The case was as sad and as tragic as we’ve seen in metro Denver in recent memory.
A man, supposedly stoned on marijuana-infused candy, flipped out and killed his wife with a gunshot to the head while their three children were in their Observatory Park house. Or so the story goes.
Yet, recent court testimony from cops was that Richard Kirk had “low” THC levels, a psychoactive ingredient in marijuana, when tested five hours after the shooting. How in the world does that square with a guy who was said to be hallucinating and subsequently asked his 7-year-old son to kill him?
If it was alcohol at work, there would be loads of research to call upon that could explain human behavior associated with its use. Unfortunately, that is not the case with marijuana.
The paucity of research — good, scientifically valid research — is a problem that will only get worse unless the federal government eases regulations constricting research, much the same way it loosened restrictions on the banking industry and how it handled money generated from marijuana businesses.
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“We can figure out pretty precisely the extent to which alcohol can have an impact,” said Stan Garnett, Boulder County district attorney, who has followed the Kirk case closely, though he is not working on it. “The situation with marijuana is completely different because there has not been much research.”
Obviously, said Garnett, when you have a murder involving marijuana and you don’t know the nuances of how it affects people, that’s a real problem.
Those nuances are something Kari Franson, associate dean for professional education at the University of Colorado’s Skaggs School of Pharmacy, has spent some time studying. And not just here in the U.S., but in the Netherlands where she said she was able to conduct clinical marijuana trials.
For instance, she said a woman’s estrogen status has an impact on her sensitivity to THC, an important psychoactive substance in marijuana, but not the only one. Women are more sensitive to marijuana until they go through menopause, Franson said.
It is fascinating information that has potentially important public policy implications when considering how much a person can safely consume prior to driving, for instance.
Franson agrees heartily that more research is needed to examine how marijuana affects people. As for the Kirk case, and the report that he had low THC levels, she said tolerance could be a salient issue.
“If he was truly naïve and was not a frequent user of the drug, he would not be tolerant to it and would require lower doses of the drug,” she said.
In fact, when she worked in the Netherlands, Franson said, researchers did not want first-time users in their studies because of the sometimes erratic nature of their reactions.
There are many variables to consider, including different strains of marijuana (which are not created equal), marijuana potency, personal body chemistry, weight, and the drug’s interaction with other substances that a person might have ingested.
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While marijuana is often compared to alcohol, Franson said she found the comparison ill-suited. She said it’s more like morphine. For both drugs, first-time users don’t need much to feel it. But over time, far more is needed to get the desired effect.
That would explain why some of Colorado’s medical marijuana users report having to consume massive amounts to knock down pain. But how does that affect a person’s ability to, for instance, safely drive a car?
While heavy users will tell you they believe they are competent behind the wheel, we need to see the studies — the highly-controlled clinical studies — that show that to be the case. It’s an issue that is too important to public safety to rely upon anecdotes or studies of questionable integrity.
“We don’t know very much about chronic users and tolerance versus the naïve user,” said Paula Riggs, a psychiatry professor at the University of Colorado’s School of Medicine. She is a big proponent of better research to inform marijuana public policy.
Before using a study to make decisions on public health and safety policy, it’s imperative to assess and understand the difference between the different types of research in order to understand their value, she said.
Two types of studies
A clinical trial is one in which those participating are highly monitored. Their doses are controlled, as are other variables. An observational study, while still valuable, would rely on recording the conditions of those who came into an emergency room stoned, for example. The issue that sometimes arises with observational studies is that a patient’s other conditions could affect the results.
“The barriers to good studies are myriad,” Riggs said.
Too often, existing studies are not well replicated by other researchers or there are other factors involved that make it difficult to draw solid cause-and-effect conclusions from the work.
Riggs, however, maintains that some research into marijuana has yielded reliable results. For instance, the work on how marijuana interferes with the brain development of young people is clear, she says.
She said chronic, heavy use by teens can result in a six- to eight-point reduction in adult IQ, an effect that seems permanent. Riggs compares it to environmental lead exposure.
“There are some data that are very clear,” she said. “We ought to at least take the data we do have and use it.”
Research restrictions
Federal restrictions on doing research on what is classified as a Schedule I drug by the Drug Enforcement Administration — as is marijuana — make it very difficult for institutions. In particular, universities that get federal grants and fear losing them have every incentive to shy away from the kind of marijuana research that would inform good public policy.
A Schedule I drug is one that is defined as dangerous, has no accepted medical use and comes with a high potential for abuse. The restrictions on research on these drugs are onerous.
It seems clear that the assessment of marijuana conferred by its Schedule I status isn’t shared by decision makers in 23 states and the District of Columbia, which have legalized medical marijuana.
Yet, how the feds view marijuana is important to the advancement of the research needed to undergird appropriate public policy.
For instance, the National Institute of Drug Abuse controls the marijuana that can be legally used in federally approved research. Researchers will tell you that the marijuana that NIDA grows isn’t comparable to what people buy on the street or from dispensaries, which often is far more potent and sometimes a different variety from what NIDA cultivates at a contract farm in Mississippi.
CU’s Franson said the federal government needs to relax rules around marijuana research so universities can conduct necessary studies. Surely, reclassifying marijuana so that it’s not a Schedule I drug would do the trick, but the action doesn’t even have to be that dramatic, according to Franson.
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If the federal government were to issue guidance giving universities the leeway to more easily conduct marijuana research — much as it did earlier this year when it relaxed banking rules so legitimate marijuana businesses could have bank accounts — that would be enormously helpful.
The message, Franson said, should be: We’re not going to punish universities trying to learn more about marijuana by taking away their federal funding.
The American College of Physicians and the American Medical Association both support clearing the way for more high quality research on marijuana.
Interestingly, the folks at NIDA said in an e-mail to me that the agency is very interested in research on the effects of marijuana administered orally since very little exists.
NIDA says there is a clinical trial under way that is designed to figure out how people respond to THC administered in different ways, including orally. However, the study is in its early stages and results are not expected until September 2016.
And surely, that study will be of benefit. But research has to be more widespread and cover foreseeable issues in various states.
Grants in Colorado
In Colorado, the state’s health department is on the cusp of considering applicants for roughly $9 million in grants.
Larry Wolk, executive director and chief medical officer for the Colorado Department of Public Health, said the research funded by the grants must stay true to the source of the money, which is the registration fees paid by medical marijuana users. So, the research will focus on medical uses of marijuana.
In the process of studying medicinal uses such as the efficacy of using marijuana to treat a seizure disorder in children, or whether it eases post traumatic stress disorder or chronic pain, it is Wolk’s hope that other information can be gleaned.
That could include some observations on how marijuana affects people who also consumed alcohol.
“It’s definitely an interest, but it is information we’ll have to glean secondarily,” he said.
These studies, Wolk said, are a step in the right direction as policy makers try to make good decisions with limited information.
“We’re sort of in a living laboratory right now,” Wolk said.
Indeed. Unfortunately, moves to legalize marijuana, particularly medical marijuana, have gotten in front of the scientific research that could have better informed those decisions. It’s time to catch up so our laws, rules and understanding of how marijuana affects people keep pace with its use.
E-mail Alicia Caldwell at acaldwell@denverpost.com or follow her on Twitter: @AliciaMCaldwell
