Research published today in Annals of Internal Medicine shows that cannabis is effective in combatting neuropathic pain, the type suffered by people with multiple sclerosis, HIV, diabetes and possibly some forms of fibromyalgia.It’s a noteworthy conclusion given that cannabis is still scheduled as an illegal, class I controlled substance by the federal government, with “no currently accepted medical use in treatment in the United States,” to use the DEA’s own words.Also today, Annals published research about cannabis and PTSD, although it essentially concluded nothing.Despite the federal law, medical cannabis already is legal in more than half the states in America, with the above-mentioned conditions and chronic pain listed as qualifiers in many of those states.
“Investigators’ conclusion that there exists clinical evidence supportive of the efficacy of cannabis in the mitigation of neuropathic pain is consistent with both prior reviews and with the anecdotal reports of patients, many of whom are seeking a safer alternative to the use of deadly opioids, and it is inconsistent with federal government’s classification of the marijuana plant….” NORML Deputy Director Paul Armentano said in a statement to DavidHeitz.com.NORML is a Washington-based marijuana advocacy group.The research was published as part of a three-article package on cannabis that went live on the medical journal’s site at 5 p.m. Eastern on Monday.
Annals of Internal Medicine is published by the American College of Physicians, a tenet of the mainstream medical establishment. I attended the American College of Physicians Internal Medicine Meeting in San Diego in May, as a member of the credentialed news media.The other articles published today in Annals concluded that there is not enough evidence to know whether cannabis is effective in treating PTSD (but that new information will be coming soon) and advised doctors that “the horse is out of the barn,” regardless.
Research cannabis looks like grass clippings
While the study found only “limited evidence” of cannabis’ efficacy on neuropathic pain, it’s important to understand that the cannabis being used for medical research is incredibly weak and not remotely representative of what’s available on the market to medical cannabis patients.Because of the arcane federal law that classifies cannabis as being more dangerous than crystal meth or heroin, researchers at academic institutions studying the medicinal effects of cannabis on people must obtain the plant from the federal cannabis garden at the University of Mississippi.This garden grows remarkably weak strains of weed with THC levels topping out at 8, 10, maybe 13 percent, depending on which reports you want to believe. Most cannabis available in medical dispensaries these days has THC levels of around 20 percent. Some have THC levels as high as 30 percent as far as flower goes and, with concentrates, THC levels can go into the 80 percent range and higher.
The weed out of the Mississippi garden is so vile that one researcher recently alerted the Washington Post. You can read here how PTSD researcher Sue Sisley got some nasty, moldy bud. After determining the mold levels would not be toxic to patients, she decided to use it anyway. It’s not like she has any other choice.I asked Armentano if he could fill me on the latest regarding the federal government’s ditch weed garden at the University of Mississippi. He sent me this link. To the federal government’s credit, the ditch weed garden is evolving to include high CBD strains. Once upon a time, it grew only one nasty strain instead of five nasty strains.The link is hilarious. The feds charge researchers $10.96 for a “marijuana cigarette.”
“Obviously, these products do not represent the broad scope of actual cannabis-based products that patients are using in the real world — a point that has been raised frequently by critics,” Armentano wrote in an email to me. “You are correct that any cannabis administered as part of a FDA-approved trial must be provided by the University of Mississippi.”
And yet, I bet when the 5 p.m. news reports the medical research coming out in Annals tonight they aren’t going to explain that the weed used in those studies is nothing like the medical cannabis available to people treating themselves for pain or PTSD.The garden also completely ignores the science of terpenes, compounds in the plant that vary by strain and have medicinal qualities as well as an aromatic effect. One wonders where the government even gets the seeds to produce the funky cannabis like what they dispense to medical researchers.
The truth is in our stories: Cannabis is saving lives
The Annals pain study actually was a review of research already published. It analyzed 27 chronic pain trials.Its official conclusion: “Limited evidence suggests that cannabis may alleviate neuropathic pain in some patients, but insufficient evidence exists for other types of chronic pain.”It then adds the always scary-sounding, “Among general populations, limited evidence suggests that cannabis associated with an increased risk for adverse mental health effects.”
