Thank you for the invitation to speak on this very important topic, which is so critical to veterans and our society.
I'm Yasmin Hurd. I'm the director of the Addiction Institute at the Icahn School of Medicine in New York. I'm also a professor in psychiatry, neuroscience and pharmacological sciences. I'm also a neuroscientist whose cannabinoid studies have been recognized internationally in consideration of opioid reduction and related psychiatric disorders.
Veterans have always been trailblazers fighting for freedoms that we sometimes take for granted. Unfortunately, in some situations, this has placed them at tremendous risk even when the battle on the field is over. Many of them face a new battle, one even greater than the physical battlefield. A significant percentage of veterans suffer from PTSD, depression, chronic pain and substance use disorder. They are all interconnected. For example, chronic pain led many down the path of prescription opioids. Veterans, like many others, were simply unaware of the potential consequences of such potent opioids—including the tragic risk of addiction. We now know that the use of opioids over a long period of time is highly addictive, which has caused the deaths of millions of people in North America, as well as a significant economic burden and the destruction of many families and communities.
Cannabis has been proposed as a new pharmacological agent to alleviate the mental and physical suffering of veterans. Despite limited scientific research, cannabis use has been widely publicized as reducing chronic pain, PTSD, anxiety and opioid addiction. This really has unfortunate consequences since the public and veterans falsely believe that marijuana can cure all of these conditions.
As a scientist, I initiated the studies of cannabidiol, CBD, a non-intoxicating cannabinoid, as a potential treatment for opioid abuse more than 10 years ago now. Indeed, we observed efficacy to reduce anxiety and opioid craving. However, such studies are still in early stages of development and require more support. There is still a lack of substantial research evidence about the efficacy of cannabis to treat all these disorders, yet anecdotal stories have propelled many people, including veterans, to start smoking marijuana. Smoking anything has significant health risks.
Instead of science-based medicines, it seems that the Canadian marketplace has developed without the required clinical trials and research that's really necessary to establish the safety and efficacy of these new cannabis health products. Therefore, veterans, like many in our society, falsely believe that recreational cannabis and medical cannabis are one and the same. They are not.
There really is an urgent need for proper education all around. We must be committed to doing the necessary clinical trials and partnering with non-recreational licensed producers to develop real, safe and efficacious medicines that the veterans administration can truly support for the treatment of veterans. The veterans administration needs to identify those companies truly committed to developing medicine.
We must also develop formulations that are medicinal. We must know the cannabinoids, such as CBD or full-spectrum cannabis signatures, the dose and concentrations, which was spoken about before, the dosing regimen and the delivery formats, such as capsules or inhalation, that work best to maintain stable relief of pain, PTSD and addiction while minimizing the side effects. We do not want to, once again, put veterans at risk because we are rushing to put out recreational marijuana as medicine. While it is easy to pass off recreational joints to veterans as medicine, it really is egregious and actually an insult to veterans who deserve much more.
By working together, I fully believe that scientists, physicians, non-recreational licensed producers and the veterans administration can develop evidence-based medicinal cannabis. I think that veterans and the general society deserve nothing less.
I have addressed a number of the points that were raised with regard to the aspect of exceeding three grams a day and the cost of the reimbursement. I can't speak to the reimbursement so much, but in terms of three grams a day, I think the aspect of standardization is critical. Three grams indicates that it's about smoking. As I indicated, for me and most people in this field, smoking is not a valid medical route of administration.
If we're creating medicines, we should create the best formulations so that we can know what doses, concentrations and dosing regimens really alleviate specific symptoms and disorders. One dose will not fit all.
There is very limited research about which particular cannabinoids, or the full cannabis plant, are needed for each of these. Again, that's why it requires more research.
Without placebo-controlled double-blind clinical studies, we will not be able to give informed information to patients and physicians.
In closing, I definitely want to emphasize overall the critical need for veterans and the public to be made aware that for cannabis to be used as a medicine, we must treat it as such. The sacrifices that veterans have made should be honoured by bringing whatever is needed to provide them with safe, evidenced-based medicines. I really think that we can be trailblazers in developing such medications together.
Thank you.