West Virginia’s medical cannabis program is designed to treat a specific list of chronic and terminal conditions, but a proposed limit could significantly curb the plant’s strength.
On September 8, the Medical Cannabis Advisory Board will hear a proposal to cap the THC in the state’s medical cannabis products at 10 percent.
The Advisory Board was created by the 2017 Medical Cannabis Act to advise the legislature by examining and analyzing cannabis laws inside and out of the state.
Dr. Libby Stuyt is an addiction psychiatrist in Colorado. She presented the science to the board’s Health and Medical Workgroup meeting on August 17.
“When you’re talking about medicine, we have to treat it like medicine,” she said. “I think we really have to follow the science related to what is determined to be medicine.”
Stuyt drew from multiple clinical studies to show there is no evidence that THC levels over 10 percent pose any medical benefit.
“The only reason to have higher potency is to get high,” she said. “That’s the only reason; I mean, there’s no documented medical benefit. And in fact, the documentation shows that the higher potency may be less medically impactful.”
Stuyt is referring to a clinical study published in the November 2007 issue of the medical journal Anesthesiology, just one of several empirical studies she referenced in her presentation.
While medical cannabis patients and advocates may not have rigorous double-blind research to back up their claims, they do have their own lived experiences with the plant’s effects on their conditions. They argue such conclusions on the efficacy of medical cannabis are based on decades of misunderstanding and limited research.
Rusty Williams is the state’s patient advocate on the medical cannabis advisory board.
“I always say 100 years of bad information is extremely hard to undo,” Williams said. “And when we’re talking about this plant, that’s what we’re up against. So education is the key to all of it.”
He became an advocate for medical cannabis in West Virginia after his own battle with cancer and experiences with chemotherapy.
“It’s important to note that I can only speak to my personal experience as a cannabis patient,” Williams said. “When I was going through chemotherapy, cannabis wasn’t legal here. I was using illegal cannabis to get through it and the lower the THC, or the lower the potency, the more I had to consume to get the desired effect.”
Williams points out that as a Schedule 1 drug, the federal government does not recognize any medical benefit of cannabis. That scheduling has significantly restricted opportunities to study the complexities of cannabis for decades.
As the plant and its derivatives have become more available in West Virginia over the past several months, Williams has consistently heard patients firsthand accounts that high-dose THC products alleviate their symptoms.
“I understand that there are some people that high THC levels do affect negatively,” Williams said. “But there’s also a ton of patients out there that need those high THC levels. So why are we trying to cap and bring, you know, and basically put all of the products on the exact same level, when we know for a fact that the medical efficacy of high THC is effective for a lot of folks.”
THC is just one of the hundreds of compounds that cannabis naturally produces. While THC is the plant’s main psychoactive component, patients say the relief they receive comes from a combination of all the compounds combined, called the “entourage effect”.
Amanda Vezinat is a military veteran who was drawn back to West Virginia by the medical cannabis industry.
“There’s so much to learn,” she said. “We’re still learning on a daily basis what you can do with cannabis. We’re learning about different cannabinoids on a daily basis.”
Vezinat treats her service-related injuries and conditions with medical cannabis.
“I do know the difference that makes, and putting a 10 percent THC cap on patients, that’s going to take away medication that we need,” she said. “Cancer patients aren’t going to get anything out of it. We’ve watched patients die waiting for this program who never got relief, and now we’re bringing relief to patients. I don’t know, it seems kind of cruel to take that away from them.”
Vezinat works for Armory Pharmaceutical, one of ten companies licensed to grow and produce medical cannabis in the state. She says her company and others are eager to carry out clinical studies and trials to learn more about cannabis.
But there is concern in the industry that a 10 percent cap wouldn’t just limit patients’ access to effective treatment, but functionally remove access to medical cannabis altogether in West Virginia.
“You got a bunch of companies that just sunk millions of dollars into facilities, they just threw away money,” Vezinat said. “You cap this 10 percent THC and the majority of everything that’s been put out, pretty much everything that’s been put out right now, it’s gonna have to be destroyed, they’re gonna have to start again.”
Vezinat and Williams both fear that many companies won’t start again, choosing instead to cut their losses rather than reinvest in a capped market. The same federal restrictions on cannabis that limit scientific research also limit the tax breaks companies involved in the industry can take.
“It’s not like other businesses,” Vezinat said. “Regular businesses that are federally legal, they can deduct their business expenses and you do not have that in the cannabis industry. You’re already losing money in a way in the industry since you can’t deduct those expenses. Now you’re going to ask them to take a bigger loss.”
The proposed cap still has several steps of bureaucracy it has to wind its way through before it becomes law. If the Medical Cannabis Advisory Board chooses to accept the proposal Thursday, it will then go to the legislature, adding more months of uncertainty in the fledgling medical cannabis program.