To the researcher’s credit, the flaw in the research that renders much of it null and void in my opinion is listed: “The cannabis formulations studies may not reflect commercially available products.”We know anecdotally, overwhelmingly so, that millions of Americans are effectively treating their pain with cannabis. Opioid overdose deaths are down in states where medical cannabis is legal. Fewer painkillers are being dispensed.As I left the dispensary this morning, a woman shared with me how she ended up being hooked on fentanyl after a surgery. Now, with her medical cannabis card, she is off opioids completely.
Last week I wrote this blog post about how cannabis should be used to treat addiction. I have pinned the post to the top of my Facebook page. The conversation is so lively I can’t even keep up with it. The number of new likes to my Facebook page just this week, since I have written that piece, is well in excess of 300.I also have been inundated with emails of personal stories. Just this week, two veterans receiving VA medical care informed me they have been put on notice for their illicit cannabis use. Both have been told if they “drop” (the VA urine tests veterans) for cannabis again, their medications will be revoked. One is on benzodiazepines for anxiety; the other is on opioids for pain.This is shocking. Abrupt discontinuation of these highly addictive medications may result in death. And again, medical cannabis is legal in more than half the states.
Medical establishment’s blessing would expedite cannabis availability
The medical cannabis blessing from the mainstream medical establishment would be an important first step toward getting insurance companies to pay for the treatment. That would make it more widely available.But the establishment isn’t going to do that without further, more rigorous clinical trials. Expensive trials…where researchers are required to use government grass clippings.
“While more rigorous clinical trials of longer durations are arguably warranted, call for such trials should not overshadow the reality that tens of thousands of patients in the US are presently using therapeutic cannabis to safely and effectively address various hard-to-treat conditions, including chronic pain and post-traumatic stress — which is why well-respected advocacy groups like the American Legion and AMVETS are lobbying in support of greater patient access to marijuana,” Armentano said.
“Further, it must be acknowledged that the longstanding politicization of the cannabis plant, and its ongoing schedule I status, has greatly impeded researchers’ ability to conduct the sort of robust, large-scale, prolonged clinical trials that are typically associated with eventual FDA drug approval. Such trials are typically funded by private pharmaceutical companies seeking market approval, whereas cannabis research must be funded by academic institutions. These institutions possess limited funds and they are not in a position to — nor are they seeking to — attempt to bring the drug to market.”
In the Annals editorial accompanying the research meta-analyses, Dr. Sachin Patel of Vanderbilt Psychiatric Hospital in Nashville writes, “Although several well-designed trials are under way to address (treating pain and PTSD with cannabis), to some degree the horse is out of the barn – and unlikely to return. Even if future studies reveal a clear lack of substantial benefit of cannabis for pain or PTSD, legislation is unlikely to remove these conditions from the lists of indications for medical cannabis.”Any medical cannabis patient with PTSD or chronic pain – and I suspect those two conditions make up most of us in many states, if not nationally – will tell you not only is it effective, it’s highly effective.
The Pharma medications for those conditions – benzodiazepines and opioids — churn out addicts and alcoholics (benzos are booze in a pill) every day. In the midst of a national opioid crisis, why aren’t the feds declaring pot legal as part of a national addiction emergency?I bet that would solve Trump’s popularity problems quick. An executive order legalizing cannabis!I’m going to end with a final quote from the Vandy doctor who wrote the editorial. I’ll warn you…it’s insulting. But I’m using it, and I’m ending with it, because it’s so incredibly ridiculous and out of touch with the realities of people suffering from pain and addiction that I hope it gets blasted around social media far and wide.
“As Nugent and colleagues note, patient characteristics associated with clinical response to cannabis products for pain are unknown,” Patel writes. “Another, more controversial explanation may be the complexity of chronic pain, with interrelated behavioral, emotional, and cognitive domains.“Perhaps cannabis decreases the clinical effect of chronic pain in some way not readily operationalized by traditional pain rating scales. Of course, it’s also possible that cannabis’ effects on perceived pain are simply not robust, and such catch-all diagnoses as pain to justify legal access to cannabis may be overused.”At the end of the day, the people of this country are only going to tolerate the mainstream medical establishment’s delusional “reefer madness,” to use the words of Berkeley medical researcher Amanda Reiman, for so long.