Alibi V.27 No.32 • Aug 9-15, 2018 

Cannabis Manual

Writing On the Wall

An interview with Dr. Jacob Miguel Vigil

Cannabis research has been stifled under the federal ban, but recent changes in our political landscape have opened the door to more study. The only problem is lack of funding. Associate Professor Dr. Jacob Miguel Vigil of the University of New Mexico co-founded the Medical Cannabis Research Fund as a way to raise money for future projects. His colleagues have been responsible for some of the most compelling cannabis research currently available. We met with the associate professor to learn about the hurdles facing this burgeoning field.

Weekly Alibi: Can you give us a broad outline of what you and your colleagues are working on?

Dr. Jacob Miguel Vigil: I am an associate professor in the Psychology Department. I'm an expert in studying instincts, and I did a lot of work in pain perception. Now I work full time in medical cannabis patients’ outcomes research. And at this point in my career, I'm basically guided by the needs of the community, and I try to direct every ounce of my efforts towards helping who I can, as best as I can.

I've kind of gone from a specialists to a generalist, and it's not so much about me these days, it's about identifying problems and trying to engage in research that could eventually come up with a solution.

So you were initially a pain specialist?

Yes. I was trained as an evolutionary psychologist, so I'm really a theorist at heart, but I waited until I got tenure before I began to advocate more directly and transparently in regard to the need for cannabis research. I had to wait until I had a secure position, otherwise they would have fired me—despite my academic record.

Just for showing an interest?

Well, it's still stigmatized at the formal levels of academia. Our medical system—our intellectual and scientific systems—are integrated with business interests, and they have been for a long time. These are entrenched, systemic issues that scientists still largely have to deal with in this particular area of biomedical research.

It's been an exciting ride so far. It's been very gratifying getting evidence that I'm helping people around me, and I'm very interested to see what kind of changes society is going to go through with regard to how medicine is appropriated, used, investigated, understood and thought about.

This big study about cannabis' effect on opioid use (“Associations between Medical Cannabis and Prescription Opioid Use in Chronic Pain Patients”)—it kind of blows my mind just how many people know about it. Generally, the layman isn't looking too deeply into scientific research.

Yes that paper got a little press attention. It's interesting how press releases and media attention can really magnify our society's awareness of information. That particular paper got a lot of views on the website. My goal now is to disseminate as much information as I can to the public, because a lot of traditional channels have been controlled.

In some ways it's an uphill battle, going through traditional conventional means of the scientific process to disseminate information that's gathered, and in other ways it's an opportunity to engage in innovative processes for getting factual information out to the real people—through social media and all the ways we can connect throughout society now.

I personally believe we're on the brink of some amazing societal paradigm changes, and cannabis is one of them.

What are these barriers in the way of cannabis research?

There are logistical barriers to being able to administer cannabis as a researcher. Even in Colorado—where a researcher can smoke cannabis in the open—they can't administer it to patients who are likely to benefit from it, or even to investigate basic claims. There's a federal system in place now that is involved and requires the approval of several entities: the National Institute of Health, Drug Enforcement Agency, the FDA. You have to get your cannabis from certain locations. So, it's basically government controlled, and it has been for almost a hundred years, to be honest.

It is what it is. It's probably the most powerful plant that exists on planet Earth, and that's why it's been constrained from human access for so long. But those barriers are coming down, partly because we've reached a watershed moment where society has been exposed to the relative risks of using cannabis compared to what they have been fed and conditioned to believe.

There's also folks out there that are being more courageous and using innovative approaches—like we try to do here in New Mexico—to actually conduct work that has been largely restricted through conventional means.

A lot of my colleagues pride themselves on being so creative, but it's funny—at least from the outside—it seems as though they oftentimes live in these boxes, and if it hasn't been done before, then they don't know how to do it. The most innovative people I've met in the past five years in regard to medical cannabis have been people that work with patients directly. Providers, practitioners—people who actually see real people and recognize the potential. For some reason, my academic colleagues are way behind the times—not only in their understanding of the content, but of the relevance of cannabis in society.

What do you believe that relevance is?

Well the potential relevance is the changes in how people think about their medicine—the level of engagement they have with their medication. Cannabis requires people to continuously experiment through trial and error, because it's always variable. Even within clone batches, one plant is different from the next. This is caused by the different conditions it’s grown in as well as genetics and so forth.

So cannabis is interesting in that patients will never have access to the same exact product ever after that batch is used up. It requires interaction unlike any medication before. And what we're uncovering clinically is that in conventional pharmaceutical medications—whether they're over-the-counter, prescription-based or at the highest levels of danger in terms of scheduled medications—the side effects are disproportionate compared to those that are known to exist and are documented for cannabis. Cannabis doesn't have the toxicity of most prescription medications.

There's going to be changes in how medicine is paid for, who pays for it. We're basically analyzing all these research questions and showing that patients are paying more out-of-pocket for cannabis to switch over from their opiates, and this is verifiable through their medical records and through urine testing. About 40 percent of patients on average—at least among our opiate using population—ultimately quit using painkillers altogether in favor of using cannabis—even though they're paying more out-of-pocket for that medication.

Obviously insurers are saving tons of money. At some point there's going to be a balance that takes place. Insurers will start promoting the use of cannabis.

Do you think it's Big Pharma keeping the research from going ahead?

Oh I have no doubt about that. When we were analyzing some of the data that showed that opiate use dramatically dropped, not only did I get chills, but there was explicit thoughts of … that the information may put us at physical risk of harm if it were disclosed.

I have no doubt that the information I was looking at—dramatic reductions in opioid use—would equate to dramatic, billions of dollars in revenue reduction. That information has been known by the pharmaceutical companies for probably decades. They're responsible for killing—at this point—close to a million people just through derivatives of opiates alone. We have data showing that just the introduction of a dispensary in a county tends to result in a reduction in all kinds of over-the-counter medications. These are trillion dollar industries.

The writing's on the wall. Cannabis is going to be substituted for other medications across the board. It's not going to replace everything at Walgreens, but it's going to be replacing a lot of products. That's a lot of money at stake.

Can you tell me about the Medical Cannabis Research Fund?

A couple of years ago I set up the Medical Cannabis Research Fund to procure the money that's required to conduct any type of study. Many of my colleagues have grant funding from the Institute of Health and so forth, but that is essentially unattainable for those advocating for our community through this type of work. I decided there was a lot of interest and the formal process wasn't working so I would create a solution to this problem, and that's what the MCRF is supposed to be.

Right now we're growing slowly. It's expanding both in scope and impact. We just recently incorporated a couple of biostatisticians from the statistics department. We have tons of data, and we're putting out tons of papers. It's exciting, and it's one of the few institutes out there in the country that are devoted to supporting medical cannabis work directly.

Its sole purpose is to target needs in our community and to engage our local researchers and people with amazing minds and skills to best help their families and neighbors. Unlike just about any other entity in science and academia, our efforts are devoted toward our community. The MCRF is devoted to improving the world one dollar and one toke at a time.

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