Here are the reasons why Americans are using the medical pot


Weed grown at a non-profit medical clinic in California.
Photo: David McNew (Getty Images)

Patients use medicinal cannabis to treat the symptoms of a wide variety of diseases – but only a few of these uses are actually supported by science. A new study on Monday, however, suggests that the vast majority of patients are prescribed a medical pot for conditions such as chronic pain and multiple sclerosis, for which there is good research supporting the use of cannabis.

In light of their findings, the authors say it is high time for cannabis to be downgraded from its federal status as a Class I drug, and should be better controlled and regulated as medical treatment.

In the US, 33 states and the District of Columbia currently allow people to use medical cannabis. These users need a special license, which can only be obtained if the doctor agrees that they have a qualifying condition. But so far, according to the authors, there has been an attempt to quantify, at the national level, why people are receiving medicinal cannabis.

In the new study, published in the journal Health Affairs, the authors analyzed data from patient registries in D.C. and 20 states, including Alaska, Illinois and New York. They also reviewed a 2017 report from the National Academies of Science, Engineering and Medicine, which reviewed the available evidence on the health benefits of weed. The report was used as a baseline to establish which qualification conditions were well supported by science.

In all, they found, 85.5 percent of patients reported conditions they had met, with "substantial or conclusive evidence" of a therapeutic effect of medical cannabis. The most common condition by far was chronic pain, with almost 65% of patients reporting it as a qualifying condition in 2016. The other two conditions well supported were nausea and vomiting induced by chemotherapy, in addition to spasms caused for multiple sclerosis.

Other qualifying conditions reported in 2016 included cancer, epilepsy, arthritis, Parkinson's disease, post-traumatic stress disorder, and irritable bowel syndrome.

Despite overall positive findings, the authors said there are less optimistic implications of the study.

On the one hand, there was no data available in many states, including California, the state where the medicinal pot was legal the longest (since 1996). Some states, even if they had patient records, did not include data on qualifying conditions, while others had a few years in which no data were published. And of course, 15 percent of patients were able to get medical cannabis for health problems that may not be effective.

There is at least limited but decent evidence that cannabis can help alleviate symptoms of some of these conditions, such as anxiety or Tourette's syndrome. For some conditions, such as epilepsy, there was inconsistent evidence of its efficacy (that is, a drug made from cannabis was recently approved for treating certain forms of seizure disorder). But there were also conditions on the list, such as glaucoma and dementia, where evidence points to the fact that cannabis is worthless.

One of the main reasons for these inconsistencies is the neglected nature of legalizing weeds. The US government has long classified cannabis as a Schedule I drug, which means that it is not considered a relevant medicinal use at the federal level. Advocates have managed to circumvent this restriction by convincing states to adopt individual laws, but this has left us in a confused system where different states have different standards of legalization and regulation (some states, for example, require doctors to be specially trained before they can prescribe cannabis). The Table I rating also reduced researchers' efforts to better study the benefits claimed by marijuana.

In New York, for example, it is now cool that cannabis is used as a treatment for people suffering from opiate dependence or as a substitution therapy for people who use opioids because of their chronic pain. But while some indirect research has found that opioid overdose deaths decline in states after the legalization of medical marijuana, there is no concrete evidence – as in randomized clinical trials – that cannabis should be widely recommended as a dependency treatment or as a substitute for patients with stable pain in opioid therapy. That does not mean it does not work in these situations, it just means that we do not know yet.

One solution to these problems, according to the authors, is the creation of a "national database of medical marijuana users to assess the risks and benefits of using medical marijuana for different medical conditions and symptoms." But because more states are likely to legalize marijuana for recreational use, it is also possible that more people will decide to self-medicate without going through the hassle of getting a permit. And this will put some more keys into the mix.

"If legal use of cannabis is increasingly dissociated from medical necessity or oversight at the state level, then a greater role for federal government oversight – for example, by the Food and Drug Administration – regarding safety and product information can be justified, "the authors said. .

All of these complications, they concluded, are a strong argument that not only cannabis should lose its drug status as Table I, but also that state and federal policymakers should begin to evaluate evidence-based ways of safely integrating research and marijuana products. the health system ".


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