The national illegality of marijuana makes studying difficult and the Wisconsin study banning it is hard to get for people who depend on it for treatment.
After four decades of using powerful prescription medications to treat Crohn's disease, a chronic digestive disorder, Patty has developed an aggressive form of skin cancer.
"It's because my body has been removed for so long, it can not fight cancer," said the Wisconsin resident.
Patty, who has been working at her father's restaurant for 27 years, is now struggling to take on full-time jobs.
"I'm trying to get a disability, but I've already been denied once.I do not plan to stop working.I just need help.J & # 39; I need help because I can not work full time, "Patty said.
In March 2017, a friend who lives in New Mexico, where medical marijuana is legal, posted her Buddha Tears, a cannabis oil product containing cannabidiol (CBD), and THC, the component psychotropic cannabis. After consuming a tiny amount of oil each day, as well as smoked marijuana, Patty said that she had found a noticeable improvement in her condition.
"Unfortunately, I have to smoke every day, because if I do not do it, I'll be in the bathroom all the time," said Patty, who asked that her last name not be published because she uses an illegal substance.
But these days, Patty is again struggling with symptoms.
"My connection (for CBD and marijuana) has been cut off," she said. "I am very angry."
While Patty and others have successfully treated their medical problems with cannabis, the drug remains illegal in Wisconsin.
And because of its Schedule I drug status – the most restrictive classification – little research has been conducted in the United States on its effectiveness as a drug. The US Food and Drug Administration has authorized a cannabis component to treat serious and rare convulsions, as well as three drugs containing synthetic cannabis-based substances; no other use has been approved.
Although it remains illegal at the federal level, 33 states and the District of Columbia authorized the medical use of cannabis. A bipartisan group of legislators proposed to legalize it for medical purposes in Wisconsinand another group of Democratic legislators introduced a bill in October to decriminalize possession of less than 28 grams. But Senate Majority Leader Scott Fitzgerald, R-Juneau, remains opposed.
A survey conducted in April by the Marquette Law School Poll revealed that 83% of registered voters surveyed were in favor of using marijuana for medical purposes with a doctor's prescription.
"When registered voters in Wisconsin support more than 70 percent of the problems, the legislature must listen and act," said Rep. David Bowen, D-Milwaukee.
According to Dr. Angela Janis, Director of Psychiatry for University of Wisconsin-Madison Health ServicesSchedule I drugs, including marijuana, are considered to have no currently accepted medical use and have a high potential for abuse, while for Schedule II drugs, the potential for abuse is less and there is a therapeutic benefit.
Janis knows this distinction very well. In addition to her academic work, Janis is Chief Medical Officer at LeafLine Labs, a medical marijuana company based in Minnesota.
"To give you an idea: Methamphetamine is listed in Schedule II because it is approved for obesity." Cocaine is listed in Schedule II because it is approved for nasal surgery because it can tighten the blood vessels during nose surgery.Therefore is the bar for what is medical benefit, "said Janis.
According to Janis, cannabis has a lower potential for abuse than any of these substances.
"Cannabis is not programmed properly, and it's one of the obstacles, but not the only one, to research," Janis said.
Janis recommends reprogramming the drug so that researchers can deepen its properties. same Smart approaches to marijuana (SAM), who opposes the legalization of marijuana, supports "totally" cannabis drugs that have been approved by the FDA, said Colton Grace, a spokesman for the group.
How marijuana works in the body
According to National Institute for Combating Drug AbuseCannabinoids are substances found in cannabis plants that act on specific receptors in the human brain and body. These are the main active ingredients in medical products derived from cannabis.
These receptors affect many essential functions, including memory, thinking, concentration and coordination. Interfering with it can have profound effects, both positive and negative.
Delta-9-tetrahydrocannabinol (THC) and CBD are two of the most studied cannabinoids. However, there are dozens of cannabinoids that can also have medical uses.
"Many cannabis strains can contain 60, 70, 80 cannabinoids that interact in different ways," Janis said.
The National Institutes of Health announced that it has spent $ 191 million on cannabinoid research for medical use in 2017-18.
