State of the Science of Cannabis
Laws around cannabis in many parts of the United States are rapidly changing. This is partly due to shifting attitudes: the public is becoming more supportive of policies that decriminalize or legalize cannabis, because prohibition has not prevented access to the drug and has disproportionately harmed people of color and their communities (among others). There is also a widespread belief that cannabis is safe relative to other substances, and may have therapeutic benefits, leading 36 states plus DC to legalize its medical use; and 18 states plus DC to legalize it’s use by adults.
Cannabis is plant containing more than 120 cannabinoids plus other chemicals in varying concentrations. Two cannabinoids have received the most attention: delta-9-tetrahydrocannabinol (THC), responsible for the main psychoactive effects associated with marijuana; and cannabidiol (CBD), which is purported to have multiple therapeutic benefits and very low toxicity or addictive liability. Marijuana products available today are more potent than they were 20 years ago (often containing more than 15 or 20% THC in flower products, and more than 50% THC in concentrates); and CBD products are ubiquitous in the market, but remain unregulated by the FDA, and many of the purported medical benefits are untested.
Although more research is needed on both THC and CBD, we do know that cannabis containing mostly THC is associated with specific harms, many of which are exacerbated in users who start young and use it often. Cannabis can be addictive; it raises the risk of car crashes; it affects cognitive performance; it can precipitate or worsen the course of psychosis in vulnerable individuals; and it negatively affects life achievement and satisfaction. Also, because the endocannabinoid system (where cannabis acts) plays an important role in brain development, cannabis may pose specific risks for children and adolescents, and babies in utero. But there is still much we don’t know about cannabis, including the reversibility or persistence of its effects; the impact of higher potencies, and new formulations on addiction and other consequences; and the potentially beneficial effects of cannabis or cannabinoids, including CBD, for treating pain and other conditions.
This presentation will focus on the current state of the science of cannabis to provide a better understanding of how cannabis works in the brain (and body) to exert its diverse effects, and to identify critical research needs and opportunities, including those stemming from the changing cannabis policies.
- Cannabis is widely used, and its use is increasing with the permissive legal environment emerging in the US.
- Cannabis products and routes of administration are also changing rapidly, with potential for greater harms in some cases.
- Science of cannabis – its mechanisms of action and what is known about its short-and long-term effects in various populations.
- Potential therapeutic uses of various cannabis components, including cannabidiol (CBD).
- Implications of changes in US State policies related to marijuana legalization for medical or adult use.
Dr. Susan Weiss is the Director, Division of Extramural Research at the National Institute on Drug Abuse (NIDA), which oversees NIDA’s extramural programs, research training, operations planning, and trans-NIH initiatives, such as the Adolescent Brain Cognitive Development (ABCD) study. Dr. Weiss is also a senior science advisor to the NIDA Director. Previously, she served as the Chief of the Science Policy Branch and Acting Director of NIDA’s Office of Science Policy and Communications, where she provided leadership and oversight for all of NIDA’s interactions with its diverse stakeholders.
Prior to coming to NIDA, Dr. Weiss served as the Senior Director of Research at the National Mental Health Association (NMHA, now Mental Health America), where she applied her research and scientific expertise to the organization’s strategic planning, public education, and advocacy efforts. Before that, Dr. Weiss directed a translational research program in the Biological Psychiatry Branch of the National Institute of Mental Health (NIMH) that studied the evolving nature of psychiatric and neurologic illnesses with the ultimate goal of developing novel treatment options for patients with affective, anxiety, and substance use disorders.
Dr. Weiss has received multiple awards, including NIH Plain Language Awards, NIH and NIDA Director’s Awards, the Ziskind-Somerfeld Senior Investigator Award from the Society for Biological Psychiatry, and a Governor’s Award, Academy of Television Arts and Sciences (Emmy, 2007), for her contributions to the HBO Addiction Project. Dr. Weiss has published nearly 150 scientific articles and book chapters. She graduated from the State University of New York at Stony Brook and received her Ph.D. in Psychology from the University of Maryland.
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