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Cannabis is no better than a placebo for treating pain (data meta-analysis)

#1
C C Offline
https://theconversation.com/cannabis-is-...rch-195394

EXCERPTS: . . . Although cannabis (and cannabis-derived products, such as CBD) may be widely used for reducing pain, how effective it really is in doing this is still unclear. This is what our recent systematic review and meta-analysis sought to uncover. Our study, published in the Journal of the American Medical Association, suggests cannabis is no better at relieving pain than a placebo.

[...] Our meta-analysis showed that pain was rated as being significantly less intense after treatment with a placebo, with a moderate to large effect depending on each person. Our team also observed no significant difference between cannabis and a placebo for reducing pain.

This corroborates the results of a 2021 meta-analysis. In fact, this 2021 meta-analysis also found that higher-quality studies with better blinding procedures (where both participants and researchers are unaware of who is receiving the active substance) actually had higher placebo responses. This suggests that some placebo-controlled cannabis trials fail to ensure correct blinding, which may have led to an overestimation of the effectiveness of medical cannabis.

Our study also revealed many participants can distinguish between a placebo and active cannabis, despite having the same odour, taste and appearance. If they are aware that they are receiving or not receiving cannabinoids, they are more likely to provide a biased assessment of the effectiveness of the intervention. So to ensure researchers are observing the actual effect of cannabis, participants can’t know what they receive.

[...] The overwhelming majority of news items reported that cannabis had a positive effect for treating pain. This means that media coverage towards cannabis tends to be positive, regardless of what a study’s outcomes actually were. There are numerous examples of the relationship between treatment expectations and placebo responses...

[...] We cannot say with 100% certainty that media coverage is responsible for the high placebo response observed in our review. But given placebos were shown to be just as good as cannabis for managing pain, our results show just how important it is to think about the placebo effect and how it can be influenced by external factors – such as media coverage... (MORE - missing details)
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#2
Seattle Offline
(Nov 30, 2022 07:28 PM)C C Wrote: https://theconversation.com/cannabis-is-...rch-195394

EXCERPTS: . . . Although cannabis (and cannabis-derived products, such as CBD) may be widely used for reducing pain, how effective it really is in doing this is still unclear. This is what our recent systematic review and meta-analysis sought to uncover. Our study, published in the Journal of the American Medical Association, suggests cannabis is no better at relieving pain than a placebo.

[...] Our meta-analysis showed that pain was rated as being significantly less intense after treatment with a placebo, with a moderate to large effect depending on each person. Our team also observed no significant difference between cannabis and a placebo for reducing pain.

This corroborates the results of a 2021 meta-analysis. In fact, this 2021 meta-analysis also found that higher-quality studies with better blinding procedures (where both participants and researchers are unaware of who is receiving the active substance) actually had higher placebo responses. This suggests that some placebo-controlled cannabis trials fail to ensure correct blinding, which may have led to an overestimation of the effectiveness of medical cannabis.

Our study also revealed many participants can distinguish between a placebo and active cannabis, despite having the same odour, taste and appearance. If they are aware that they are receiving or not receiving cannabinoids, they are more likely to provide a biased assessment of the effectiveness of the intervention. So to ensure researchers are observing the actual effect of cannabis, participants can’t know what they receive.

[...] The overwhelming majority of news items reported that cannabis had a positive effect for treating pain. This means that media coverage towards cannabis tends to be positive, regardless of what a study’s outcomes actually were. There are numerous examples of the relationship between treatment expectations and placebo responses...

[...] We cannot say with 100% certainty that media coverage is responsible for the high placebo response observed in our review. But given placebos were shown to be just as good as cannabis for managing pain, our results show just how important it is to think about the placebo effect and how it can be influenced by external factors – such as media coverage... (MORE - missing details)

I have a hard time with this one. It's true that I don't know what taking CBD is like but if you had chronic pain and you were smoking pot (for example) I can't help but believe that you would have to feel better than if you weren't smoking pot.

If you were in pain, having a drink of alcohol would almost have to result in less pain as well.

Having said that, I do think that many people can learn to reduce pain or live with pain without taking anything once they get used to it and learn to relax rather than fear the pain.

I can see that it's probably better if you don't continue to use CBD but I have a hard time believing that it has no effect. Again I know little about CBD so maybe it is nothing like smoking pot?
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#3
C C Offline
(Dec 1, 2022 03:53 AM)Seattle Wrote: I have a hard time with this one. It's true that I don't know what taking CBD is like but if you had chronic pain and you were smoking pot (for example) I can't help but believe that you would have to feel better than if you weren't smoking pot.

I found it something of a stretch, too, especially when it comes to multiple sclerosis. Though that's purely due to Montel Williams raving for years about how it gave him his life back, and his early desperation when he couldn't obtain it legally.

Quote:I can see that it's probably better if you don't continue to use CBD but I have a hard time believing that it has no effect. Again I know little about CBD so maybe it is nothing like smoking pot?

CBD isn't psychoactive in an intoxicating way like THC -- it's not the component that makes you high. Though CBD could be "mood altering" in a positive way, relieving psychological symptoms like anxiety. Whereas THC can do the opposite.
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#4
Seattle Offline
(Dec 1, 2022 05:38 AM)C C Wrote:
(Dec 1, 2022 03:53 AM)Seattle Wrote: I have a hard time with this one. It's true that I don't know what taking CBD is like but if you had chronic pain and you were smoking pot (for example) I can't help but believe that you would have to feel better than if you weren't smoking pot.

I found it something of a stretch, too, especially when it comes to multiple sclerosis. Though that's purely due to Montel Williams raving for years about how it gave him his life back, and his early desperation when he couldn't obtain it legally.

Quote:I can see that it's probably better if you don't continue to use CBD but I have a hard time believing that it has no effect. Again I know little about CBD so maybe it is nothing like smoking pot?

CBD isn't psychoactive in an intoxicating way like THC -- it's not the component that makes you high. Though CBD could be "mood altering" in a positive way, relieving psychological symptoms like anxiety. Whereas THC can do the opposite.

OK, then if the study is rigorous maybe CBD is no better than a placebo. I'm not aware of the history of why CBD came to be used in the first place.
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#5
C C Offline
(Dec 1, 2022 04:45 PM)Seattle Wrote: OK, then if the study is rigorous maybe CBD is no better than a placebo. I'm not aware of the history of why CBD came to be used in the first place.

I tend to not place a lot of stock in the conclusions of a meta-analysis. These overarching evaluations rarely settle the long-running debates that they were originally introduced to resolve. Much like the specific research papers themselves that they are collectively parasitical on, one meta-analysis study might conclude one thing about the assembled research data and a separate effort the opposite. (Or just another "we dunno fer sure".)

Similar to armchair reasoning being vulnerable to the quality of its premises, a meta-analysis effort will just crank out more merde or confusion if many of the individual studies it is examining and collating were poorly designed and flawed themselves.

Plus, the rules of meta-analysis aren't competent or supreme enough to wholly deprive its mortal conductors of having to make their own interpretations and decisions along the way. Personal preferences or biases can creep in during the course of the process.

Due to the sometimes conflicting results, opinions reversing back and forth, and unclear issues over the years... The "human sciences" often look like the "it's a racket" part of the overall disciplinary enterprise. That mess supplies material for multiple, interested parties to appeal to in their "But science says so!" claims. So this particular one on display in the produce section at the "research market" apparently provides a potential assist for an anti-weed agenda.
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#6
Syne Offline
(Dec 1, 2022 04:45 PM)Seattle Wrote: I'm not aware of the history of why CBD came to be used in the first place.

For those not looking to get high.
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