BOSTON — Across the U.S., 28 states allow some form of legal marijuana use, eight allow recreational marijuana use and 14 allow use of the cannabinoid, cannabidiol. With several more states pushing legislation to legalize the use of recreational marijuana, there is an ever-increasing need to study the health impact of marijuana and the cannabinoids it contains.

Providing timely education for clinicians, researchers and health professionals was the goal of the second-annual CannMed2017 conference held last month at Harvard University. The conference focused on the intersection of clinical application, medical research, cannabis-based therapeutics, cannabis safety and production. Topics covered a wide range of clinical areas including concussion, pain management, cancer, inflammatory disorders, neurological disorders, impact on adolescent development as well as cannabis regulations.

This is the second year that Medicinal Genomics Corporation and Courtagen Life Sciences have organized the cannabis educational program. They described the event as "a gathering of the greatest minds in medical cannabis research, where they will discuss the work they are doing to better understand this remarkable plant and how their work will shape future cannabis regulations."

A featured speaker was Michael Dor, M.D., the chief medical officer for the Israeli Ministry of Foreign Affairs and head of the Medical Cannabis Unit. The government of Israel is considered to be on the forefront of cannabis research and facilitated the pioneering work to study, develop and expand the medical marijuana industry. Dor presented the history and current status of this work.

Raphael Mechoulam, Ph.D., is considered to be the father of cannabinoid science, having been part of the team that isolated the psychoactive ingredient in marijuana as well as the endogenous cannabinoids in the human brain. He is an Israeli organic chemist and professor of medicinal chemistry at the Hebrew University of Jerusalem in Israel. His lecture was broadcast live from Israel.

There were presentations discussing the complexity of the marijuana plant and cannabinoids. Kevin McKernan, the chief science officer of Medicinal Genomics Corporation, presented information about the potential to provide customized, targeted treatments of disease using the genetic matching of cannabis plants to a patient's positive response.

He provided behavioral examples among groups of patients with autism. To achieve this, Medicinal Genomics utilizes a highly sophisticated Next Generation Sequencing laboratory, bioinformatics system and DNA-based technologies to decipher the genetic code of marijuana plants.

The abstract of Markus Roggen, Ph.D., vice president of Extraction/OutCO, also discussed the differences in plant strains and presented techniques to more consistently extract cannabinoids so as to have consistent pharmaceutical effect.

An additional category of plant components was discussed in the work of Marco Troiani, the CEO of Digamma Consulting, a firm specializing in cannabis research and development. His abstract covered the terpenoids, an organic compound that brings the characteristic smell and taste of cannabis and enhances or attenuates the effects of cannabis.

Mary Kathryn Dahlgren, Ph.D., a clinical research scientist from McLean Hospital in Boston, presented a research abstract related to the impact of heavy recreational marijuana use, in the abstinent state of marijuana acute intoxication on a set of simulated driving tasks. The study found that those users who had started marijuana use before the age of 16 were impaired in driving tasks compared to those who had started use at a much older age, as well as those who were not chronic heavy users.

My own work was presented in the same session, and I reported case studies of retinal ganglion cell impairment identified with functional visual fields, with acute use of marijuana. The abstract further discussed the contributions such sensory deficits can make to impaired driving with marijuana use.

One of the final events of the conference was a panel discussion on cannabis as medicine in professional sports. The panel featured former National Football League players Ricky Williams, Eben Britton, Nate Jackson and Lance Johnstone. Medical experts were Perry Solomon, M.D., and David Nathan, M.D.

The athletes gave individual perspectives on cannabis as a substance banned within the NFL and its use for pain management as an alternative to more detrimental, but allowed treatments. The stories were poignant, humorous and compelling.

While educational programs such as CannMed2017 are crucial to address both the negative and positive aspects of marijuana use, they certainly demonstrate how much more study is needed.