Some effects are already known. For example, THC can affect the central nervous system, producing benefits such as decreased vomiting and nausea, increased appetite, reduced pain and anti-inflammatory effects. CBD also acts as an anti-inflammatory, increasing immune function, reducing pain and preventing certain cells from proliferating.
Cannabinoid receptors are not found in areas that control breathing, which explains the absence of fatal overdose of marijuana, Janis said. CBD actually blocks the psychotropic effects of THC, said Janis.
In addition to all these cannabinoids, the sativa cannabis plant has a lot of other chemicals. For example, terpenes, which give each variety its particular smell, such as lemon or pine, "would have a lot of effects, but we do not know what they actually do in the body," Janis said.
An effective treatment against pain
In 2017, the National Academies of Science, Engineering and Medicine have published one of the most comprehensive reviews of scientific research on what we know of health effects of cannabis and derived products. The committee reviewed over 10,000 scientific abstracts. It resulted in nearly 100 findings and found substantial evidence for only a few indications, the most important being pain.
According to the report, there is substantial evidence that cannabis is an effective treatment for chronic pain in adults, particularly nerve pain, Janis said.
The group also found conclusive evidence of cannabis treatment of nausea and vomiting associated with chemotherapy and muscle spasm associated with MS.
The report also showed moderate evidence that cannabis or cannabinoids are effective at improving sleep in people with sleep apnea, fibromyalgia, chronic pain and multiple sclerosis.
He also found limited evidence that cannabis was effective in increasing appetite and decreasing weight loss associated with HIV / AIDS, muscle relaxation and pain related to MS, symptoms of Tourette, anxiety and post-traumatic stress disorder (PTSD).
Anecdotal evidence has also proven the effectiveness of cannabinoids in the treatment of Rett syndrome.
Norah Lowe, 10, began to feel relief after a rare neurological disease a year ago, when she started using CBD to treat her symptoms. Rett syndrome affects almost every part of a child's life, including his ability to speak, walk, eat and breathe. A distinct characteristic of the condition is the almost constant repetition of the movements of the hand.
Norah, who uses a wheelchair, experienced "increased flexibility, decreased pain and muscle cramps, increased communication, cognitive abilities, reduced seizures, better mood control, and so on. "said his father, Josh Lowe.
At a press conference organized by state representative Melissa Sargent, D-Madison, to present her latest bill aimed at legalizing marijuana for medical and recreational purposes, Lowe said that He was frustrated that state law prohibited Norah from trying marijuana for medical purposes, which helped other people with this disease. .
A 2017 study published in the Cochrane systematic reviews database analyzed several studies, concluding that cannabis-based drugs were better than placebos for pain relief – and that these drugs also improved sleep and psychological distress – he concluded their adverse effects may be greater than their adverse effects.
According to the Marijuana Policy Project, the most common conditions Accepted by states that allow cannabis for medical purposes are the relief of symptoms of cancer, glaucoma, HIV / AIDS and MS. Other common indicators include Alzheimer's disease, inflammatory bowel disease, Crohn's disease, Parkinson's disease and PTSD, according to the group, which advocates the legalization of marijuana.
In addition, the University of Michigan published a study in the February issue of Health Affairs understand why people use cannabis for medical purposes and whether these purposes are based on evidence.
The authors found that 85.5% of medical cannabis uses were for conditions for which there was substantial or conclusive evidence of therapeutic efficacy. Even more, they found that chronic pain is currently the most common qualifying condition reported by patients treated with medical cannabis. It was used by 64.9% of these patients in 2016.
"It's a good sign," says Janis. "Even though a doctor can write it (a cannabis prescription) for a variety of things, it seems to be used for what it's intended for."
Barriers to research continue
As cannabis is an Annex I drug, it is "very difficult to study at any institutional level" because, to do this, researchers need the approval of the US Drug Enforcement Agency, which "has not always wanted to provide them," said David Abernathy, vice president of data and government affairs for the United States. Arcview Group, a company that advises investors in the cannabis industry.
For this reason, "things like placebo-controlled, double-blind clinical trials were not happening in the United States," said Abernathy. But there has been a lot of research over the past decade in other countries, including Israel, Canada, China, and Italy, and "we are now starting to see more research in the United States. Unis", a-t-il déclaré.
