For the first time ever, a World Health Organization (WHO) committee is reviewing marijuana’s status under international law. And technical documents the committee recently released include several positive, evidentiary findings about the plant’s medical value.
The committee’s pre-review—which will be formally unveiled at its meeting next week—could ultimately go on to influence international drug policy, as well as the classification of cannabis under the laws of individual nations.
The moves by the WHO’s Expert Committee on Drug Dependence (ECDD) come about a month after the United States government requested public input on marijuana scheduling at the international level. That resulted in the submission of more than 17,000 comments that the Food and Drug Administration indicated would be used to inform the U.S.’s response and recommendations to WHO, which is part of the United Nations.
In addition to reaffirming its earlier findings that CBD is a low-risk cannabinoid that provides demonstrably positive health benefits for patients in a critical review, WHO’s new documents also look at the science of marijuana overall and examined cannabis tinctures and extracts, THC and THC isomers.
Here’s what the committee found
In terms of the potential risks of marijuana use, the committee first acknowledged that nobody has ever died from an acute marijuana overdose and described cannabis as a “relatively safe drug.”
Research indicating that marijuana use was associated with a greater risk of adverse cardiovascular events “appears at best to be weak,” the committee wrote.
Notably, the committee also cited a “wealth of preclinical literature” that shows cannabinoids “reduce cancer cell proliferation” and inhibit “cancer cell migration and angiogenesis in numerous cancer cell types.”
The therapeutic benefits of cannabis
Getting into medical properties, the committee’s pre-review examined several health conditions that often qualify patients for medical marijuana in jurisdictions that have legalized it. Those conditions include: appetite stimulation, chronic pain, epilepsy, neuropathic pain, opioid withdrawal, post-traumatic stress disorder and sleep disorders.
The committee’s review of existing scientific literature on the effectiveness of cannabis treatment for these and other conditions found evidence that cannabinoids reduce pain, promote sleep and improve motor function for individuals with Parkinson’s disease. However, one common theme in the pre-review was that not enough clinical research had been conducted for the committee to make a determination about the potential health benefits of cannabis for multiple conditions.
Michael Krawitz, a U.S. Air Force veteran and legalization activist who has worked for years to reform international treaties on marijuana, told Marijuana Moment that the evidence about marijuana’s medical benefits included in the review was insufficient. He said it was reflective of the “creeping slow nature of the international bodies,” which have not viewed marijuana reform as “a priority.”
“Why did it take so long?” Krawitz said. “Why is it 2018 and they’re just now reviewing a treaty that should have been reviewed in the ‘70s or the ‘80s or the ‘90s?”
In some respects, the research situation is a bit of a catch-22. Part of the reason for the lack of clinical research into marijuana is that it’s prohibited under international treaties, which bar United Nations (UN) member states from legalizing cannabis for non-medical or scientific reasons.
“Often, the U.S. government hid behind its obligations under the Single Convention to avoid expanding research into illicit substances, even as scientific and medical exceptions to prohibition were explicitly spelled out in the U.N. treaty for marijuana and other drugs,” the Brookings Institution’s John Hudak explained.
The last section of the new pre-review deals with the epidemiology of marijuana. While recognizing that cannabis “has some therapeutic potential,” the review also raised concerns about several short-term and long-term effects of use, which “may be relevant to public health.”
The acute effects, according to the commission, include “[c]ognitive effects including impaired short-term memory, altered judgement and impaired motor coordination, which increase the risk of injuries (best studied with traffic injuries under the influence of cannabis, where causality has been established despite some negative epidemiological results)” and “altered judgement,” which “may also lead to problematic decisions with respect to increasing risk of sexually transmitted diseases.”
The committee determined that heavy, frequent use was also associated with “[i]mpairment of the brain (especially of the adolescent brain),” “[p]oor educational outcome and partially lasting cognitive impairments, with increased likelihood of dropping out of school” and “[i]ncreased risk of chronic psychosis disorders (including schizophrenia) in persons with a predisposition to such disorders.”
Why this pre-review matters
Reform advocates hope that the pre-review will be accepted and there will be a subsequent call for a more in-depth critical review. That would involve a deliberative process allowing experts to provide the committee with new information before a final recommendation on cannabis’s status would be made to UN Secretary-General António Guterres.
Guterres is a supporter of broad drug policy reform. As Portugal’s prime minister, he oversaw the enactment of a law decriminalizing marijuana and other drugs. In a March speech before the UN’s drug policy body, he touted the success of that policy.
Krawitz said an ideal outcome of the current review would be a committee recommendation to remove cannabis from the international treaty’s list of schedule 4 drugs, which could ultimately free up member states to push ahead with their own reform efforts.