On December 15, 2010, the FDA notified MAPS that our planned study of smoked or vaporized marijuana for veterans with chronic, treatment-resistant PTSD had been placed on full clinical hold until we are able to provide specific information about the source, composition, concentration, and manufacturing method of the active and placebo marijuana cigarettes we plan to use. We have requested that the National Institute on Drug Abuse (NIDA) provide the marijuana as a result of the agency’s monopoly on the legal supply of marijuana for use in FDA-approved studies. Despite having submitted the study protocol to NIDA and the Public Health Service (PHS) nearly two months ago, we still have not heard a word about the likely time frame for the NIDA/PHS protocol review.
Fortunately, the FDA has a set a precedent of reviewing and even approving protocol designs before having complete information on the source of the drug. We expect to receive FDA’s protocol critiques very soon. Even if we obtain FDA approval, the protocol must also be approved through the NIDA/PHS review process. In the 1990s, MAPS had two medical marijuana protocols approved by the FDA but rejected by NIDA, preventing the studies from taking place.
On January 14, 2011, an official from NIDA sent an email to MAPS Executive Director Rick Doblin, Ph.D., indicating that the agency does in fact have the various levels of marijuana with delta-9-tetrahydrocannabinol (THC) that we need for our study. The study protocol calls for marijuana with five different concentrations of THC and cannabidiol (CBD): 0% THC (placebo), 2% THC, 6% THC, 12% THC, and 6% THC/6% CBD. NIDA claims that it has marijuana cigarettes of 0.004% (placebo), 2.1%, 5.6%, or 6.7% THC. They also claim that their facility at the University of Mississippi has in stock bulk marijuana containing 12% THC that can be manufactured into cigarettes, and that they can blend different batches to produce cigarettes containing marijuana with 6% THC and between 4% and 6% CBD (despite their initial insistence that they did not have any marijuana with CBD).
NIDA appears to be doing its best to provide what we need for the study, perhaps due to the pressure we have been putting on them through Professor Lyle Craker’s ongoing lawsuit against the DEA seeking a license to grow marijuana for federally regulated research under contract to MAPS.