Sunday, 26 April 2015

Medical cannabis not yet the the Apirin of the 21St Centuary

Belendiuk KA, Baldini LL, Bonn-Miller MO. Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders.
Addict Sci Clin Pract. 2015 21;10(1):10. [Epub ahead of print]


The present investigation aimed to provide an objective narrative review of the existing literature pertaining to the benefits and harms of marijuana use for the treatment of the most common medical and psychological conditions for which it has been allowed at the state level. Common medical conditions for which marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: Alzheimer's disease, amyotrophic lateral sclerosis, cachexia/wasting syndrome, cancer, Crohn's disease, epilepsy and seizures, glaucoma, hepatitis C virus, human immunodeficiency virus/acquired immunodeficiency syndrome, multiple sclerosis and muscle spasticity, severe and chronic pain, and severe nausea. Post-traumatic stress disorder was also included in the review, as it is the sole psychological disorder for which medical marijuana has been allowed. Studies for this narrative review were included based on a literature search in PsycINFO, MEDLINE, and Google Scholar. Findings indicate that, for the majority of these conditions, there is insufficient evidence to support the recommendation of medical marijuana at this time. A significant amount of rigorous research is needed to definitively ascertain the potential implications of marijuana for these conditions. It is important for such work to not only examine the effects of smoked marijuana preparations, but also to compare its safety, tolerability, and efficacy in relation to existing pharmacological treatments.
There is simply not the definitive evidence that cannabis does this or that, yet there are many pot docs and pot heads claiming it does everything. This is then used as part of the legalise recreational cannabis campaign. It is very strange that medical cannabis has been approved in so many States in the USA, whilst the FDA are making companies including GW pharma jump through hoops to demonstrate that their drugs do something. I am sure that compounds in cannabis can have medical benefit and work on biology that is useful in the control of MS symptoms and progression. To address the later it is most likely to be trials with medical marijuana to show this but how do you control a trial with cannabis, because if you don't know you are getting it, you are not getting enough to be useful....It's the biology

Baker D, Pryce G, Jackson SJ, Bolton C, Giovannoni G.The biology that underpins the therapeutic potential of cannabis-based medicines for the control of spasticity in multiple sclerosis.
Mult Scler Relat Disord. 2012;1(2):64-75.

Cannabis-based medicines have recently been approved for the treatment of pain and spasticity in multiple sclerosis (MS). This supports the original perceptions of people with MS, who were using illegal street cannabis for symptom control and pre-clinical testing in animal models of MS. This activity is supported both by the biology of the disease and the biology of the cannabis plant and the endocannabinoid system. MS results from disease that impairs neurotransmission and this is controlled by cannabinoid receptors and endogenous cannabinoid ligands. This can limit spasticity and may also influence the processes that drive the accumulation of progressive disability.

8 comments:

  1. This study is a load of bull crap, and these authors should be absolutely ashamed. In each disease section, the authors list a benefit of marijuana but then provide a bunch of ridiculous reasons why the studies aren't sufficient in their ivory tower opinion to warrant medical marijuana.

    For example, they say that almost 1 in 4 HIV patients use marijuana to reduce pain and nausea, but "because drug use is a risk factor for HIV infection, treatment of symptoms with marijuana may be contraindicated for this subpopulation". Pro Tip: I'm pretty sure these people already have HIV infection. They also say that dependent marijuana users (9% in general) have lower drug adherence by citing a paper that also says normal marijuana users (91%) actually have HIGHER drug adherence and reduced symptoms.

    For MS, they list numerous studies showing marijuana improves spasticity and sleep, but they then say another study showed some patients have worse balance and posture "so there is currently insufficient evidence to determine the efficacy of smoked marijuana on spasticity". OK, so let the patient try marijuana and see if they benefit or experience worse balance. Can I get a follow-up paper published in a medical journal with this ground breaking idea?

    I can somewhat understand (but often disagree with) why the medical establishment wants to prevent patients from using potentially dangerous drugs to treat their disease (e.g. the FDA rejecting Alemtuzumab). However, marijuana is almost entirely for symptomatic relief and has almost no serious side effects. If patients like myself with life destroying diseases finds that marijuana makes their lives a little better, these doctors should stay the hell out of it. Don't these clowns have better things to do like actually trying to cure these diseases?

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    1. Marinol which is THC is licenced as an anti nausea drug and is also licenced in HIV to limit wasting.

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  2. Cannabis here in the states needs to be taken off the schedule 1 list of highly addictive drugs with no medical benefit. This labelling is preventing needed research on the cannabinoids and the potential benefit in medicine. THC the psychoactive compound in marijuana is only one of hundreds of cannabinoids and its level of "addictiveness" is less than socially accepted psychoactive drugs such as: caffeine, nicotine, and ethanol. GW pharma is doing the proper bench-work in the testing of compounds for therapies. I agree, it is contradictory that the U.S. federal govt. is letting states decide on marijuana legalization yet the FDA inhibits study by pharma due to its schedule 1 label.

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    1. The addiction issue is hyped it was very very difficult to show addiction in animals but likewise the issue of hundreds of compounds in cannabis is hyped to, in many cases it revolves around THC content.

      We sometimes have got THC from the US government and they grow cannabis too although i have heard their joints have bits of twig in them. Once we got a shipment from US and it was flown over. When the pilot realised what he had be flew it back tothe states not knowing it came from us government when it came back we got it without the US or UK customs taking the export and import permits that we had got.
      We rung up the drugvsquad at the Home Office and pooped the permits in the post:-)

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    2. I think MD meant popped the permits in the post.

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  3. This issue of cannabis is "complicated," I think there's a lot of prejudice involved ... They forget that the active ingredients contained in Cannabis are like any other ... They forget also that it is not talking to "recreational" use of cannabis ... And I see prejudice even among doctors, I heard once from a neurologist who said he prescribe CBD for a child patient with Dravet's Syndrome...Conheço MSers that both smoke cannabis as they are already using the CBD, or Sativex, and say they are feeling pretty good, especially with respect to the symptoms ...

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    1. I agree that there is, despite the now huge amount of evidence for it's medicinal properties, that there is still "reefer madness" prejudice amongst many members of the medical profession. In the UK, they keep banging on about psychosis and schizophrenia as a result of cannabis use yet, considering the numbers of people using cannabis in the UK over the last 50 years has increased dramatically, the incidence of schizophrenia has remained exactly the same or if anything has decreased slightly. Go figure........................

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  4. Post-traumatic stress disorder was also included in the review, as it is the sole psychological disorder for which medical marijuana has been allowed. Florida medical marijuana attorneys

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