What we don’t know on medical marijuana (a lot)

Although Colorado has become a popular destination for families seeking medical marijuana to treat children’s seizures, that state’s public health chief has some strong words of caution for parents.

Dr. Larry Wolk
Dr. Larry Wolk

Dr. Larry Wolk, executive director of the Colorado Department of Public Health and Environment, told GHN he empathizes with the families, but he cautioned that more data are needed on the safety and efficacy of cannabidiol (CBD) oil, a non-psychoactive marijuana derivative, to treat seizures in children.

“We still don’t know if this works,” Wolk said. “We hear about cases anecdotally where it is effective. But nobody covers the cases that are ineffective. We need to do research.”

Colorado, which legalized medical marijuana in 2000 and recreational uses in 2013, has become a mecca for Georgia families seeking CBD oil to help their epileptic children whose frequent seizures have not been relieved by currently marketed medicines. Some families have moved to the state to gain access to the oil.

During the 2014 Georgia General Assembly session, state lawmakers — motivated by the pleas of desperate families — made an unsuccessful attempt to pass legislation legalizing CBD oil in the Peach State.

On Thursday, Gov. Nathan Deal offered an alternative. He authorized Georgia Regents University of Augusta (GRU) to set up two clinical trial programs of CBD oil for treatment of pediatric epileptic seizures. He also pledged state funding to support the initiative.

It’s an incremental step, he acknowledged. “The two pathways,” he told reporters, “will not provide immediate relief” and will require months to establish.

The medical marijuana legislation was one of several health-related measures that failed after intense debate in the Legislature this year, resulting in vocal criticism from many members of the public.

Gov. Nathan Deal
Gov. Nathan Deal

Among those unsuccessful bills was an attempt to privatize the state’s foster care system. In his remarks Thursday, Gov. Deal, a Republican who’s running for re-election this year, announced that the Department of Human Services will establish a pilot program in two regions of the state to study the viability of creating public-private partnerships to help improve the foster care program.

Colorado’s Wolk told GHN he has seen a big percentage increase in the number of children who have come to the state to get CBD oil. But he noted that children are only a small percentage of the people who use medical marijuana.

His state’s medical marijuana registry, he said, has 275 kids and 170,000 adult registrants, and that most of these people are using marijuana itself, not CBD oil or other derivatives, to control pain.

Wolk, a pediatrician, has been advocating for research studies not only on CBD oil, but on other medical uses of marijuana.

He asked the state for $10 million, generated from medical marijuana fees, to conduct observational studies in partnership with Colorado academic

If Wolk gets the funding as expected in July, he said observational studies, which are not clinical trials and do not require FDA approval, could begin in January 2015 and that he could have data in six months.

Studies of CBD oil, he said, would examine the percentages of THC (the psychoactive ingredient in marijuana) in relation to the non-psychoactive CBD.

Currently, he noted, “Nobody is required to represent what the active milligram strength is. It’s supposed to be low in THC and high in CBD. But we don’t know.”

In addition, the studies should yield important short-term data. “We can assess whether the oil affects high blood pressure, high cholesterol or harms the liver,” he said.

Wolk also said the researchers could conduct electroencephalographies (EEGs) of children’s brain activity to prove the CBD oil is working.

“No one has done EEGs” on such children, Wolk said.

In fact, he suggested, the CBD oil studies would provide the first data ever on the safety and efficacy of the treatment for children with seizures.

In meantime, GHN asked Wolk what advice he would give to families in Georgia that are desperately trying to find some relief for their children.

“I tell people to make sure they are fully informed,” he said. “Be wary of the ‘miracle cure’ label.”