Proposition 64 passed in November, legalizing recreational marijuana use in California. When it goes into full effect Jan. 1, 2018, UCLA students and anyone 21 or older will be able to buy marijuana from stores with retail licenses. Currently, patients have used medical marijuana to treat a variety of conditions, including nausea, pain and seizures.
The Daily Bruin spoke to physicians and parents familiar with using medical marijuana as treatment for illness and investigated the potential for research into the plant, despite federal policy barriers.
Rashmi Mullur and Ravi Aysola watched helplessly as their infant son seized again in their arms.
“There were days where I would hold my son and have that seizure happen 50 times in a row, incessantly, for hours and hours during the day,” said Aysola, a pulmonologist and sleep doctor at UCLA. “All I could do as a father – as a physician – was to hold him and say, ‘I’m here.’”
Just four and a half months after he was born with a congenital brain malformation, Siddharth Aysola began contracting infantile spasms. Mullur and Aysola immediately drove their son to the Ronald Reagan UCLA Medical Center emergency room. Within a week, Sidd started to experience seizures.
“I think one of the only good things about being a physician and a special needs parent is that you are more aware of what to look for,” said Mullur, an endocrinologist at UCLA. “So when we were warned that seizures could develop, we knew to look for it – there was no long delay.”
At the inaugural 2017 UCLA cannabis symposium April 20, Mullur and Aysola shared their son’s story with about 250 in-house audience members and 10,000 viewers online.
Mullur said after her son went on steroids and other medications, the seizures disappeared for a little while. However, by the time of Sidd’s first birthday, the epilepsy had returned.
His debilitating condition forced him to live his life in a wheelchair, unable to walk or speak.
Mullur tried a number of medications and nonpharmacological alternative therapies, such as ketogenic dieting, acupuncture, chiropractic care and cranial sacral therapy, but her son did not respond well to any of these treatments. He remained unaware and aloof, even at his preschool graduation.
“I started to look up maybe if there were herbal supplements that might help with seizures,” Mullur said. “I didn’t find a lot of anything until we found medical cannabis.”
In summer 2013, she discovered medical cannabis through a small Facebook group called Pediatric Cannabis Therapy.
“There were some parents in there who had kids with brain cancers and they really needed something for pain control,” Mullur said. “There were some parents in there who had kids with epilepsy.”
Soon afterward, Sidd started on medical cannabis at the recommendation of a local physician, Mullur said.
Within six months, Sidd went from being an inattentive and unresponsive boy in a wheelchair, to being cognitively aware and alert, walking with a walker and holding his head up.
“I don’t know if we could have seen that without medical cannabis,” Mullur said.
She said the biggest difficulty she and her husband have encountered has been obtaining access to the most effective type of cannabis for their child.
“You can’t find it in a dispensary, if you’re looking for a high quality CBD product,” she said.
The entourage effect, or chemical combination of terpenes that gives each strain of cannabis its unique flavor, has made a big difference for Sidd. These terpenes, or oils in the CBD Sidd consumes, are largely responsible for the therapeutic effects of the medication on her son, Mullur said.
However, many people are still biased because they do not understand the therapeutic effects cannabis can bring to people like Sidd. Aysola said he feels grateful that he lives in a time and academic community that values his son, seeks to help him and is willing to take risks.
Aysola added that as an intensive care unit physician, he often treats patients with epilepsy professionally. But he also has to go home and do the same thing for his son. He said he hopes that by sharing his experiences as a physician and a father, more people can be aware of the potential value cannabis has as a medication and overcome their biases.
“I know we are held to the highest standard at this institution, which is why I’m thankful that we are here,” he said. “I hope that what we do here helps establish the legitimacy of a scientific approach that will lead to a rational application of thoughtful, compassionate medicine.”
For Siddharth Aysola, Christian and Connor Kramme and many other patients, cannabis, although ineffectively studied, provides relief and treatment for their illnesses.
They attribute the efficacy of the medication specifically to a compound called cannabidiol, or CBD, one of many cannabinoids in the cannabis plant.
Unlike THC, CBD is nonpsychoactive and acts on the body by binding allosterically to cannabinoid receptors, which are mostly located in the central nervous system. This changes the ability of THC and other endocannabinoids to bind to the same receptor and activates the endocannabinoid system to release neurotransmitters that induce therapeutic effects.
