In this industry, removing a question mark can mean a great deal — especially when it's removed from a government website. Earlier this week, the National Institute on Drug Abuse switched the title of its website page from "Is Marijuana Medicine?" to "Marijuana as Medicine." And that wasn't the only change.
Nearly every section of the site, which was last revised in July 2015, has minor changes.These revisions may seem inconsequential, but for the cannabis industry and patients who use marijuana for medicinal purposes, they appear significant.
Here are seven things that changed on the NIDA's medical marijuana page, and why they matter:
1. No link to WhiteHouse.gov
In the first section, titled "What is medical marijuana?," the explanation of the term begins the same way it did in the last update: It explains what "medical marijuana" is and also states that the FDA has not approved cannabis for medicinal use. Everything else remains the same until the very end of the section. Because the Trump Administration removed the White House website's page that explains state laws related to marijuana, that link is now missing from the NIDA's website.
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When he ran for president, Donald Trump indicated that he was in favor of marijuana being used for medicinal purposes, but since he took office, his administration has given many signs that that stance has been abandoned, from appointing Jeff Sessions, a staunch anti-marijuana opponent, as attorney general, to multiple statements from press secretary Sean Spicer indicating a potential federal crackdown on cannabis. Just this week, Sessions said marijuana is "only slightly less awful" than heroin.
2. Explaining cannabinoids
In this section, the important change isn't what's missing, but what's been rephrased. In the July 2015 revision, THC was described as "marijuana's main mind-altering ingredient." The latest revision adds the words "that makes people, 'high'." There's also a new link link to a page explaining Synthetic Cannabis.
Synthetic marijuana is used primarily to enhance the high in THC-centric marijuana products. Adding information about synthetic marijuana to a section about cannabinoids makes a distinction between natural cannabinoids derived from the plant and synthetic products made in a lab. Most medical products come directly from the plant; this point is important. Multiple studies have shown synthetic marijuana to be more harmful than products made exclusively from the cannabis plant, and THC products get a bad rap when synthetic marijuana causes harmful effects.
3. CBD and childhood epilepsy
One of the most drastic changes is an informational box once titled "What is CBD?" The updated title reads: "CBD and Childhood Epilepsy."
The box itself explains how CBD can treat epilepsy; the small shift in the headline reflects how accepted this practice has become. So does a change in the verbiage. Instead of reading, "These drugs may be less desirable to recreational users because they are not intoxicating," the updated version is more direct: "These drugs aren't popular for recreational use because they aren't intoxicating."
This change is major for medical patients: So much of the time, their medicine is compared to THC and negative cultural norms associated with smoking marijuana. Specifying that drugs that medical patients use are not in any way comparable to the high users get from THC is an important distinction.
4. Alzheimer's disease removed
Alzheimer's disease was removed from a list of conditions that are the focus of current scientific pre-clinical and clinical trials. That could be because multiple studies have been published since 2015 linking cannabis to improved memory.
Last summer, the Salk Institute discovered a compound in marijuana that helps remove deadly plaque from nerve cells and could be used treat Alzheimer's. There's even a medical dispensary in New York that's partnering with a retirement home to use cannabis to aid in elderly patient care.
5. "State approved"
Four more states legalized medicinal cannabis since the last edit of this page; four more legalized recreational use. In over half of the states in this country, cannabis is legal in some form. The section about potential health risks used to read "regular medicinal use of marijuana is a fairly new practice." The revision? "State-approved medicinal use of marijuana is a fairly new practice."
States with legalized marijuana face uncertainty in the age of Trump. But acknowledging that states have approved marijuana for medical use on a government site is significant as the industry grapples with questions about states' rights.
6. Section on pregnancy
An entire section has been added to the revised page, focusing on the use of medical marijuana during and after pregnancy. The gist: There needs to be more research before a definitive answer can be made about the effects of marijuana on a fetus or infant.
The only study that measures THC in breast milk, for example, is from 1982 and provides data from just two subjects. "All of Colorado policy around marijuana use and breastfeeding is derived from one person's data," notes Dr. Heather Thompson, deputy director of Elephant Circle, a local organization working with a physician in Texas who is conducting a study on the effect of THC in breast milk.
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7. Medications with cannabinoids
In the section that explains the two FDA-approved drugs containing THC, dronabinol and nabilone, an important sentence was added: "Continued research might lead to more medications."
Cannabis research had been virtually halted; the federal government prohibits most labs from using any marijuana in studies that isn't grown from one specific lab. But this is changing. Last summer, the DEA ended the government's monopoly on cannabis research, which has allowed new groups to study the plant. Then, last winter, the Colorado Department of Public Health put $2.35 million dollars toward funding for seven studies that will hopefully answer some questions about the health and safety impacts of marijuana.
Note: These are only some of the changes on the site, which you can see here.