The treatment database on NCI’s website is called the Physician Data Query (PDQ). The PDQ entry on cannabis and cannabinoids is maintained by the Complementary and Alternative Medicine (CAM) Editorial Board. The lead reviewer on the marijuana summary statement is CAM board member Donald Abrams, director of integrative oncology at the University of California-San Francisco cancer center.
the use of cannabis in cancer treatment, and his wish to accurately portray its medical applications becomes clear early in the documents.
On March 24, just a week after the finished summary had gone online, Susan Weiss — chief of the Office of Science Policy and Communications within the National Institutes on Drug Abuse (NIDA) — sent NCI officials an email saying her agency had just become aware of the summary. Weiss told them the NIDA wanted the summary changed to acknowledge that the FDA hasn’t approved marijuana; to take away any implication that it was recommending prescribing marijuana; to highlight the supposed “addiction potential” of marijuana; and to link to the NIDA’s own page on the supposed “adverse effects of marijuana.”
The NCI balked at the last two requests: ”I am unaware of any convincing evidence indicating that marijuana is addictive,” communications officer Rick Manrow of the the NCI reasonably said.
But the agency agreed the first two requests were fair. The CAM board grappled for days with how to cooperate with the NIDA without compromising its independence or editorial integrity. Meanwhile, yet more federal agencies offered their two cents’ worth.
“[A press officer with the FDA] contacted me this morning because he has been getting calls from FDA staff, as well as at least one high-profile reporter, asking about NCI’s ‘endorsement of medical marijuana.’ I provided him with the background I had,” wrote Brooke Hardison, NCI media relations analyst. “He needs to provide information for staff at the FDA, and they are trying to figure out how to respond to this issue. I suggested that it might be good for him to have a conversation with those more closely involved in this issue.”
Meanwhile, national attention to the story continued to grow, and NIDA, notoriously anti-pot, was worried about this whole “marijuana treats cancer” thing.
On learning that Ethan Nadelmann, founder and executive director of the Drug Policy Alliance
had tweeted about the summary, the NIDA’s Weiss wrote to NCI, “We will be contacting our colleagues at ONDCP [Office of National Drug Control Policy] just to give them a heads up about it.”
Weiss also wrote to her NIDA colleagues, saying “We think that ONDCP needs to be informed.”
The ONDCP, of course, is the office of the Drug Czar. Current czar Gil Kerlikowske, as with all drug czars, is bound by law to oppose marijuana legalization for any purpose, even to save cancer patients.
In any event, the NCI caved to the NIDA’s demands by removing any implied support for prescribing marijuana — noting that the FDA hasn’t approved cannabis as as prescription drug — and, much to the consternation of lead reviewer Abrams, removing a reference to marijuana’s anti-tumor properties.
“You know, the epidemiological data from Kaiser
do possibly support an anti-tumor effect in humans,” Abrams wrote. “After reflecting for a few hours, I am not happy that NIDA has been able to impose their agenda on us. The text was vetted by the whole Board. I would ask that we [involve] the whole Editorial Board in the discussion before being bulldogged.
“I am considering resigning from the Board if we allow politics to trump science!” Abrams wrote.
All the relevant CAM board members eventually agreed to the version that went up on March 29 and 30. That last day was when Phil Mocek submitted his FOIA request and is thus the last day that appears in the records given to him.
It is interesting to note that, toward the end of the correspondence record, NCI and NIDA officials were discussing the latter agency providing further information on the supposed “adverse effects of marijuana” so that the CAM Board could “take it into consideration” during its May 6 meeting. Several NCI and CAM members said any “convincing evidence” could result in larger changes to the entry.
NIDA prepared a list of anti-marijuana talking points, including the claim that nine percent of cannabis users “become addicted to the drug” and a completely undocumented claim that marijuana use leads to permanent cognitive impairment, in the hopes of causing just such changes in the NCI’s entry.
But, the Independent
reports, May 6 came and went without any additional changes being made to the database.
One can only imagine the kinds of behind-the-scenes wrangling that continues as we speak.