The U.S. government will spend $3 million to find out if marijuana can relieve pain, but none of the money will be used to study the part of the plant that gets people high.

Nine research grants announced Thursday are for work on CBD, the trendy ingredient showing up in cosmetics and foods, and hundreds of less familiar chemicals. THC research was excluded.

The federal government still considers marijuana an illegal drug, but more than 30 states allow it use for a range of medical problems, some without good evidence.

The science is strongest for chronic pain, the most common reason people give when they enroll in state-approved medical marijuana programs. But little is known about which parts of marijuana are helpful and whether the intoxicating effects of THC can be avoided.

“The science is lagging behind the public use and interest. We’re doing our best to catch up here,” said Dr. David Shurtleff, deputy director of the National Center for Complementary and Integrative Health, which is funding the projects.

THC has been investigated extensively, Shurtleff said, and its potential for addiction and abuse make it unsuitable for treating pain.

Other federal agencies have supported marijuana research, but much of the focus has been on potential harms. Shurtleff said the grants answer the call in a 2017 National Academies of Sciences, Engineering and Medicine report, which concluded a lack of marijuana research poses a public health risk.

Another driver is the nation’s opioid addiction crisis, with its roots in overuse of prescription painkillers. The crisis has sparked new scientific interest in marijuana’s pain-easing properties.

Dr. Judith Hellman, a grant recipient from University of California San Francisco, said scientists need to better understand pain and to find more ways to treat it. “It’s very exciting to have the opportunity to do that,” she said.

Hellman’s research involves the body’s ability to produce signaling molecules similar to marijuana’s ingredients. Her and Dr. Mark Schumacher’s work involves human immune cells in the lab, then tests on mice.

Human test subjects will be involved in only one of the grant projects. University of Utah researcher Deborah Yurgelun-Todd will scan the brains of human volunteers with lower back pain to see how CBD extract — mixed with chocolate pudding — affects pain-signaling pathways. Half the volunteers will get pudding without CBD as a control group.

Two more human studies may be funded in a second round of grant awards, NCCIH said.

In July, the National Institute on Drug Abuse said it would grow 2,000 kilograms (4,409 pounds) of marijuana this year at the University of Mississippi, which holds the sole federal contract for producing research cannabis. Those plants won’t be used in many of the new projects, which instead will use lab-made versions of the chemicals.

Researchers in Illinois hope to create a library of useful compounds found in cannabis plants.

“We make them from scratch and test them one by one,” said David Sarlah of the University of Illinois. Marijuana contains such tiny amounts of the interesting ingredients that it’s too costly and time consuming to isolate enough for research, Sarlah said.

Sarlah, an organic chemist, will make the chemicals. His colleague Aditi Das will run tests to see how they react with mouse immune cells.

“There are so many beneficial effects that patients report. We need to know the science behind it,” Das said.

The United States is suffering from an epidemic that is estimated to have claimed 400,000 lives. In what is now known as the opioid crisis, drug manufacturers have been raking in huge profits over the past two decades by mass prescribing a diverse class of addictive painkillers known as opioids.

Now, about 130 people in the United States die every day after overdosing on opioids, making it the nation’s biggest accidental killer, while millions more continue to suffer from the dependence and addiction that the drugs cause. 

Things reached a boiling point this week after drug-maker Purdue Pharma filed for bankruptcy and agreed to a $12bn settlement for its role in fuelling the crisis. 

Before that, a landmark case saw pharmaceutical giant Johnson & Johnson pay $572m in compensation for its role in the epidemic of addiction in Oklahoma alone.

It’s a crisis that has been described as a “uniquely American problem” – a phenomenon that could only really emerge from the US healthcare system, where insurance companies seek out cheap solutions and many doctors who prescribe the drugs receive payments from the manufacturers to do so. 

In 2012, this crisis peaked, when more than 255m opioids were prescribed, at a rate of 81 prescriptions per 100 Americans. 

The trouble is that many aspects of the problem have a wider relevance too, and not least in the UK, where a government review recently revealed that almost 12m people (about one in four adults in England) are now taking medicines that are addictive for pain, depression, or insomnia. 

The majority of these are antidepressants, which doctors issued nearly 71m prescriptions for in 2018, a 97 per cent increase compared to 2008. What’s also worrying is that prescriptions of opiates have risen 22 per cent from a decade earlier to 40m. Both of these medicines can be difficult to withdraw from and are easy to abuse.

