Early in 2021, I attended our Clinical Therapeutics quarterly editorial board meeting during which various topics of interest were discussed for consideration as future candidates for specialty updates. One of those topics was cannabis. Clinical Therapeutics had published a 6-article specialty update in September 2018 on the clinical applications of cannabinoids for neurologic disorders that featured recent developments in epilepsy and multiple sclerosis.
The timing seemed right to broaden the scope of publication to include the research agenda and the direction of policy, not the usual fare of the journal, but the aperture of the Overton window was shifting, if not also expanding,2 and an opportunity was sensed to undertake discussions of the social and economic implications of recent legalization and evolving regulation.Because I have a colleague with a professional background in this area, I contacted him to discuss possible suggestions for someone who might be interested in serving as a guest editor to manage the project. Once I mentioned the topic, he said, “You need to talk with Julie Johnson.” Soon after contacting Dr Johnson and explaining the project, she expressed her well-informed interest and promptly provided me with a 2-page, single-spaced outline of topics. Fast forward to the present, and Clinical Therapeutics has finalized the details for rolling out not only a specialty update but also a dedicated special issue on cannabis research and policy, for which I am pleased to provide the introduction, beginning with Dr Johnson herself.
Dr Johnson received her PhD in social policy from Brandeis’ Heller School of Social Policy. Her thesis concerned the effects of the changing medical marijuana statutes on adolescent use of marijuana and alcohol.3
Dr Johnson then completed postdoctoral training at Johns Hopkins Bloomberg School of Public Health in the Drug Dependence Epidemiology Training Program, extending her work in medical marijuana statutes. One of her mentors contacted her about the opening of a research director position at Massachusetts Cannabis Control Commission (MCCC), the agency charged with regulating and researching cannabis policy in the Commonwealth.4
Interviews followed, and Dr Johnson became the inaugural research director of MCCC. To begin to understand why there has been recent, heightened attention to cannabis, one has only to look at the trend of cannabis-based research publications during the past 50 years (Figure 1) and to note a long-smoldering 25-year baseline of publications ranging from 234 (in 1970) to 400 (in 1995) per year, followed by a nearly perfect exponential curve of publication growth during the next 25 years to 4316 publication sper year (in 2020)—a 10-fold increase. Thus, there is the suggestion that the correlation in the uptick in publications reflects a distinct turn in focus and attention to the topic, including policies such as California’s Proposition 215 that passed in 1996.5This proposition legalized the cultivation, possession, and use of marijuana for medical purposes, establishing a statutory pathway for other states to follow. From 1998 until 2013, 19 other states and the District of Columbia passed comparable laws that enabled varying degrees of medical use of marijuana. Dr Johnson and her colleague, Alexander Colby, contextualize the historical developments.6
Figure 1Number of articles on cannabis per year identified by Scopus.
The most recent federal legislation passed into law (Medical Marijuana and Cannabidiol Research Expansion Act [MMCREA]) on December 2, 2022, has added to the momentum in a substantive, process-focused way by easing restrictions on research applications by clinical investigators, ensuring availability of research-grade medical marijuana, and promoting the development of new drug products that contain marijuana or cannabidiol through the US Food and Drug Administration’s Investigational New Drug regulatory mechanism.7
Purcell et al8provide a thoughtful analysis of the multiple components of this legislation. The particular timing of the MMCREA reflects the critical mass of cannabis-related research that has been building in multiple, inextricably related areas: the rapidly changing statutory and regulatory landscape at both the federal and state levels; closely related and far-reaching public health effects on cognitive function, social interaction, and public safety; economic impact on communities; international dimensions to all these areas; and the disparate impacts across these domains.
Purcell et al8provide a thoughtful analysis of the multiple components of this legislation. The particular timing of the MMCREA reflects the critical mass of cannabis-related research that has been building in multiple, inextricably related areas: the rapidly changing statutory and regulatory landscape at both the federal and state levels; closely related and far-reaching public health effects on cognitive function, social interaction, and public safety; economic impact on communities; international dimensions to all these areas; and the disparate impacts across these domains.
Johnson and Colby initiate this specialty collection with a historical introduction to the medicinal use of cannabis mentioned above, provide an overview of cannabinoids and the endocannabinoid system, and then introduce a full range of topics covered by the series: law, ethics, regulatory, and policy; clinical guidance, benefit-risk and adverse events; and adolescence and physiologic, mental, and social development.9So, kudos to Dr Johnson and her team for achieving a masterful collaboration of professionals from a very diverse set of disciplines, who, through their persistence and dedication, have brought important contributions to light. We hope you find these offerings informative, enlightening, and stimulating.
References
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Benefits and risks of therapeutic cannabinoids for neurologic disorders.
Clin Ther.2018; 40: 1436-1437
- The Mackinac Center for Public Policy. The Overton Window. https://www.mackinac.org/OvertonWindow. Accessed April 26, 2023.
- Heller School for Social Policy and Management. Uncharted Territory: A Q&A with Julie Johnson, PhD’15, Inaugural Research Director for the Massachusetts Cannabis Control Commission. May 31, 2018.
- Commission and Leadership Team. Cannabis Control Commission. Commonwealth of Massachusetts. https://masscannabiscontrol.com/about/commission-leadership-team/. Accessed April 26, 2023.
- Milestones in U.S. marijuana laws. New York Times. November 5, 1996. Accessed April 26, 2023. https://archive.nytimes.com/www.nytimes.com/interactive/2013/10/27/us/marijuana-legalization-timeline.html#/#time283_8117.
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History of cannabis regulation and medicinal therapeutics—it’s complicated.
Clin Ther.2023; 45: 521-526
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New law eases federal restrictions on medical marijuana research and cultivation.
The National Law Review.December 7, 2022; (Accessed April 26, 2023)
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The cannabidiol and marijuana research expansion act: promotion of scientific knowledge to prevent a national health crisis.
The Lancet Regional Health – Americas.2022; 14: 100325-100335
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Cannabis research and therapeutics: an international quasi-experiment in cannabis policy.
Clin Ther.2023; 45: 488-493
Article info
Publication history
Accepted: April 28, 2023
Received: April 28, 2023
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Copyright
© 2023 Elsevier Inc.
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