Commentary: U. takes careful steps toward medical cannabis use

FILE - This Sept. 11, 2018, file photo shows blankets of frost known as trichomes on a budding marijuana flower at an artisanal cannabis farm SLOgrown Genetics, the coastal mountain range of San Luis Obispo, Calif. Liberal California became the largest legal U.S. marketplace, while conservative Utah and Oklahoma embraced medical marijuana. (AP Photo/Richard Vogel,File)

There is more that science doesn’t know about cannabis than what it does know. This includes CBD and THC, compounds in cannabis that may offer medical benefits.

There have been few high-quality scientific studies on cannabis. Most of what is offered as evidence for the medical benefits of cannabis is really a collection of subjective patient reports. These reports haven’t received scientific scrutiny — the kind of scrutiny that is standard in bringing prescription drugs to the U.S. Food and Drug Administration for approval. Lack of data makes it hard to recommend cannabis as either safe or effective.

Still, cannabis for medical use is now legal in Utah. It has been twice approved by Utahns — first by initiative and again by our elected representatives. A year from now, in March 2020, the state will determine exactly how medical cannabis is regulated and distributed.

At University of Utah Health, we’ve assembled a task force of physicians, scientists and legal experts to offer evidence-based guidance for all patients and health care providers. In accordance with state law, we determined our providers may issue recommendations for medical cannabis on a case-by-case basis to patients who are evaluated and diagnosed with a qualifying condition, and when a provider determines that the patient could benefit from treatment with medical cannabis.

When assessing whether to provide a recommendation, U of U Health providers are sympathetic to the difficult symptoms and medically complex issues that some patients face. Ultimately, their decisions will depend on many factors that require a comprehensive understanding of each patient’s overall health. For instance, providers must take into consideration possible interactions between medical cannabis and other medications, and whether other viable treatments exist.

Scientific evidence shows that products derived from cannabis can benefit some medical conditions. For example, cannabidiol, which comes from the cannabis plant, is FDA approved for treating certain forms of severe childhood epilepsy.

However, not much research has been done with whole plant cannabis because it is a controlled substance. And what we call medical cannabis is actually numerous pharmacologically active substances at unknown strengths, which means we know little about its health benefits and not enough about its health risks.

There is a lot we still need to learn about medical cannabis. As a major medical research center, it is our responsibility to fill in these knowledge gaps. Our providers will share what we know and what we don’t yet know about medical cannabis. (healthcare.utah.edu/medical-marijuana) Studies underway on our campus include determining how use of CBD to treat seizures affects the central nervous system and how it interacts with other drugs; imaging studies to determine the impact on the brain during adolescence; and analysis of health records to determine risks and benefits of using cannabis and its derivatives. Continued evaluation of the health effects of cannabis is warranted.

At University of Utah Health, our focus is on the health and well-being of patients and communities throughout the state. In this new era that includes legalized medical cannabis, we are committed to provide the best quality health care and to remain a trusted source of expert information.

Dr. Ed Clark | VP of Clinical Affairs, U of U Health, President of Utah Medical Group,

Ed Clark, M.D., is a pediatrician as well as associate vice president for clinical affairs at University of Utah Health and University of Utah Medical Group president.