The Lancet recently published a four year study on the efficacy of cannabis for pain among opioid users. This is the title that the media chose to report the studies findings: “Australian Study Finds No Strong Evidence That Cannabis Use Reduces Pain or Opioid Use in People Living With Chronic Non-Cancer Pain.” While we applaud the authors and their work, the sensationalist title the media picked up is beyond misleading. What it should have said was: “We Desperately Need Access to Medical Grade Cannabis Products So We Can Conduct Better Studies.”
Assuming the reader got past the headline and actually read the study, they would have noticed the significant limitations of the study, the media buzz exaggeration, and just how truly underdeveloped this study actually is:
See the following excerpts of the study:
“This finding needs to be qualified as participants had access only to illicit cannabis and were not taking cannabis as part of structured pain management under medical supervision.”
“Expectations that cannabis will reduce pain and opioid use might differ for participants using medicinal cannabis compared with those using illicit cannabis.”
“Because of the illegality of cannabis during the study period, it is possible that cannabis use has been under-reported.” (One in six subjects reported using cannabis in this study!)
“Additionally, we recorded frequency of cannabis use, rather than quantity and type of cannabis, but there are major complexities in reliably measuring total cannabis consumption given variations in tetrahydrocannabinol content and amounts consumed in a session of use.”
And finally, our personal favourite:
The use of prescribed opioids in the treatment of chronic non-cancer pain is controversial because of insufficient evidence for their long-term effectiveness.
The irony is of this last point would be laughable if it wasn’t so terribly sad and dangerous. The idea that opioids are prescribed as a matter of course for the treatment of pain throughout the medical community, although they have “insufficient evidence for their long-term effectiveness” when we know full well that they cause addiction and carry an annual death toll of more than 64,000 people in 2016 (up 21% from 2015) in the United States alone, while cannabis is denied as a treatment option, although there is no history of overdose to date.
“Irony” is a understatement.
So what did this study actually accomplish?
First, it reinforces the need for legal medical programs that provide appropriate, medical grade cannabis products for specific indications or conditions. Or, at the very least, a range of safe, properly-labeled products. After 60 years of research, 20 years of medical cannabis programs, and mountains of anecdotal evidence, it would serve us (the global “us”) to not blight the future of medical cannabis for the treatment of pain and the reduction of opioid use based on one in six people who admit to having made an illicit purchase of a few grams somewhere in Australia.
We can do better than that.
Second, this study should serve as a call to arms for the cannabis industry to establish a language that is clear and understandable to the general public and researchers alike. Not all products derived from the Cannabis Sativa plant are created equal. Every strain provides a different cannabinoid and terpene profile and different delivery methods impact on the amount and type that is absorbed by the body and of course, every human has their unique endocannabinoid system that is impacted by those cannabinoids in a different way. This is what needs to be researched and this can only be done within a Medical Cannabis program.
As Yossi Tam, Director of the Multidisciplinary Center for Cannabinoid Research at the Hebrew University of Jerusalem recently said, “Prescribing “cannabis” is like writing a prescription for ‘pills’.”
We need to create a modern lexicon that accurately describes what is being given, to whom, and for what reason. We understand that this is going to take time. We ask researchers in the field to be aware and sensitive to different types of cannabis available and to be far more comprehensive in their investigations and reporting.
We have some ideas about the establishment of this lexicon and will be sharing much of it in Sydney at our CannaTech Medical Cannabis Summit this October. If you are interested in being involved in this conversation, please contact us CannaTech@israel-cannabis.com