Also consider that both countries have been engaged in a longstanding war on drugs that has led to a widespread denial of  the medical properties that exist in banned substances. 

We know that medical cannabis creates important pain-relieving molecules that are 30 times more powerful than aspirin, but that crucially, offers relief without the risk of addiction and fatal overdose that prescription painkillers do. 

While opioids work by blocking the brain’s receptors, the cannflavins in medical cannabis target pain with a different approach, by reducing inflammation. 

If you look first at CBD-dominant strains that have very little or no THC, the World Health organisation has said that “in humans, CBD exhibits no effects indicative of any abuse or dependence potential” and that “to date, there is no evidence of public health-related problems associated with the use of pure CBD”. 

This is crucial because patients now report many benefits of CBD, which include relieving insomnia, anxiety, and chronic pain.

So if CBD can be an effective, non-addictive, and a safe substitute for opioids, then what of medical cannabis that also contains the psychoactive compound THC? 

Critics of the drug say that this type of cannabis is itself addictive. While decades of global conservatism towards cannabis has resulted in a shortage of medical trials, recent studies show it can be particularly effective for the severe chronic pain that plagues millions, and is still far safer than opiates because it’s impossible to overdose on and far less addictive. 

Health Canada, the Canadian version of the NHS, found that while cannabis addiction does exist, the risk is far lower than in tobacco, alcohol, and opioids, while the NHS states that 10 per cent of regular cannabis users are at risk of addiction. 

Pre-clinical studies are also uncovering that certain cannabinoids may even alleviate opioid withdrawal symptoms. In fact, striking recent statistics suggest that prescribing medical cannabis instead of opioids has the potential to prevent around 25 per cent of deaths associated with opioid addiction each year. 

Also bear in mind that in American states where cannabis is legal for medical uses, prescriptions for opioids and anti-depressants has fallen on average by an extraordinary 30 per cent, a rate still strengthening with time. 

The financial burden that these health care crises have on British society each year already runs into billions of pounds, including the cost of lost productivity in the workforce.

Medical cannabis is an inexpensive and effective alternative to many treatments, that is now widely viewed as a non-toxic and non-addictive substitute for pricey prescription drugs. 

This alone should be a good enough reason for the NHS to consider CBD or medical cannabis both as a substitute to prescribing opioids, and as means to alleviate the opioid withdrawal symptoms addiction that already afflicts so many.

There's little doubt that the U.S. is going to be the most lucrative legal cannabis market, once it's fully up and running, and assuming pot is legalized federally. And while the No. 2 spot has typically belonged to Canada, it may not end up that way. While Canada certainly has a head start, having been just the second country to fully legalize marijuana (Uruguay was first), it hasn't exactly been a smooth ride for the cannabis industry there in the period since.

Supply issues have been a big problem, and restrictions on advertising have made it difficult for companies to build their brands. However, even if those issues are addressed, the potential for the Canadian market may still not be all that big, if for no other reason than its relatively small population of 37 million people. 

Results so far have been so disappointing that researchers from BDS Analytics recently cut their revenue forecasts for the Canadian market: Where they previously expected it to hit $5.9 billion in 2022, they now are predicting it will hit $5.2 billion by 2024. The managing director of BDS Analytics, Tom Adams, blames the "very cautious approach" that the country's government is taking to cannabis for the slower growth of the market.

Another market that could prove to be a better option for investors: Asia

One research company, Prohibition Partners, believes that the market for legal cannabis in Asia could be worth more than $5.8 billion by 2024, eclipsing the $5.2 billion that Canada would have by the same time, if both figures prove to be correct. Researchers estimate that nearly 86 million people on the continent use cannabis every year. 

The big advantage for Asia is certainly its size -- there are vastly more potential cannabis consumers in that part of the world. The disadvantage, however, is that the effort to get it legalized for adult use in the nations is likely to be more of an uphill battle. There's still a lot of opposition to marijuana in the region, and penalties for using it or selling it are still extremely stiff in some counties.

While it's unfair to compare the Canadian market to an entire continent, the reality is that the bulk of the sales in Asia are expected to come from just two countries, China and Japan, which Prohibition Partners anticipates could make up 90% of the market. 

