Anyone wanting to use cannabis in the USA, whether for mevdical or recreational reasons, needs to pick their location carefully. So far, 33 US states have legalised the use of medical cannabis and 11 states have permitted recreational use. But while this may indicate a trend of increasing liberalisation towards the drug, a closer look at the money being spent on its research presents a more complex picture.
In a recent study, academics from Pennsylvania State University collected data on 3,269 research grants from 50 separate funders of medical cannabis research worldwide. Between 2000 and 2020, the USA spent US$1.49 billion dollars on cannabis research (compared to US$40 million in the UK and US$32.2 million in Canada). The study found that annual cannabis research funding is rising in the USA, from less than US$30.2 million in 2000 to more than US$143 million in 2018. Nevertheless, the drug remains illegal at the federal level and, in 2020, research into the potential harms of cannabis, such as drug abuse, dependency and withdrawal, received 20 times more funding than potential cannabis therapeutics.
‘The government’s budget is a political statement about what we value as a society,’ says Daniel Mallinson, a policy researcher at Pennsylvania State University. ‘The fact that most of the cannabis money is going to drug abuse and probably to cannabis use disorder versus medical purposes – that says something.’
The concern among some researchers is that the medical benefits of cannabis are going understudied. One 2019 meta-analysis found that cannabis has been linked as a therapeutic device to a wide range of conditions, including multiple sclerosis, movement disorders, psychiatry conditions, Alzheimer’s, epilepsy, cancer, rheumatic disorders and glaucoma. ‘When states legalise medical cannabis, they do so for a variety of diseases – some of those have decent scientific research supporting them,’ says Mallinson. ‘Because of federal prohibition, however, many say that high-quality medical research is lacking.’
Support for legalisation of cannabis is rising in the USA. Gallup have been conducting opinion surveys since 1969, when 12 per cent of Americans supported legalisation. In 1995, public support jumped to 30 per cent. Last year, Gallup reported that 66 per cent of Americans support legalisation. But the topic remains divisive and the picture is uneven across political lines. Also according to Gallup, 76 per cent of US Democrats currently support legalisation, compared with 51 per cent of Republicans.
Sound medical research could be a key driver of further legalisation. However, federal prohibition puts that research in a cul-de-sac: ‘We’re stuck in a back and forth, where the low amount of quality medical research is compounded by the fact that federal prohibition makes new research challenging to carry out,’ says Mallinson. ‘One way to get over this is to delist cannabis as a controlled substance, but that would take a huge amount of political effort. I have to believe, however, based on changing attitudes, that there will be more research funding going into therapeutics in the future.’