In the fall of 2016, Insys Therapeutics put itself at the forefront of the campaign against legalization of marijuana in Arizona. With a whopping $500,000 contribution to “Arizonans for Responsible Drug Policy”, the pharmaceutical company made history with this being one of the single biggest campaign contributions EVER to an anti-marijuana-legalization campaign. That, however, is not the story here. Insys gathered national attention based on one peculiar additional piece of the story – the company also developed a synthetic version of marijuana called Syndros.
In July of 2016, Syndros was approved by the Food and Drug Administration for use in AIDS treatment and in the treatment of cancer symptoms. This drug is a synthetic version of THC, and was marked as a Schedule II drug, indicating a “high potential for abuse” – such as morphine, cocaine, and several prescription painkillers.
Insys and Marijuana Policy
This is not the company’s first foray into influencing marijuana policy. In 2011 the company contacted the DEA in an effort to oppose decreasing restrictions on natural THC, using the “abuse potential” as a main arguing point. However, just last year the company again contacted the DEA – this time to loosen restrictions on synthetic CBD, a compound of cannabis. These seemingly contradictory statements might be explained by Insys’s very own drug development; they are currently working on a drug utilizing synthetic CBD, so it is very much in their interests that the CBD restrictions be loosened. All in all, Insys’s history of opposing natural cannabinoid derivatives while simultaneously supporting synthetic cannabinoids seems to directly relate to their bottom line.
The ethical landscape might be a bit fuzzy but perhaps explainable from a simply commercial standpoint, if it were just a matter of a large pharmaceutical company trying to prevent competition with its own product. However, a systemic study published in JAMA in 2015 looking into the medical use of cannabinoids adds another angle to the story.
This study, looking at the effects of cannabis in the treatment of pain and other symptoms of common diseases, showed significantly positive results. As compared to a placebo, the use of cannabinoids showed a reduction in overall pain and a reduction in the severity of pain. Additional data showed a possible link between cannabis use and reduced nausea and vomiting from chemotherapy treatments, improved sleep quality, and increased weight gain for patients with HIV.
This data is especially significant when you consider the effects of the alternative treatments – namely, prescription drugs. Many patients already utilize cannabis as an alternative to prescription drugs. One study showed that 66 percent of patients utilize medicalized cannabis a prescription drug alternative due to the “better symptom management, less adverse side effects, and less withdrawal potential”.
With increasing rates of opioid prescription – in 2005 approximately 10 million people were treated with long-term, daily opioid prescriptions – there is an ever-increasing risk of addiction. It is estimated that over 5 million Americans might suffer from an opioid addiction, half of which are estimated to be resulting from an initial opioid prescription for pain management.
With literally millions of lives on the line, and millions more exposed to potential addiction daily as a result of being prescribed strong daily prescription pain management medications, it is increasingly apparent that medical cannabis fits a well-defined and much needed niche in the pain management world. When companies like Insys directly oppose marijuana legalization to further their own interests, it is the chronic pain patients that suffer. Finding an ethical justification for the promotion of Syndros in a manner that opposes legalization of marijuana is difficult considering the millions of lives that are directly affected. While it is certain that money talks, hopefully science will speak just as loudly. In an age of increasing litigation and lobbying, it will take continued dedicated research to influence public opinion and to fight large companies like Insys that buck scientific results in order to pursue their own interests.
This post was originally published on April 7, 2017, it was updated on October 5, 2017.