CONTACT Seeking clarity from Dr. Sanjay Gupta on marijuana

Many people have asked for comment about Dr. Sanjay Gupta’s mea culpa yesterday regarding his views of marijuana as medicine. I will be featured in a segment of his upcoming documentary on the subject and will reserve judgment until I view it.

However, I’m concerned about the lack of clarity and inaccuracy of news coverage and interviews that already have led up to this broadcast. They underscore the need for public education — and professional education for journalists and physicians.

Perhaps Dr. Gupta should be apologizing if he already has not recognized what physicians and medical researchers who specialize in addiction research and treatment have for many years: there are potential medical benefits from the constituents, or ingredients — there are more than 80 of them — in cannabis. They should be researched, and they are being researched. They should be developed the right and responsible way into medications that stand the rigor of qualified researchers and, ultimately, receive the approval of the United States Food and Drug Administration.

Medications derived from cannabis that meet these standards already are on the market. The latest, an oral spray made from two ingredients of the plant and called Sativex, is scheduled to receive FDA approval in about a year. Sativex — like the other cannabis-dervied medications on the market — effectively treats problems without making its users high and does not require them to smoke anything.

Smart Approaches to Marijuana (Project SAM), a nonprofit I help to direct, explains what cannabis-based medicines and their development should look like. The organization also does a nice job of explaining the drug-scheduling process in the United States. I am troubled by broadcasts and interviews Dr. Gupta has given, challenging the U.S. Drug Enforcement Agency’s classification of marijuana. His comments include this one:

“I also looked closely at the DEA’s scheduling policy,” he said on CNN. “They classify marijuana as a Schedule I substance. It is in the category of the most dangerous substances out there. And when I looked carefully at that, I found there was really no scientific evidence to say it was that dangerous, that it had high abuse potential and that it had no medical applications. I believe it does have medical applications.”

I encourage Dr. Gupta — and anyone else reading this — to learn more about drug scheduling in the United States, which Project SAM does a nice job of explaining here. Rescheduling marijuana is not necessary for more research, and it would do nothing to bring more cannabis-based medications to market.

And, naturally, I’m troubled by his assertion that marijuana doesn’t appear to have high abuse potential, when 6 percent of high school seniors in the United States use the drug daily — and when marijuana is the No. 1 reason adolescents in this country are admitted for addiction treatment.

Again, I look forward to watching Dr. Gupta’s documentary — I met with field producers and did not meet him — soon. I hope this work clearly distinguishes between responsibly developed, cannabis-based medication and smoked marijuana. I hope it clearly explains how medical marijuana is actually delivered to most of its patients, who report ill-defined “chronic pain.” I hope it explains that the medical marijuana movement is largely funded by people positioned to launch the recreational marijuana industry (People who have been hard at work for decades to sow the seeds of confusion that now reigns supreme in our country. See this video from a 1993 conference of recreational drug users.). I hope it thoroughly explains how medical marijuana has affected children and child mental health — and how the harm to them is continuing to mount. I hope it adequately connects the practice of medicine to the legitimate and profound problems for public health and safety that we’re already chronicling. These problems are the reasons physicians with strong backgrounds in public health policy — such as those at the American Society of Addiction Medicine, the Association for Medical Education and Research and the American Academy of Pediatrics — are now speaking out more boldly against marijuana legalization in its current and proposed forms in the marketplace.

It is imperative that someone with Dr. Gupta’s reputation and media platform make all of these distinctions with great care and tremendous clarity.

In the meantime, here is a statement from Project SAM that represents my views well:

“Dr. Gupta is a medical professional we highly respect, whose judgment and views are listened to by millions of Americans. But his turnaround on marijuana seems to be based on marijuana’s potential medical value, rather than on a desire to legalize marijuana outright.

“So far as we know, Dr. Gupta has not endorsed legalization, a policy all major public health groups, including the American Medical Association and American Public Health Association, also do not endorse. Project SAM opposes legalization primarily because of the new Big Marijuana industry that will commercialize the drug for profits.

“In this country, there is major confusion between the medicinal application of the constituents in marijuana (e.g. CBD, a non-intoxicating element found in marijuana) and the use of smoked, street-bought marijuana consumed for the purposes of getting intoxicated (which is uniformly high THC/low CBD).

“We are troubled that some of CNN’s coverage of Dr. Gupta’s views muddies the water on this issue. For example, a headline stemming from Dr. Gupta’s upcoming documentary on CNN.com is ‘Marijuana stops child’s severe seizures’. However, this story is about a child who is benefiting from a non-smoked marijuana extract that does not get her high because it does not contain marijuana’s active ingredient, THC. Because most Americans think of marijuana as the THC-filled, smoked substance, this headline is misleading. It would be like broadcasting, ‘Opium cures pain for millions of people,’ instead of acknowledging that Morphine, an extract of opium, is the substance at play.

“Just because marijuana is a Schedule I drug, it does not mean that medicines based on certain parts of the marijuana plant cannot be approved in the United States. We fully agree with Dr. Gupta that the medicinal value of marijuana should be studied to develop pharmacy-obtained, legitimate, standardized, non-smoked medications.

“Dr. Gupta is a person America looks up to with high esteem — and for good reason. He is thoughtful, thorough, and dispassionate about the science. That is why we are troubled by how people might interpret his comments: as a license to support legalization, when in fact, it appears that he is simply arguing for the need to study marijuana’s medicinal value and end the demonization associated with marijuana. Project SAM agrees with those ends too, and urges the media to correctly cover this story.

About Chris Thurstone

Dr. Christian Thurstone is one of about three dozen physicians in the United States who are board certified in general, child and adolescent and addictions psychiatry. He is medical director of one of Colorado’s largest youth substance-treatment programs and an associate professor of psychiatry at the University of Colorado Denver (UCD), where he conducts research on youth substance use and addiction and serves as director of medical training for the university’s addiction psychiatry fellowship program.

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