Great opportunity for companies to expand into Asia today 

One company that could benefit greatly from a strong Asian market is GW Pharmaceuticals (NASDAQ:GWPH), maker of Epidiolex, the first cannabidiol (CBD)-based treatment to be approved for use by the U.S. Food and Drug Administration. The U.K.-based company has already set its sights on other international markets. Epidiolex has been approved for clinical trials in Japan; if it is successful and approved by regulators there, that could lead to greater acceptance of CBD treatments across the continent. 

GW is still growing, and after recording $72 million in sales in its most recent quarter, the company is poised for a big improvement this year. In all of 2018, GW generated just $29 million in revenue.

However, the opportunity isn't limited to just pharmaceutical products, as any cannabis company producing CBD products could have an incredible opportunity to grow in Asia. And with many of the world's largest cannabis producers focusing on North America and Europe, now could be a great time for a company to establish a strong position there.

One-and-a-half million people in the United States suffer from rheumatoid arthritis (RA). In fact, The Arthritis Foundation estimates that three times as many women as men have the disease and it affects individuals of all ages, but primarily women ages 30 to 60.

Commonly affecting the hands and feet of the body, RA is considered an autoimmune disease, where the body attacks joints, leading to inflammation and pain as well as a loss of motion. With a diagnosis comes a rapidly-changing lifestyle, often causing activities and hobbies that were once loved and now off-limits. Through stories on the National Rheumatoid Arthritis Society website, many individuals have shared that arthritis has caused a dramatic lifestyle change that’s often accompanied by depression and anxiety. But that doesn’t have to be the case.

Changing perceptions around cannabis with arthritis

With patients young and old experiencing the debilitating effects of rheumatoid arthritis, individuals like Pearl Schomburg are advocating for doctors to mention the effects of cannabis in office. Pearl explained to Newshub, “Cannabis balm was the first thing I discovered and was shocked by how well it worked.” The Arthritis Foundation recently shared information about CBD and marijuana on its website to educate patients around its use. Recognizing the potential to treat both inflammation and pain, they advise to always discuss CBD and cannabis with your care team and make sure to contact the manufacturer to see proof of a third-party analysis for purity.

Promising new studies on CBD and cannabis in treating RA

In a 2018 study published by the U.S. National Library of Medicine, researchers found that terpenoids, which exist in cannabis, offer anti-inflammatory properties, but didn’t offer as much relief as purified CBD. Often used in chronic inflammation and for pain, purified CBD offered better relief in the study over other mixtures, including CBD.

Psoriasis, a condition where cells build on top of the skin and cause pain and redness, is often coupled with RA and offers treatment that can be very expensive. John S. from Minneapolis explained that his medicine came in the form of a shot billed to insurance at $60,000 each year creating a debilitating pattern of relying on pharmaceutical medicine that is often inaccessible. Would he explore CBD and cannabis? He explained, “It’s been on my mind; a year ago, I wouldn’t have even thought about integrating CBD, now I’m looking at reviews online.” In fact, MedicalNewsToday cited 2016 research that suggested that cannabinoids offered benefits to individuals with psoriasis.

New uses on the horizon

With the market ever-changing, not only are tinctures available, but patches as well. In 2016, a study found that placing CBD on the body in a topical fashion offered some relief for pain and inflammation over other methods. CBD comes in many forms, including:

• Topicals: Creams, patches, balms and lotions applied directly to the skin
• Edibles: Food and drink-related CBD and THC-infused items that are consumed by mouth
• Vapes: Oil that is heated and inhaled into the lungs
• Tinctures: Drops taken by mouth with or without flavor
• Dissolvables: Fairly new to the market, bath bombs are infused with CBD to help with relaxation and healing

As the cost of medicine continues to rise, CBD and cannabis offer a more affordable solution to many experiencing the effects of RA, inflammation and psoriasis.

House of Cannabis, a new pot shop in Twisp, WA, is seeing a steady increase (about 52%) of customers coming in aged 50 and older. Mainly focused on pain relief, House of Cannabis has been both startled and empowered by the number of older adults coming in for the first time.  “Arthritis is probably the most common issue people are dealing with in their hands, back and legs,” shared Cindy Knutson, the retailer’s general manager and state-certified medical cannabis consultant. “We’re seeing a shift in mindsets and the market,” Knutson continued, notating that adults who typically wouldn’t have spoken about cannabis or CBD are now sharing with their friends.