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Why the Patients Are the Biggest Losers in Big Pharma’s Involvement in Cannabis-Based Medication

If there are any reasons to the chronic halt in the legalization of the medicinal use of marijuana in many countries, it is now sure that these reasons would include, if they are not headed by, the pharmaceutical companies’ lobbying against it. Marijuana has been proven for decades to have a curative effect on patients of a wide array of diseases, and the bigger the list grew, the fiercer the fight got. The story of Rick Simpson, for example, who led the movement of hemp oil treatment from his home province of Nova Scotia in Canada, only to be chased by the Royal Canadian Legion, the government, and as became very apparent, big pharma, is a crying version of pharmaceutical companies’ aggressive stance towards an alternative cure that proved to deem the prescription drugs they produce obsolete.

The lobbying efforts against marijuana legalization in general, and medical marijuana legalization in particular, in the U.S., have been ongoing for decades. However, right around the 1980s, after the evidence on marijuana’s benefits became too obvious to ignore, certain players in the industry decided it was time to profit from it, namely the Illinois-based pharmaceutical giant AbbVie. In 1985, the dronabinol pill that AbbVie had developed under the name Marinol was first approved to be launched the next year. Dronabinol, on which Marinol is based, is a basically man-made version of tetrahydrocannabinol (THC), one of the two main substances (or cannabinoids) naturally found in cannabis. Ever since its launch Marinol has been propagated as the safe form of THC that does not include any of the psychoactive properties of natural marijuana and has been since then marketed and prescribed for patients with AIDS and cancer. Many patients with the said diseases have throughout the years expressed their disappointment with synthetic versions of cannabinoids over and over again, after the medications had failed to produce the desired results. That has been known for long by institutions, researchers, and even individuals who advocate the medicinal use of marijuana, for there is one critical factor that is absent in these medications and only available in the natural form of weed: something called the “entourage effect.” That term is used to describe the synergistic reaction that occurs between around 500 natural compounds (including around 85 cannabinoids) that exist in the marijuana plant and happens to produce the curative effects that the plant has come to be known for. That means that the extraction of a single element from cannabis, or the artificial production of that element in the case of drugs like Marinol, would not create the same medicinal effect of natural marijuana.

Despite that shortcoming, or perhaps due to it, Marinol has been listed on Schedule III under the Controlled Substances Act, a category specified for drugs with a possible medicinal use that allows research on the substance – an example of other drugs on that schedule would be Tylenol with Codeine. On the other hand, although marijuana has been legalized for medicinal uses in 24 states and D.C., on a federal level it is still listed on Schedule I under the Controlled Substances Act, which is specified for drugs with “a lack of accepted safety for use under medical supervision, and a high potential for abuse,” which puts cannabis in the same category as heroin, LSD, and ecstasy, and restrains any attempts at further researching its curative potential. Perhaps a statement that is on point in this regard was that made in an article published by Motherboard last July, saying that “The U.S. government’s cool with weed now—as long as it’s fake.”

In recent years, after the tide of medical marijuana legalization on state levels had become too strong to halt, big pharma has been trying to exploit the federal bias against marijuana and the obstacles placed in front of any attempts at researching it. As is always the case with the pharmaceutical industry, whenever drug-development potential is found in a substance, more and more companies decide to jump on the bandwagon, and the fierce competition that arises starts to marginalize the patient’s good in favor of profit generation. One particular player in that arena seems to be aiming for a takeover of the “cannabis-based medications” market. That player is UK-based GW Pharmaceuticals, who has been for eighteen years researching the possibilities of developing medication drugs based on cannabis extracts. The company’s first publicized product was Sativex, a cannabidiol- or CBD-based spray that is to be marketed for patients with multiple sclerosis (MS) and was later even decided to have it prescribed for patients with certain types of cancer. The product is still going through the trial phases that precede its gaining of the FDA approval, but the company seems on a roll to create the highest capital gain possible. Ever since Sativex was launched, GW’s CEO Justin Gover has appeared on many TV shows, roaming the media whenever the company experiences some breakthrough. However, in conformity with my claim that the main emphasis of such companies is on capital gain and profit generation, it is no coincidence that Gover’s appearances have been confined to media outlets such as Bloomberg, “the Street” with whom he had an interview hours before the company’s stock market IPO, and CNBC’s “Mad Money” show with which Gover has become almost a regular guest, all of which focus almost solely on the market potential of the products, making the medicinal value of the company’s products of marginal importance or just limited to the extent of the products’ ability to generate profit. GW has already stricken deals with pharma giants such as Novartis, Bayer, and Almirall to market the product throughout the 30 countries where it has been approved.

As expected, the nearing of the Sativex’s FDA approval came with an announcement by Insys Therapeutics last July of the FDA approval of a dronabinol solution called Syndros, which is said to treat diseases including those which Sativex is already marketed for. It wouldn’t be even too skeptic to relate this announcement to Gover’s latest appearance on CNBC last September, again with “Mad Money,” where he announced a ‘Big Step Forward’ made by GW Pharmaceuticals, which was the success of clinical trials made on a new product which is Epidiolex, a treatment for patients with epilepsy. GW Pharmaceuticals intends to submit the FDA application for Epidiolex during the first half of this year, which drove the company’s stocks 60% higher during 2016, and they are still expected to skyrocket as the product nears its FDA approval.

Aside from these products’ inadequacy due to their lack of the “entourage effect” mentioned earlier, the problems of such a market trend are manifold. First off, one of the main things that make marijuana special apart from its medicinal properties, is that finally people with many diseases can quit their dependence on the big brands that charge them thousands of dollars for a treatment, in favor of a cheaper, more effective, and more natural cure to their ailments and diseases without having to endure any severe side effects. It is worth noting that the average annual prescription of Sativex in New Zealand costs around $16,000. As the restriction on marijuana in the US and elsewhere persists, the inability to conduct proper research on it will keep hindering doctor’s ability to prescribe it for patients with several diseases, which will in turn constrain these patients’ options to the legal versions of cannabis which have been proven less, if at all, effective. “The scheduling disparity is frustrating to everybody who is trying to do research on the plant and understand the physiological effects of the plant and its chemical components,” said Catherine Jacobson, director of clinical research at Tilray, a Canadian medical cannabis company, as she spoke to Motherboard a few months ago. Furthermore, as the competition ensues, the harbingers of which we see in the announcements and counter-announcements I mentioned earlier, the situation that is to be created will be a great confusion to patients who would not know which of these medications carries the real cure to their suffering, leaving the choices up to the doctors who would be prescribing the cannabis-based medications according the marketing deals they will get to strike with one pharmaceutical company or the other.

In a nutshell, the current trend is typical of pharmaceutical companies’ attempt to overtake the medicinal options available for patients with all types of diseases, using their legal privileges to push onto the market products that are ineffective, and at times with hazardous effects, in order to pile up as many profits as they can from every given disease and curative substance. Even if these products are to become an inevitable reality that is here to stay, it is only honorable and ethical that the natural alternative, which has been proven over the years by the few types of research and studies allowed for it to have much more effective and desirable results at a lower cost, be given at least the same legal privileges as these pharmaceutical products that would enable further more comprehensive research to be conducted on it.

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