"The Institute of Medicine Report on the Health Effects of Marijuana"
When some misinformed people hear
of the grand opening of a new
plant-based medical practice,
one plant in particular may come to mind.
Over the years, I’ve gotten lots of questions
about cannabis, and I figure it’s high time
to try to clear the haze.
I didn’t want to just take
a pot shot token effort
and end up with some half-baked puff piece.
There are burning issues about a growing industry,
with so much buzz and smoke and mirrors,
the science can really take a hit.
I mean, are there acute chronic effects?
Blunt trauma from impaired driving perhaps?
I wanted to give the straight dope,
weed out any doobieous research,
and it’s been quite a trip.
420 articles published within
just the past few months!
This is the review everyone was waiting for,
the 2017 current state of evidence
from the Institute of Medicine
tasked with conducting a comprehensive review
on the health effects of cannabis.
Started out with 24,000 sources,
and whittled it down to about 10,000
to produce this 468 page document.
What did they find?
I think it’s fair to summarize
that they found the purported benefits
to be much smaller and weaker
than are often reported,
but so too the purported risks.
So, good news for the recreational user,
who is mostly just worried about not getting cancer,
but bad news for the patient
who actually wants it to help their cancer.
The only three benefits they could find
substantial evidence for, was as a treatment
of chronic pain in adults,
chemo-induced nausea and vomiting,
and relieving self-reported muscle tightness
in patients with MS.
Even archetypal medical marijuana indications,
like glaucoma, failed
to live up to expectations.
Despite popular belief to the contrary,
extensive research over decades
has documented that marijuana is not effective
in the management of clinical glaucoma,
a disease of increased pressure within the eyeball.
I mean, it does lower pressure,
but only for about an hour.
So, you’d have to smoke a dozen joints a day,
and even if you did smoke those few thousand a year,
your body gets used to it.
So, what little benefit there is disappears
within a few months in most patients.
On the other hand, conspicuously missing
from this list of adverse side-effects
of long-term or heavy use
is any mention of chronic obstructive
pulmonary diseases like emphysema,
which you can get from smoking tobacco.
And similarly, it doesn’t look like
smoking marijuana increases the risk
of respiratory cancers, like lung cancer
or head and neck cancer,
though cannabis may increase the risk
of testicular cancer.
There have been three studies so far
on marijuana use and testicular cancer,
with marijuana appearing to increase risk about 50%,
but only, it seems, for those smoking
once a week or more,
or for 10 years or longer.
So, what did they conclude overall,
were they for legalization, opposed?
Basically, they concluded,
there simply isn’t enough research,
leaving patients, health care professionals,
and policy makers without the evidence
they need to make sound decisions either way.
Further, this lack of evidence-based information
poses a public health risk.
That’s one thing everyone on both sides
can agree on,
the need for definitive clinical research.
Otherwise, we’re just left with
anecdotes, blogs, and ads,
which don’t “provide a sound basis
for assessing the safety and efficacy of pharmacologic agents.”
Because cannabis is just
a naturally occurring plant
and cannot be patented,
the pharmaceutical industry is MIA.
What we need are large clinical trials.
Until then, we’re all just going to be
scratching our heads.
But, where’s the funding going to come from?
For drug companies,
interest in the plant is scant—
where’s the payback?
Big Pharma is interested in a reasoned approach however.
“The development of newer cannabinoid modulators
in profitable pill form will one day
(writes this pharmacology professor)
make the use of herbal cannabis
a thing of the past.“