George’s Corner: Marijuana (Oops: Cannabis)

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Some musings on perhaps the most popular Schedule I, legal in some states, illegal in the United States, drug.

Full disclosure: I am a Californian. I live in a rural farming area. I also chair a committee that advises the county regarding land use issues in our area.

As this is written, California is finalizing its implementation of a referendum that declared that the sale and use of recreational marijuana will be legal Jan. 1, 2018. It appears that the finalizing is rather tangled and there are a variety of versions of how it will work, confused by the fact that individual counties can declare their own rules in many matters.

It has become clear that polite society calls it cannabis.

In the early 1960s I was running a hospital pharmacy in Berkeley. A UC Berkeley student who worked there part-time asked me what I thought about marijuana. I said I saw it as a social drug not unlike alcohol. However, marijuana was new to society and alcohol has been around for a long time. So I asked her: How do you think society would react to alcohol if it were just now being discovered?

Years Later

Over 50 years later we are still trying to sort out the role(s) of this drug.

At a federal level we are in a prohibition state of mind. Product is being burned, people are going to jail. Bootleggers are all over the place. The historical comparisons are awesome.

As an aside, I have peripheral neuropathy. It hurts a lot of the time. My niece applied some of her marijuana ointment to the bottoms of my feet. They were less bothersome for the whole day.  I’ve used it several times since.

At the state levels there are several attitudes. It’s illegal and that’s that. It’s okay for “medical” purposes. Or, anybody older than XX can buy it, sell it, and use it — provided all of the taxes get collected. Of course, to collect taxes states and/or counties and cities need to have licensing systems and tax collection systems.

The Money issue

Of course the prices of drugs that are desired and have limited availability are high. There is a lot of money changing hands. That creates some interesting issues. In order to run a bank in the United States you have to have federal deposit insurance. But to get that, a bank needs to not process money that is, according to the federal government, from an illegal source. So banks won’t process marijuana money. The result is big bags of money in the trunks of cars looking for a money laundromat. And any time there are big bags of money, there are people who will be trying to get those big bags in nasty ways.

The science is bad. Bad, in that there isn’t much that the medical sciences understand about cannabis sativa. The primary reason is that the academic centers that develop this knowledge can’t do their thing. There are no National Institutes of Health (NIH) grants. And anyone who does study cannabis and who may later want an NIH grant is toast. To top it off, you might be able to do a study if you do go through all of the bureaucratic hassles to study it legally. However, there is only one federally approved source of cannabis, and the product is an old strain that is nothing like the potent stuff that is on the market today. So forget it. California, the sixth-largest economy in the world, a center of academic medicine, with a huge need to understand this drug, cannot begin to study it.

Other Challenges

Law enforcement also has a problem. They can measure alcohol concentrations. And they have clear definitions about how much is too much. We don’t even know what to measure in cannabis, much less how to measure it, and how much is too much to say that someone is stoned on marijuana.

Growing it is a challenge, even though it is a common weed. (Hence, one of its names, “weed.”) Finding a place to grow it is problematic. Illegal grows have to be in remote areas so they won’t be easily found. Rural legal grows do not need to be remote, but they do have to deal with neighbor issues and crop thieves. Neighbors say the plants smell bad, fences look bad, private security methods can be dangerous, greenhouse lighting is too bright at night, and “I don’t like the stuff.”

Dosing has always bothered me. The strength of street drugs is always an issue. Cannabis is problematic because it has more than one pharmacologically active chemical. And each of them has a different profile. Work is being done on sorting this out, but not in the places where it should be done. (See an above paragraph about the science issues.)

Do you remember all of the talk about track and trace in the drug industry? There is talk about doing that with cannabis. Trim off some of the plant, put it in a little bag, and tag the bag. It gets assayed, and the assay stays with that handful until a final product is sold to the user. Good luck with that one.

Unanswered questions

The thing that fascinates me is trying to guess what the industry will look like in five years. What will its farming, distribution, testing, marketing, labeling, and retail selling system be? And what will be its retail prices? Will it be a huge industry dominated by a few companies, as with the tobacco industry? Will it be a cottage industry like it is now? Will it be like beer, with several big brewers and many small boutique brewers? And, of course, what will be the solution for the banking problem?

Those of us in the pharmacy world think our economics, laws, and regulations are a mixed salad. The cannabis economics, laws, and regulations are a salad still being tossed.

As for me, I am going to restrict my use to my feet. My preference is a social drug that I grew up with, that I understand, and that I can and do control: Jack Daniels. CT

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