CBD has been widely recognized as having the potential to treat conditions like arthritis, multiple sclerosis, schizophrenia, epilepsy and other neurological disorders. Currently, researchers in the United States are investigating its possible anti-cancer properties.
However, despite the passage of Proposition 64, marijuana is listed as a Schedule I drug by the federal government. As a Schedule I drug, it is deemed as having a high potential for abuse and lacking safety for use under medical supervision, according to the Drug Enforcement Administration. Because of this, research into CBD has been scarce without sufficient funding.
Nevertheless, many researchers at UCLA claim that research into cannabis holds much potential for clinical treatment. One student is even changing the course of his career in an effort to help researchers investigate how these exogenous cannabinoids can affect the human body.
Jeff Chen takes off his white coat after a long day at the hospital – and may never put it back on again.
Chen, a graduating medical student and business administration student, is forgoing residency after medical school to pursue a business career in cannabis. He recently created the UCLA Cannabinoid Affinity Group, which aims to help researchers obtain funding for cannabis projects and eventually build a world-class cannabis research center on campus.
“As human beings and scientists, we want the truth,” he said. “I can have a broader impact at the systems level if I can help accelerate the research and understanding (of cannabis).”
The UCLA Cannabinoid Affinity Group is comprised of a growing list of UCLA physicians and researchers who support research into cannabis to discover its potential risks and benefits as a treatment for illnesses.
“There is a hypothesis that cannabis could represent a cheap, safe and effective alternative to many currently used drugs,” Chen said. “(We) desperately need to study its therapeutic effects.”
Previously, Chen took a leave of absence from his dual studies to create a nonprofit organization, the National Institute of Cannabinoid Research, which aimed to share information about marijuana’s health benefits and harms with the public.
All drugs have harms, but he said he thinks cannabis’ toxicities in particular have been overstated.
Chen said after watching Sanjay Gupta’s CNN documentary “Weed,” which highlighted the health benefits of marijuana, he was inspired to study its medicinal effects. He talked to many patients who had benefited from this treatment and decided he could use his passion for medicine and entrepreneurship to impact health care at a larger level.
“Our health care system is in a crisis,” he said. “We are spending more and getting less. If cannabis can reverse that, it deserves a serious conversation that we haven’t had.”
Before Californians passed Proposition 64, about 1 million people in the state had legal access to cannabis. Now, 27 million Californians have legal access.
With the addition of Measure M, which passed in March to allow the city to regulate the marijuana industry in Los Angeles, Chen predicts there will be an accelerated need to research the drug because of increased consumption.
However, many barriers still hinder the advancement of cannabis research.
Since cannabis is still labeled as a Schedule I drug by the federal government, researchers must obtain a Schedule I drug license and approval from the Drug Enforcement Administration to conduct studies, Chen said. In addition, he said the University of Mississippi has monopolized all federal cannabis cultivation available for research, which makes it difficult for other universities to conduct studies.
“We need laws and policies guided by research and not by archaic politics,” he said. “Since 1970, I’d like to say things have changed, but unfortunately nothing has.”
In August, however, the DEA announced an end to the monopoly and will begin allowing public universities to grow cannabis for research purposes, which Chen said he thinks is a step in the right direction.
Chen added he thinks UCLA has the infrastructure needed to grow cannabis on campus, noting the success of the medicinal herb garden next to the Ronald Reagan UCLA Medical Center, the greenhouses on Tiverton Avenue and the botanical gardens across the street from the School of Dentistry.
“California is now the largest legal cannabis market on the planet, (and) cannabis is the fastest growing industry in America,” Chen said. “If we don’t catch up, we’re going to be left behind as other countries jump on (medical marijuana research).”
Starting in 2018, California will provide $10 million in state funding to study the impacts of cannabis legalization. It will be one of the largest population health experiments because of this unprecedented access, Chen said.
With large-scale crowdsourcing, private and corporate philanthropy, and support from research foundations, Chen said he is hopeful a center focused on cannabis research on campus will become a reality.
“It’s definitely with a heavy heart that I’m delaying residency,” he said. “Eleven years (after I first decided to pursue medicine), I’m finally a doctor but not practicing. But we’re all working toward the same goal: improving people’s lives – that’s why it’s not a waste of 11 years.”