Johnson concludes with a discussion of what this all means for the future of cannabis, and where things are headed next: “Cannabis legalization is complicated and there is no ‘one size fits all’ policy or cannabinoid product profiles for therapeutic efficacy,” she writes. “For future success in legalization, it is critical to both expand clinical and applied cannabis research, as well as better connect research and policy.”

Dr. Johnson’s work at the Commission has focused on merging academia and policy by bringing diverse stakeholders together and publishing for a variety of audiences to advance cannabis policy research. The Commission’s robust legislative research agenda, outlined in St. 2017, c. 55, § 30(f) and St. 2017, c. 55, § 62, was established to both understand and monitor the social and economic trends of cannabis use in Massachusetts and inform future decisions that would aid in the closure of the illicit marketplace. To learn more about how Dr. Johnson and her team have executed their state’s research mandate, visit MassCannabisControl.com/Research. Commission reports are also available for the public’s review at MassCannabisControl.com/PublicDocuments/Reports.

---

Notes 
Clinical Therapeutics Themed Issue: Cannabis Research and Policy: Therapeutic Potential of Cannabis in Modern Day Policy and Clinical Practice
Guest Editors: Julie K. Johnson, PhD, and Alexander Colby, MA (Massachusetts Cannabis Control Commission)

The articles appear in Clinical Therapeutics, volume 45, issue 6 (June, 2023), published by Elsevier. All articles in this themed issue are openly available at www.clinicaltherapeutics.com. 

Data from The United Nations Office of Drugs and Crime (UNDOC). Drug Market Trends: Cannabis and Opioids. Austria; 2022.

About Clinical Therapeutics
Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition to feature articles published monthly, each issue of Clinical Therapeutics features a specific theme section dedicated to an annual update of a specific topic area. A special guest editor will comprise each update with reviews, commentaries, and original research highlighting what’s new or controversial in the topical specialty. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases. www.clinicaltherapeutics.com

About Elsevier
As a global leader in information and analytics, Elsevier helps researchers and healthcare professionals advance science and improve health outcomes for the benefit of society. We do this by facilitating insights and critical decision-making for customers across the global research and health ecosystems.

In everything we publish, we uphold the highest standards of quality and integrity. We bring that same rigor to our information analytics solutions for researchers, health professionals, institutions and funders.

Elsevier employs 8,700 people worldwide. We have supported the work of our research and health partners for more than 140 years. Growing from our roots in publishing, we offer knowledge and valuable analytics that help our users make breakthroughs and drive societal progress. Digital solutions such as ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath support strategic research management, R&D performance, clinical decision support, and health education. Researchers and healthcare professionals rely on over 2,800 digitized journals, including The Lancet and Cell; our 46,000+ eBook titles; and our iconic reference works, such as Gray’s Anatomy. With the Elsevier Foundation and our external Inclusion & Diversity Advisory Board, we work in partnership with diverse stakeholders to advance inclusion and diversity in science, research and healthcare in developing countries and around the world.

Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers.