Casual Discussion Science Forum @scivillage

Full Version: There Isn't Much Evidence for Medical Marijuana
You're currently viewing a stripped down version of our content. View the full version with proper formatting.
Pages: 1 2
https://sciencebasedmedicine.org/medical...-evidence/

EXCERPT: . . Marijuana has been legal to some extent in Canada (and in many US states) for some time, in the form of “medical” marijuana. The Canadian government authorized the sale of marijuana for that purpose, while it simultaneously emphasizes that cannabis is not an approved therapeutic product. The medical market, for many, appears to simply be a means to access products for recreational, or non-medical use, and has generated wildly unsubstantiated claims about the medical merits of marijuana for conditions like autism and the treatment of cancer. Dispensaries have appeared across Canada and the US, usually with very easy referrals for prescriptions. Some dispensaries ignore any prescription requirement entirely and will sell marijuana directly to the public without any medical assessment or advice. With the introduction of government-overseen (and in some Canadian provinces, government-delivered) retail sales in Canada later this year, it’s reasonable to assume that unregulated dispensaries will eventually disappear.

With recreational sales imminent in Canada (and already here, in states like California), there are questions about the future market for “medical” marijuana. [...] Given the major changes we are seeing in how we can access marijuana, it’s worth summarizing the current state of evidence for marijuana when used for specific medical purposes. With marijuana becoming much more accessible, physicians, other health professionals, and their patients need high-quality information about its value for different medical conditions. David Gorski reviewed much of the evidence in a series of posts over the past three years. Now, three new documents prepared for Canadian physicians and health professionals concisely summarize the current evidence base for medical marijuana.

[...data from documents presented...]

[...] The use of psychoactive drugs like marijuana is a health issue, particularly when used for medical purposes. Regrettably, there is a lack of high-quality data that shows marijuana for most medical purposes is both safe and effective. What little evidence exists is of poor quality and may not even be representative of the purposes for which medical marijuana is sought. There are significant gaps in information necessary to treat marijuana like other forms of medicine: Dosage standardization and overall quality control may not be in place. Overall effectiveness, contraindications, drug interactions, adverse events and long-terms risks when marijuana is used as medicine are not well understood. The best evidence suggests that marijuana may be a reasonable treatment option only when safer, more effective, and better tolerated treatment options have been tried first. If marijuana is to be treated as medicine, then it needs to meet the same standards of quality, effectiveness, and safety we would expect of any other prescription drug. That standard has not yet been met.

[...] The pharmacy profession seemingly sees a bright future in medical marijuana, with big chains striking deals with producers...

MORE: https://sciencebasedmedicine.org/medical...-evidence/
Everyone always knew medical marijuana was only a gateway to legal recreational use, since no one seemed interested in developing products without the psychoactive properties....that would have been the best candidates for the study of actual medical efficacy.
(Jan 12, 2018 08:27 AM)C C Wrote: [ -> ]https://sciencebasedmedicine.org/medical...-evidence/

EXCERPT: . . Marijuana has been legal to some extent in Canada (and in many US states) for some time, in the form of “medical” marijuana. The Canadian government authorized the sale of marijuana for that purpose, while it simultaneously emphasizes that cannabis is not an approved therapeutic product. The medical market, for many, appears to simply be a means to access products for recreational, or non-medical use, and has generated wildly unsubstantiated claims about the medical merits of marijuana for conditions like autism and the treatment of cancer. Dispensaries have appeared across Canada and the US, usually with very easy referrals for prescriptions. Some dispensaries ignore any prescription requirement entirely and will sell marijuana directly to the public without any medical assessment or advice. With the introduction of government-overseen (and in some Canadian provinces, government-delivered) retail sales in Canada later this year, it’s reasonable to assume that unregulated dispensaries will eventually disappear.

With recreational sales imminent in Canada (and already here, in states like California), there are questions about the future market for “medical” marijuana. [...] Given the major changes we are seeing in how we can access marijuana, it’s worth summarizing the current state of evidence for marijuana when used for specific medical purposes. With marijuana becoming much more accessible, physicians, other health professionals, and their patients need high-quality information about its value for different medical conditions. David Gorski reviewed much of the evidence in a series of posts over the past three years. Now, three new documents prepared for Canadian physicians and health professionals concisely summarize the current evidence base for medical marijuana.

[...data from documents presented...]

[...] The use of psychoactive drugs like marijuana is a health issue, particularly when used for medical purposes. Regrettably, there is a lack of high-quality data that shows marijuana for most medical purposes is both safe and effective. What little evidence exists is of poor quality and may not even be representative of the purposes for which medical marijuana is sought. There are significant gaps in information necessary to treat marijuana like other forms of medicine: Dosage standardization and overall quality control may not be in place. Overall effectiveness, contraindications, drug interactions, adverse events and long-terms risks when marijuana is used as medicine are not well understood. The best evidence suggests that marijuana may be a reasonable treatment option only when safer, more effective, and better tolerated treatment options have been tried first. If marijuana is to be treated as medicine, then it needs to meet the same standards of quality, effectiveness, and safety we would expect of any other prescription drug. That standard has not yet been met.

[...] The pharmacy profession seemingly sees a bright future in medical marijuana, with big chains striking deals with producers...

MORE: https://sciencebasedmedicine.org/medical...-evidence/

in the interests of scientific research we would like to ask you some questions about your current medical conditions and ask you to tell us that you are also a criminal.
please print your name clearly at the top of the page and we promise not to publish your name.
...

when do the smart people start talking ?
I have read many articles about medical marijuana and how it can help you in terms of chronic pain, bone injuries, eating disorder/anorexia, anxiety disorders and panic attacks, inflammation, even cancer and a lot more. Like this article about a marijuana strain from http://www.ilovegrowingmarijuana.com/nova/ . Cbd and thc are also new to me and I don't even smoke. If this is true I cant find any solid conclusive evidence that speaks to its efficacy.
(May 29, 2018 06:37 PM)Rien Wrote: [ -> ]I have read many articles about medical marijuana and how it can help you in terms of chronic pain, bone injuries, eating disorder/anorexia, anxiety disorders and panic attacks, inflammation, even cancer and a lot more. Like this article about a marijuana strain from http://www.ilovegrowingmarijuana.com/nova/ . Cbd and thc are also new to me and I don't even smoke. If this is true I cant find any solid conclusive evidence that speaks to its efficacy.

Ah, a new member. Welcome!

There hasn’t been enough research because I think it’s still classified as a Schedule I drug, but the FDA has agreed to support additional research by making the process easier.

Quote:For marijuana (or any drug) to become available by prescription, you need to conduct FDA-approved clinical trials that demonstrate that a particular strain of marijuana is both safe and effective. If you were successful in doing so, that particular strain of marijuana would be available by prescription in pharmacies nationwide — not just in the 25 medical marijuana states.

While dozens of FDA-approved studies have shown that marijuana has medicinal value in the treatment of cancer, multiple sclerosis, epilepsy, AIDS, and pain, the problem is that no single, reproducible strain of marijuana has moved all the way through the FDA approval process. As such, the FDA must claim that marijuana hasn’t yet been proven to have medical value, which led the DEA to conclude the same thing. To be fair, the DEA did announce that they will end NIDA’s monopoly on marijuana grown for research purposes, which could help lead to the types of research the FDA is seeking. Source
(Jan 12, 2018 08:27 AM)C C Wrote: [ -> ]The medical market, for many, appears to simply be a means to access products for recreational, or non-medical use

True. I think that happens a lot. But having said that, I voted to legalize recreational marijuana here in California.

Quote:and has generated wildly unsubstantiated claims about the medical merits of marijuana for conditions like autism and the treatment of cancer.

I agree that marijuana is unlikely to be a very effective direct treatment for cancer. (It might be a lot more effective for the pain and anxiety associated with having cancer.) I don't see it as having much effect on real full-frontal autism either. (But given that "autism" has been expanded into a whole range of things that it never used to be, I expect that it might be a possibiity worth trying with less extreme forms.)

But those are the most extreme sort of claims and emphasizing them just turns medical marijuana into a caricature.

I think that medical marijuana can be quite effective for things like low-level chronic pain, with far fewer dangers than alternative medications. I know that the chairman of pain medicine at the U. of California San Diego Medical Center says that he has no problems with recommending marijuana to his patients. He considers it safe and a far more conservative treatment option than opioids.

