Marijuana can help some patients, but doctors say more research needed
DENVER — Marijuana appears to be an effective treatment for chronic pain, nausea and symptoms of multiple sclerosis, concludes a report from some of the nation’s top doctors and public health experts.
Commissioned by the National Academies of Sciences, Engineering and Medicine, the report says there’s “conclusive or substantial” research backing the effectiveness of cannabis for those three conditions. But it warns of dangers from marijuana use: an increased risk of car crashes, lower birth weight babies and problems with memory and attention. It found strong connections between heavy cannabis use and the development of schizophrenia and other psychoses.
A wide variety of state and federal government agencies helped pay for the study, which included medical doctors, mental health practitioners and addiction specialists. The study’s authors said the increasing legalization of medical marijuana across the country makes this a “pivotal” moment in the national conversation. Legalization advocates hailed the report as long-awaited confirmation that marijuana can have medical benefits.
The report is full of cautions and caveats and repeatedly notes the lack of good data compared with typical medicines. “Conclusive evidence regarding the short- and long-term health effects (harms and benefits) of cannabis use remains elusive. A lack of scientific research has resulted in a lack of information on the health implications of cannabis use, which is a significant public health concern for vulnerable populations such as adolescents and pregnant women,” the report said.
Put another way: “Knowing is better than not knowing,” said Rizwan Parvez, a psychiatrist and medical director of the residential drug and mental health treatment center Newport Academy, in Bethlehem, Conn. Parvez said the American medical system is based on the scientific method — and medical professionals remain open to changing their approach based on new data. He cited the recent federal guidelines about peanuts as an example of how new information can change medical recommendations.
“We will be forever open to the idea that our understanding is wrong,” he said. Parvez said medical marijuana advocates risk losing credibility when they suggest cannabis is a panacea with virtually no risk, especially when modern marijuana strains are far more potent than what Baby Boomers used in the 1960s and '70s. Parvez said he’s unquestionably seen people who’ve suffered from marijuana-induced psychoses. “Across the (cannabis) dispensary counter, everything looks great. I’m on the other end, picking up the pieces.”
The study examined more than 1,000 studies of smoked marijuana and a synthetic version of the active component of cannabis, sold under the name Marinol. Marijuana is classified by the federal government as a Schedule 1 controlled substance, deemed to have “no currently accepted medical use” and a high risk of addiction. But 28 states and the District of Columbia permit some form of medical marijuana use, in large part because voters themselves changed the state laws. The DEA has declined to lower marijuana’s classification.
Parvez said although millions of people have used marijuana, anecdotal evidence isn’t good enough. He said there are strong parallels with alcohol: “Some people use it recreationally, and other people burn their lives to the ground with it.”
Marijuana companies develop more consistent strains, extractions and dosages, but without the federal government to standardize their work, and laws generally banning transport across state lines, doctors cannot easily conduct rigorous studies. Skeptics say people making claims about the health benefits of marijuana should be held accountable through research and testing.
“The FDA process exists for all medications, and the same process should apply to marijuana,” said Jeff Zinsmeister, executive vice president of Smart Approaches to Marijuana, which generally opposes legalization. “Absolutely, there should be more research. We’re just concerned about this movement from the ballot box largely being pushed by people looking to make money off it.”
Medical marijuana advocates say cannabis is good for relieving pain and reducing seizures, and the industry has attracted some high-profile backers, including Whoopi Goldberg, who co-founded a company marketing pot-infused oils and teas aimed at women's menstrual cramps.
Sue Sisley, one of the few researchers conducting federally sanctioned marijuana studies, said the federal government has been an obstacle. Sisley is beginning Phase 2 clinical trials of marijuana treatment for post-traumatic stress disorder in veterans. Sisley was fired from her research position at the University of Arizona in June 2014, a move she attributed to the university’s reluctance to be associated with marijuana research. The university denied that claim. Sisley is president of Scottsdale Research Institute, where she has received several pounds of federally grown marijuana and the green light to begin treating patients. Getting that cannabis took seven years, she said.
“The overall tone of NAS' report seems more favorable than ever before to the idea that cannabis is a medicine,” Sisley said. “It’s especially promising content in this report, coming from such a respected federal agency.”