For years, U.S. federally-funded research on the benefits of medical cannabis has been woefully lacking. Current government regulations greatly limit this type of research to primarily drug addiction studies. However, the fact remains that clinical studies on the efficacy and safety of any drug–including medical cannabis–are a cornerstone requirement for any pharmaceutical that hopes to see the light of day.
The government recently issued its intent to study the effects of lesser-known cannabinoids and terpenes regarding their potential effectiveness in treating pain.
Researchers who want to study medical cannabis have long been plagued by this catch 22. However, the federal government recently issued its intent to study the effects of lesser-known “minor” cannabinoids and terpenes regarding their potential effectiveness in treating pain.
The “intent to fund” notice was issued by the National Center for Complementary and Integrative Health (NCCIH) as a precursor to the official Funding Opportunity Announcement (FOA) expected to be released in January 2019, with applications due in March.
What Is the NCCIH?
The National Center for Complementary and Integrative Health (NCCIH) is one of 27 institutes that make up the National Institutes of Health (NIH), which is run by the US Department of Health and Human Services. NCCIH is the lead NIH institute for funding of complementary and integrative health approaches. They use rigorous scientific investigation to study the safety and utility of various health interventions.
For this study, NCCIH is casting a wide net, inviting state agencies, nonprofits, small businesses, for-profit organizations and many others to apply. Federal entities cannot apply due to cannabis’ current status as a DEA Schedule I drug.
The FOA will fund basic research, but will not support clinical trials that examine efficacy of cannabinoids or terpenes on changes in pain outcomes such as pain severity, pain interference, or functional outcomes. The institute is encouraging interdisciplinary collaborations from multiple fields—chemistry, neuroscience, pharmacology, immunology, and more.
What Are Minor Cannabinoids?
While THC is the best known and most extensively studied cannabinoid, other cannabinoids like cannabidiol (CBD) are becoming increasingly popular and quickly gaining ground in the research world. However, the many other cannabinoids and terpenes have rarely been studied.
For this latest research, minor cannabinoids are defined as “anything other than THC.” In particular, there is interest in researching cannabigerol (CBG), cannabinol (CBN) and cannabichromene (CBC). The agency is also interested in research on several terpenes, including myrcene, ß-caryophyllene, limonene, a-terpineol, linalool, a-phellandrene, a-pinene, ß-pinene, terpinene, and a-humulene.
Prioritizing Pain Relief
NCCIH’s primary motivation is to fund chronic pain research. Chronic pain affects about one-third of all Americans and takes a dramatic toll. Pain treatment costs up to $635 billion annually, which amounts to roughly $2,000 per American, and companies estimate that chronic pain costs them over $300 billion in lost productivity each year.
NCCIH is particularly interested in whether cannabis’ analgesic properties can be separated from its intoxicating properties.
Numerous studies have established that both THC and CBD are effective on various types of pain, and there is even evidence that other cannabinoids and terpenes synergistically work with THC and CBD to boost effectiveness—a phenomenon known as the entourage effect. NCCIH is encouraged by the supposed mechanism that terpenes can influence the signaling, and thus the activity of, cannabinoid receptors, but states that research is needed to draw conclusive evidence. NCCIH also supports the study of how minor cannabinoids and terpenes might modulate biological and neurological systems associated with pain perception.
The research could offer insight into viable pain management alternatives to the status quo long-term chronic pain management which mainly relies on opioid treatment—a treatment fraught with problems, one of which is the national epidemic of opioid misuse. Early research has shown that some cannabinoids enhance the pain-alleviating effects of opioid drugs, and that can mean people taking lower narcotic doses.
NCCIH says that NIH and the US government place a high priority on developing alternative and novel pain management strategies. The institute decided to release the FOA due to the growing body of literature regarding the analgesic properties of the cannabis plant. They’re particularly interested in whether cannabis’ potential analgesic properties can be successfully separated from its intoxicating properties, and says that more research is needed to study the plant’s basic biology and diverse phytochemicals.
It’s still unclear which cannabis components may have analgesic properties, and very few studies have truly examined the interaction between pain pathways and cannabinoids and terpenes. But given the country’s massive opioid crisis, this study encourages high hopes in our journey toward safer alternatives.