I know for a fact that marijuana can be quite effective in improving social functioning in people who suffer from severe social anxiety. I've seen a loner who always kept to himself and avoided being in groups or interacting with strangers become downright outgoing when he'd been smoking dope for a while. (That might have some relevance to the "autism" diagnoses too, since I expect that a lot of that is trendy mis-diagnosis these days.) If it works well with one kind of anxiety, I expect that marijuana might be effective with other sorts of anxiety too. So there may be valuable psychiatric applications.    

Quote:The use of psychoactive drugs like marijuana is a health issue, particularly when used for medical purposes.

Well sure. But when all the other treatment alternatives consist of psychoactive drugs, and if marijuana is the least dangerous of the bunch, then it might seem to be a preferred alternative. See my opioid remarks up above.

Quote:Regrettably, there is a lack of high-quality data that shows marijuana for most medical purposes is both safe and effective. What little evidence exists is of poor quality and may not even be representative of the purposes for which medical marijuana is sought. There are significant gaps in information necessary to treat marijuana like other forms of medicine: Dosage standardization and overall quality control may not be in place.

I agree that dosage can be important when considering marijuana for pain. Too little is ineffective, and too much can make sensitivity to pain worse. So yes, attention needs to be paid to those kind of things.
From the UC San Diego Medical School:

https://onlinelibrary.wiley.com/doi/pdf/.../add.14382

"For Schedule III opioid prescriptions, medical cannabis legalization was associated with a 29.6% (p=0.03) reduction in number of prescriptions, 29.9% (p=0.02) reduction in dosage, and 28.8% (p=0.04) reduction in related Medicaid spending."
The difference between 'psychoactive' drugs and 'therapeutic' drugs is (surely) that the psychoactive drug acts on the perception of whatever it is rather than the cause. As social animals what happens when our perception is altered by a drug is very much influenced by our peer group and expectations. The wider you open the window the more the wind blows in. The same psychoactive drug might give pain relief or uncontrollable laughter or paranoia - a slight upward (or downward) turn of the lip of someone you are with is sufficient.
(Jul 15, 2018 02:52 AM)confused2 Wrote: [ -> ]The difference between 'psychoactive'  drugs and 'therapeutic' drugs is (surely) that the psychoactive drug acts on the perception of whatever it is rather than the cause. As social animals what happens when our perception is altered by a drug is very much influenced by our peer group and expectations.  The wider you open the window the more the wind blows in.  The same psychoactive drug might give pain relief or uncontrollable laughter or paranoia  - a slight upward (or downward) turn of the lip of someone you are with is sufficient.

Very true. I've seen studies that showed that the effect of alcohol was largely the expectation of the culture. I've even tested that myself by keeping someone intellectually engaged as we drank...and we remained very clear and alert compared to others and how much we drank. I've even brought my brother from the brink of passing out, just using that headache technique I told you. I don't know that the effect of marijuana is quite so socially dependent, but it is definitely dependent on the individual...maybe the kind of mental baggage they bring. And LSD is definitely affected by both mental baggage and mood priming going in.

I doubt medical professions make the psychoactive/therapeutic dichotomy you do. That sounds like you're making a more palliative vs efficacious distinction. In that sense, marijuana is likely only palliative, where CBD oil (and that component in marijuana) may be more efficacious. The reason people seek out marijuana over CBD oil is that they are seeking palliative self-medication, likely for emotional reasons.
(May 30, 2018 06:51 PM)Yazata Wrote: [ -> ]...So there may be valuable psychiatric applications...

This is a British study where cannabiodiol [CBD - a component of marijuana] was administered to college student volunteers, some of whom had exhibited psychotic-like symptoms in the past but hadn't been diagnosed as psychotic, hence were considered as being at clinically high risk [CHR] of becoming psychotic in the future. Apparently functional MRI brain-scans in these individuals could detect functional abnormalities in parts of the brain associated with psychosis. After administration of CBD, their fMRI scans were noticeably more similar to those of healthy controls.

Work still needs to be done on how long-lasting this effect is, on whether it really is associated with a lower likelihood of subsequent onset of full-blown psychosis in individuals considered CHR, and on whether this kind of drug therapy might have beneficial effects for those already diagnosed as psychotic.

https://jamanetwork.com/journals/jamapsy...le/2697762
Pages: 1 2