Cannabis is used for medical purposes by millions of people around the world each year. Among these patients, millions source their cannabis in absence of any kind of medical supervision, mostly due to the prohibition of cannabis in those countries. Among those patients that do use medical cannabis, the most common reason is for the relief of pain conditions. Chronic pain affects as many as 1 in 3 people in developed countries, defined variably as pain occurring most or every day for 6 months.
Below is a graph from our upcoming European Cannabis Report outlining the indications for medical cannabis in various regions.
The Findings of the IASP
The global research consortium released a statement earlier this month on their findings of the effectiveness and safety of medical cannabis for pain.
The group stated:
“Due to the lack of high-quality clinical evidence (the IASP) do not currently endorse general use of cannabis and cannabinoids for pain relief.”
This was the result of a review of several clinical trials and meta-analyses of these trials, including a set of results from over 7,000 patients. The statement goes on to say:
“The evidence neither supports nor refutes the use of cannabinoids, cannabis or cannabis-based medicines in the management of pain”.
The group also indicates a: “Pressing need for preclinical and clinical studies to fill the research gap, and for education on this topic.”
Articles produced by members of the IASP as well as other academic figures have suggested that medical cannabis not be prescribed to patients on the basis of these findings. In advance of a review of the medical cannabis pilot scheme in Denmark, a member of the IASP has indicated to Danish media that cannabis is being prescribed in the country due to the approval of politicians rather than the normal avenue of pharmaceutical authorisation.
Similarly, Professor Vagg, a pain researcher in Australia has argued that the findings of the IASP show that cannabis should not even be prescribed as a last resort, as there is no evidence of efficacy.
On the other hand, many have also spoken out to defend the use of cannabis in the medical setting. For example, physician and clinic operator Tina Horstead told local Danish media that the findings of the IASP are only one of many such reviews of the efficacy of medical cannabis for pain which is at odds with other reviews which found differing results including an upcoming paper she co-authored on Danish patients.
Industry analyst Rhys Cohen has also laid out arguments for the existence of trial schemes and compassionate access pathways for medical if not also full access schemes for medical cannabis in response to the findings.
The following is the opinion of the author, Conor O’Brien, Industry Analyst for Prohibition Partners:
The IASP has made a valuable contribution to the ongoing efforts to understand the medical potential of cannabis and cannabinoids but I disagree with the implications for ongoing treatment of patients. There are many patients around the world who report medical cannabis to be a viable treatment for pain, and a favourable alternative to opiates. Prescription of medicines without full authorization from health regulators is of course not optimal, but likely a better solution that full prohibition.
As has been said before, regulators do not necessarily need to be certain of the medical utility of cannabis when allowing for its use under some kind of legal, supervised conditions. Whether or not cannabis should be prescribed as an approved medication will depend on results of further studies and their interpretation by health authorities. If empirical evidence cannot be firmly established for the use of cannabis/cannabinoids in pain, this will raise an interesting question on how best to support the millions of people who use the plant for this purpose regardless.
For now, medical cannabis access schemes benefit users by providing safe, regulated products administered with the guidance of health professionals instead of unregulated products being “self-prescribed” by patients.
Prohibition Partners supports all research efforts which further our understanding of the specific benefits and risks associated with medical cannabis for pain as well as the efforts of all medical cannabis patients to obtain the best medical advice and the most reliable products.