As U.S. business and government continue to butt heads over medicinal cannabis, some educational institutions are turning to science to help elevate and inform the conversation.
Helping blaze the trail toward cannabis’ acceptance in academia is none other than the University of Vermont, which now offers a range of college-level coursework and training on the plant through its Larner College of Medicine (no doubt home to some other ‘berners’). Ranging from online modules to the traditional classroom setting, courses are designed to give students and professionals a thorough, evidence-based understanding of the scientific ‘why’ behind weed–no more, no less.
For the past two years, UVM students have been especially quick to partake of Pharm 200: “Cannabis Past, Present, and Future,” the nation’s first-ever ‘higher learning’ course on the science of medicinal cannabis (so close, UC Davis). Pharmacology professor and researcher Karen Lounsbury, Ph.D., who designed the annual class with co-teacher Wolfgang Dostmann, Ph.D., explained by phone that sticking to up-to-date clinical knowledge was critical to their mission, and to getting the three-credit course approved.
Under Vermont law, cannabis possession and distribution can still result in fines or prosecution outside of the medical space, and state regulations wouldn’t allow Lounsbury’s students to visit dispensaries. At UVM, like other academic institutions, research that involves cannabis materials also must first traverse a field of red tape, as required by federal law.
From the college’s perspective, “The only requirement was making sure it was a serious, evidence-based science class,” Lounsbury said. To establish both legality and legitimacy for the course, then, Lounsbury and her colleagues have focused on introducing fundamental concepts in pharmacology and key concepts in human physiology “underlying medicinal and other cannabis use.”
That means molecular biology, neuroscience, chemistry, and physiology, all explained in relation to cannabis and the human body–relationships which, red tape notwithstanding, scientists are starting to know a good bit about.
In Pharm 200, Lounsbury said, that knowledge is broken down into three sections. “First we cover plant biology and history. That includes the history of the medicinal value of the cannabis plant, which is most closely related to hops, and the specifics of why the plant produces cannabinoids at all; how they benefit the plant.”
“Another section is on the medicinal chemistry of cannabis: what chemicals are there, which are biologically active, what other components might alter their activity,” Lounsbury said. “This also gets into the pharmacology of cannabis, how they chemicals get into the body, where they go, and how they’re metabolized.”
“The third and biggest section of the course is therapeutics: its applications for pain, nausea, inflammation, autoimmune disease and disorders, Parkinson’s, mental health disorders, and the safety aspects of use.” Lounsbury noted that research on the therapeutic applications of cannabis has sprouted considerably over the past few years, particularly around the chemical compound cannabidiol, or CBD.
“New clinical trials keep popping up. A few years ago, there were just five active studies. Now there are 39 clinical CBD studies ongoing, and many in the U.S. and abroad. The National Institute of Health is also funding over 40 projects, mostly through the National Institute on Drug Abuse, which now has 15 projects approved for CBD research.”
According to Lounsbury, the increase in (above-board) scientific inquiry around cannabis has in many ways resulted from public pressure put on states. “And as states continue to get medical marijuana laws on the books, they’re more willing to support research on the plant,” she said.
In their inaugural run with the course in 2016, Lounsbury and Dostmann found the class had quickly filled up with students from numerous disciplines, as well as practicing physicians from around the area. “We even had a retired but still-lobbying state official in the course, and one assistant to a state legislator.”
For their spring 2017 class, they decided to impose some prerequisites for the biologically focused course, while still leaving it open to undergraduate, graduate, and continuing education students. As a result, not quite as many outside community members were enrolled, but the majority seem to have moved on to UVM’s other cannabis educational offerings quite seamlessly, Lounsbury said.
Those offerings include a yearly cannabis Cannabis Science and Medicine Professional Certificate program, a Cannabis Speaker Series of online webinars, Community Medical School video presentations, and online, on-demand Cannabis Science and Medicine Continuing Medical Education (CME) modules.
The goal of all this, according to Lounsbury, is to equip students, professionals, and the Larner College medical community with scientific awareness of a plant which, after thousands of years of therapeutic use and over a century of U.S. prohibition, has started to (re-)gain the limelight in mainstream medicine. All the while, Lounsbury noted, new cannabis studies continue to roll out, suggesting a range of potential applications which clinical research must confirm or deny–hopefully along a time frame that helps patients sooner rather than later.
“We only really cover evidence-based medical results of cannabis use, but during certain classes, I’ll also show a lot of videos containing patient testimonials on conditions it’s helped with, from nausea to paid to PTSD, which are very convincing. But then I’ll also show the clinical data behind these applications, and the meta-analysis of cannabis’ clinical role.”
“There’s so much to be learned in this area, which can frustrate students, and a lot more research is still needed,” she added.
In Lounsbury’s Intro to Pharmacology course, she also includes a lecture on opioids and drugs of abuse, and addresses the basics of cannabis and THC, another major chemical component. In doing so, she references the plant’s medicinal analgesic and anti-inflammatory properties and compares its toxicology levels with alcohol, heroin, tobacco, and other drugs.
Because of the way cannabis is processed in the body, it may offer strong options for treating opioid patients, whether as a replacement pain-killer or simply a safer alternative. “Cannabis activates the same pathway in the brain, but not the same receptor, whereas with methadone, you’re still on the same receptor,” Lounsbery explained.
“It is addicting, but mildly so compared to opioids,” she said (not to mention non-fatal). “Around 9% of users will become dependent on cannabis, and with opioids it’s upwards of 40%.”
She added, “Sometimes you have to take a small risk to beat a big one.”
Considering the ongoing impact of the opioid epidemic, and cannabis’ potential as both a major industry and a safer, often far cheaper treatment for various medical conditions, Lounsbery’s small risk in bringing cannabis science to academia seems like the right kind to take:
Thoughtful, constructive, and evidence-based.