Confusion Over Marijuana's Therapeutic Value in Virginia

Mar 24, 2016

Ann's son's nightly dosage of THC/CBD. This whole plant cannabis oil has a 1:1 ratio of CBD:THC. The flower buds shown here are infused in an organic olive oil base, which is then put into capsules, which Ann's son takes before bedtime.
Credit Jessie Knadler

One component of marijuana has been gaining a lot of attention lately as a healing agent, treating everything from epilepsy to PTSD to arthritis. A law just passed in Virginia allows this component, known as cannabidiol, or CBD, oil, for the treatment of epilepsy. But medical marijuana proponents say that CBD on its own is actually not that effective as a healing agent. WMRA’s Jessie Knadler explores what really is doing the healing and why it’s so politically noxious.

Over the past several years, there’s been a surge of interest in cannabidiol (CBD), a compound in the cannabis plant that has been shown to have a wide range of medical benefits, from stopping seizures to alleviating arthritis—and it doesn’t get you high. Because of this, CBD is legal to varying degrees for medical purposes in 16 states, including Virginia.

Legislators like it because it’s “safe,” unlike THC, which, if you’ve ever seen a Harold & Kumar movie, is the part of the plant that turns you into a glassy eyed, shiftless stoner, at least according to marijuana prohibitionists.

So is CBD the key healing component of cannabis?

Ann thought so. Ann (whom I interviewed for a previous story) is not her real name because CBD is only legal to treat patients with epilepsy in Virginia; she uses it illegally to treat her teenage son’s Crohn’s Disease. After two weeks of treatment, her son did not show any improvement. Zero.

ANN:    He wasn’t absorbing any of his nutrients, losing weight rapidly. He was on a very soft, warm mushy food, almost liquid diet. Missed school. It was very stressful. I was at a loss— I was in tears, I was exhausted.

Then a medical marijuana doctor advised adding an equal ratio of THC – the psychoactive part of the plant – to his treatment.

ANN:    Probably within seven days, he was starting to heal up.  We saw that is was working.  He was feeling better.  His wound was healing.  And, he was starting to gain some weight, and starting to eat more.

It’s called the Entourage Effect. Scientists aren’t really sure why it works, but there is mounting evidence cannabis compounds – there’s something like 500 different chemical compounds in the plant -- work best when they act synergistically. In other words, you can’t just take CBD out of marijuana and make a medicine. You need the whole plant. You need THC. And that is political kryptonite in a state like Virginia.

Yet lawmakers here are tentatively aware of this Entourage Effect, and that is why the latest bill to pass the General Assembly allows for the manufacture and distribution of CBD and THCa oils as a treatment for epilepsy. THCa has all kinds of therapeutic benefits.

Democratic Senator David Marsden of Fairfax sponsored this latest bill. But just because his bill allows for THCa does not mean he is a proponent of whole plant therapy.

SENATOR DAVID MARSDEN:  Well, that’s psychoactive marijuana …..that’s what we’ve taken out of the plant that we’re going to be using in Virginia because we’re using the non psychoactive CBD and THCa oils ….I don’t believe in recreational use. I don’t think it’s good for any society to have people distorting reality.

He’s right. THCa is non psychoactive. That is, until you heat it. 

DR. DUSTIN SULAK:     Anyone who gets THCa from a dispensary and takes it home and heats it for half an hour has THC on their hands and I think if lawmakers knew that they’d be even more confused.

That’s Dustin Sulak, a medical marijuana physician based in Maine, which has more liberal medical pot laws than in Virginia. His three clinics treat more than 18,000 patients, including some 350 seizure patients.

SULAK: The media headlines that describe THC as the recreational part of the plant and CBD as the medical part of the plant really have it all wrong. THC is a primary therapeutic component of cannabis and that’s not going to change. THC should be included in these laws. They should be crafted to make sure a medical provider is doing a good job supervising the patient’s use and making sure they’re using it appropriately for their benefit. And in that scenario THC is safer than any prescription drug because there’s no toxic side effects and there is no lethal overdose.

Bottom line, he says, you can’t divorce THC, with all its derivatives and stoner baggage, from medical marijuana.  CBD alone is not enough.

But as Senator Marsden points out, not everyone wants to get high. Whole plant therapy opens the door to recreational usage. Marijuana is still listed as a controlled substance under Schedule I, in the same category as heroin. Ann’s son didn’t want to get high even as his disease has been in remission for six months since adding THC.

ANN:    He’s a very high academic achiever. He doesn’t want to do drugs. He doesn’t want to do anything against the law.

SULAK: A lot of people think that to use THC for a medical purpose you have to get high and that is clearly not the case. The medical benefits of THC are observable at much lower doses than the doses required to get someone intoxicated.

Ann’s son takes a very low dose of THC at bedtime. He says he’s never felt any effects from the drug and even he did, he’s asleep. And he’s still a straight A student.

Here’s Senator Marsden again speaking about his fellow legislators.

SENATOR MARSDEN:  Where people do not to go at this point for sure is psychoactive marijuana.

Yet the scant medical marijuana laws being passed in Virginia already allow for psychoactivity due to the inclusion of THCa.

ANN:    I don’t understand why lawmakers are trying to isolate different parts of the plant—only THCa or only CBD when the whole plant is already there just as nature intended.

It seems likely this is an issue that the General Assembly will have to revisit. Regardless, Ann’s son will still use THC to treat his disease.