L'examen de la recherche sur le cannabis mené par les académies nationales en 2017 a confirmé que le statut de la drogue en tant que substance de l'annexe I rendait son étude difficile. "Les chercheurs ont également souvent du mal à accéder à la quantité, à la qualité et au type de produit à base de cannabis nécessaires pour traiter des questions de recherche spécifiques", a révélé la revue.
Patty, la patiente de Crohn, pense que son traitement au cannabis a non seulement atténué les symptômes de son Crohn, mais elle lui attribue également le maintien de son cancer agressif de la peau.
According to one Article de 2018 publiées dans Biochemical Pharmacology, des études ont montré le potentiel des cannabinoïdes pour réduire la progression du cancer de la peau. Cependant, il y a un manque significatif d'études cliniques suffisamment prometteuses pour faire des déclarations concluantes pour le moment.
"Je n'ai pas eu l'huile de cannabis depuis mars 2018, et une fois que je ne pouvais plus en obtenir, je veux dire, je viens de terminer ma 12e opération (pour un cancer)", a déclaré Patty. "Alors, tu me dis, qu'est-ce que tu en penses?"
Cette histoire a été produite dans le cadre d'une classe de reportage d'investigation à l'école de journalisme et de communication de masse de l'Université du Wisconsin-Madison, sous la direction de Dee J. Hall, rédacteur en chef de Wisconsin Watch. Les collaborations de Wisconsin Watch avec des étudiants en journalisme sont financées en partie par Ira et Ineva Reilly Baldwin Wisconsin Idea Endowment à UW-Madison. L'association à but non lucratif Wisconsin Watch (www.WisconsinWatch.org) collabore avec la radio publique du Wisconsin, la télévision publique du Wisconsin, d'autres médias et l'école de journalisme et de communication de masse UW-Madison. Toutes les œuvres créées, publiées, postées ou diffusées par Wisconsin Watch ne reflètent pas nécessairement les vues ou opinions de UW-Madison ou de ses sociétés affiliées.
La liste des médicaments à base de marijuana approuvés par le gouvernement fédéral aux États-Unis est courte
La Food and Drug Administration des États-Unis n’a approuvé que quatre médicaments contenant des produits liés au cannabis; d'autres pays ont approuvé plus.
Le débat sur les effets du cannabis sur la santé se polarise depuis de nombreuses années. Ce n’est qu’au cours des deux dernières décennies que la substance a été légalement utilisée à des fins médicales. Il existe actuellement quatre produits médicamenteux liés au cannabis approuvés par la US Food and Drug Administration.
Ce sont Marinol, Syndros et Cesamet, qui contiennent des cannabinoïdes synthétiques; et Epidiolex, le premier médicament contenant du cannabis approuvé par la FDA.
Marinol a d'abord été approuvé pour traiter les nausées et les vomissements provoqués par la chimiothérapie anticancéreuse, mais comprend désormais le traitement de la perte de poids et de l'anorexie chez les personnes séropositives. Par conséquent, le médicament est un médicament de l'annexe III, ce qui signifie qu'il a un usage médicinal accepté. Syndros a été approuvé pour les mêmes indications que Marinol.
Cesamet imite les effets du THC, l’ingrédient psychotrope du cannabis. Il a été approuvé pour le traitement des nausées et des vomissements associés à la chimiothérapie. Il s'agit donc d'un médicament de l'annexe II.
Epidiolex est approuvé par la FDA pour le traitement des convulsions associées au syndrome de Lennox-Gastaut et au syndrome de Dravet, deux formes d'épilepsie sévères et difficiles à traiter. Epidiolex est un médicament de l'annexe V, la classification la moins restrictive de la Loi sur les substances contrôlées.
Certaines drogues dérivées du cannabis ne sont pas encore approuvées aux États-Unis, notamment le Sativex, une combinaison de THC et de cannabidiol.
Sativex combine des quantités égales de THC et de CBD provenant de deux extraits de cannabis. This product, which is sprayed inside the cheek or under the tongue, has been approved to alleviate the symptoms associated with multiple sclerosis, including muscle spasms and neuropathic pain. Sativex has been approved in 25 countries outside of the United States, including Canada and the United Kingdom.
The Cannabis Question is a series exploring questions about proposals to legalize marijuana in Wisconsin.