WLAA: U-M professors conducting studies on cannabis use from a public-health perspective

“When the routine question, ‘Do you use cannabis?’ changed to ‘Are you still addicted to cannabis?’ from one doctor’s visit to another, I stopped informing mainstream health care professionals of my use,” said a Michigan Medical Marijuana patient. “I’ve been prescribed many different medications over the years and have never been asked about being addicted for using any of them until now.”

For a plant that has been used as medicine for over 5,000 years and was recommended by physicians in the US for a variety of treatments up until the early 20th century, cannabis appears to be the most misunderstood medicine in, and out, of today’s Healthcare System.

Public Health Researchers Daniel J. Kruger, Ph.D. and Jessica S. Kruger, Ph.D out of the University of Michigan are working on bridging the gap by conducting various studies about cannabis use from a public health perspective.

“This is an area we’ve gotten into just in the past few years,” said Daniel Kruger, “and honestly, I’ve been sort of a bystander on cannabis issues until a few years ago, but what I was seeing is that mainstream Public Health was still very much operating in the era of prohibition. For example, If you go to a Public Health conference or if you read the research ninety nine percent is: What are the adverse effects of cannabis? How can we prevent people from using it? and What does cannabis put people at risk for?”

The lack of mainstream acceptance and years of prohibition has placed people who are prescribed cannabis as medicine at risk for less informative care.

“I also feel that sometimes people who are users of cannabis tend to be somewhat marginalized,” said Jessica Kruger, “so that’s a huge opportunity in which I think Public Health can change the focus from abstinence-based to harm reduction.”

The War on Drugs was effectively a war on perception when it comes to cannabis that continues to this day. Cannabis has a federal Schedule 1 classification, which according to the DEA’s website deems it as a “substance with no currently acceptable medical use and a high potential for abuse.” As a result, there has been a reasonable amount of fear around cannabis from the medical community and prospective patients.

“We’ve had a very warped view in recent years and that comes from the War on Drugs,” said Jessica Kruger. “Previously hemp was grown and cannabis was used as medicine and then the War on Drugs came. Now, oftentimes how you’re asked at a physician’s office is are you using any other drugs or illegal substances. Usually, if anyone asks you if you’re using something illegal, you’re probably going to say no.”

There are valid concerns about cannabis use, as with any other medicine, but the narrative is not consistent and dated.

“There are risks and concerns, like people driving while intoxicated or minors using cannabis, said Daniel Kruger, “but from a Public Health perspective we should really be having a broader picture. The role of Public Health is to maximize benefits to individuals in society and minimize costs, risks and harm.”

The more we know about cannabis, the less afraid people will be to discuss it with an open mind.

“I think the more people view this as a social norm the better,” said Jessica Kruger. “If you base everything around worry and the uptick in people driving while under the influence you’re never going to move anywhere. We know from Colorado that you’re going to see an uptick and effects that you wish you didn’t see, but that’s going to level off and the best thing that we can do is educate people; educate people about how to use it, and how to use it safely.”

The current study, Assessing and Monitoring the Experiences of Medical Cannabis Users is designed to aid mainstream medicine into integrating cannabis.

“The central issue is the relationship between mainstream medicine and cannabis as medicine,” said Daniel Kruger, what are the disconnects and connects in the system. Basically, our argument is that we really want to have an integrated unified system. If your physician doesn’t know that you’re using cannabis medicinally that can lead to problems. We’re assessing the extent to which these are integrated or separate in people’s experiences.”

Integration isn’t merely a matter of checking boxes and providing information at a doctor’s office, but the idea is to learn more about effective treatment, proper dosing and best mode of use.

“One thing that I’m very interested in is how to use marijuana safely,” said Jessica Kruger. “We know that smoking is not the safest route. If someone is smoking a joint they’re getting a lot of carcinogens, it’s something combusting that they’re inhaling, so even suggesting something as simple as using a vaporizer instead of smoking is a harm reduction technique that can actually promote health for these folks versus not even asking the mode of which people use.”

The provisioners at The Om of Medicine in Ann Arbor are currently helping with recruitment for the study and look forward to seeing how the results will help create more clear guidelines in assisting their patients.

“Having a holistic approach and really honoring cannabis as a plant medicine is something that we really try to empower our patients with,” said Lisa Conine, The Om of Medicine Community Outreach Coordinator. “Because we’re conditioned by the Western approach to Medicine of having a pill, this is what your take, you don’t ask questions, you just do what you’re told kind of a thing. A lot of people get introduced to cannabis and they’re afraid of the fact that they have to figure it out.  We are here to guide them, but they know their body best and that’s what we try to empower people with. Still use the scientific method, that’s our biggest thing is going low and slow taking notes really approaching it with a methodical type of outlook, but we do also look for standardization because that’s important to have.”

The study is currently open for recruitment for Michigan Medical Marijuana card holders, as well as those in other states who have been approved for medical cannabis, over 18 years of age and can be accessed here. The survey takes less than 15 minutes and the questions are straightforward.