School of Pharmacy The University of Mississippi National Center for Natural Products Research Medical Marijuana in Mississippi Larry Walker Director Emeritus NCNPR Cannabis and cannabinoids Medicinal benefits of Cannabis ID: 1041402
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1. Research Institute of Pharmaceutical SciencesSchool of Pharmacy, The University of MississippiNational Center for Natural Products ResearchMedical Marijuana in MississippiLarry Walker, Director Emeritus, NCNPR
2. Cannabis and cannabinoidsMedicinal benefits of CannabisEvolution and range of state Medical Marijuana programsComponents of a sound medical approachLegislative vs. administrative Medical Marijuana in Mississippi
3. More than 500 compounds discovered in CannabisMore than 120 “cannabinoids”: THC, CBD, CBG, CBC, etc.THC and CBD are of primary interest now medicallyTHC (D9 or D8) are psychoactive1. Cannabis and CannabinoidsPure THC
4. Nausea and vomitingAppetite stimulationMotor control, spasticitySeizuresPain perception and processingOthers?2. Potential Medical Benefits of Cannabinoids(at present, primarily THC or CBD) With any medical treatment:Dose matters!Delivery route matters!Product quality matters!Monitoring of benefitAssessment of risks
5. I-65 and SB 2765: Simple Medical QuestionsWhat is it? 2.5 oz of what? – buds, extract, solutions, gummies?THC content???Route of administration (smoking, vaping, dabbing, oral, topical)?Product promotionProduct quality and consistencyFormulation IndicationsDose level, frequencyRisk/benefit assessments (clinical trials)OutcomesAdverse events
6. Top end dosage 4 per day of 10 mg2.5 oz of MJ w 10% THCwould be equivalent to 700 of high dose Marinol capsules
7. 3. Evolution of State Medical Marijuana ProgramsFirst wave – ballot initiatives, 1996 – 19997 states, including CA, OR, WA, AZ, AK, NV, MEPrimarily smoking, legal protections, little attention to quality/sourceMost of these states are now recreational use statesEarly legislative initiatives, 2000 – 20088 more states during this period; others “decriminalized” medical usePatient registriesMore explicit allowances on source/suppliesExpanding variety of product types Revenue streams established in many states
8. Evolution of State Medical Marijuana Programs2nd generation legislation, 2009 – presentAnother 20+ states with comprehensive programsRegulation of growers, distribution, dispensariesMore medical care integrationGrowing focus on testing/labelingGrowing dependence on revenue streams Migration of many MM states to recreational (11)
9. 4. Components of a sound medical approachDesigned and run by MDOH w other agenciesRoles for physicians, pharmacists, health professionalsTesting consistent quality products in defined indicationsPatient registryDocumenting outcomes in an unbiased wayHelping patients in the process
10. 5. Legislative issues?Objectives medically and fiscallyResponsible agenciesLegal protections for patients, caregivers, health professionalsRevenue allocation by stateConsistency with other state laws
11. Or we COULD lead the nation with a medically sound program…We could follow everyone else… irreversibly We could hold out – another year or two? What about Mississippi?Three Possible Paths