An opinion piece in Oct. 25th San Diego Union-Tribune, below:
Re: Medical Marijuana: The science behind the smoke and fears
Over the years more than 18,000 scientific papers have been published on marijuana/cannabis and only a handful have reported it to be safe and effective for any medical condition.
The three recent studies Dr. Grant refers to were all done by the Center for Medicinal Cannabis Research and have a biased premise to start with regarding availability of funding. The National Institute of Alternative and Complementary Medicine funds peer-reviewed worthy research and has resources available to fund projects which meet criteria for valid medical research.
It appears that marijuana studies by CMCR, founded in 2000, do not make the grade. The CMCR website lists 10 studies completed since that time and the results of six have been published. Media coverage of these few unremarkable studies has far outweighed coverage of the several thousand studies during these same ten years which have illuminated the many serious side effects associated with the use of marijuana, including more than 30 studies published between 2003 to 2005 strongly linking cannabis use to schizophrenia and other psychiatric problems.
In the three studies mentioned by Dr. Grant, he says that they were placebo controlled. A placebo for marijuana? In the book “Snake Oil Science – The Truth About Complementary and Alternative Medicine” author R. Barker Bausell writes extensively about the difficulty of discerning the placebo effect when it comes to the use complementary and alternative medicines because of the “expectation of benefit.” The criteria employed to identify valid studies include 1) publication in a high-quality journal, 2) the use of at least fifty patients per therapeutic group, 3) retention of at least 75 percent of the participants throughout the course of the study, and 4) employment of a credible placebo control. None of the published CMCR studies meet all of these criteria.
Further, the Food & Drug Administration states that for a drug to be approved for human use 1) The drug’s chemistry must be known and reproducible, 2) There must be adequate safety studies, 3) there must be adequate and well-controlled studies proving efficacy, 4) Acceptance by qualified experts is required, and 5) the scientific evidence must be widely available. There is simply no way to measure the dose or purity of smoked marijuana. Unless, of course, some of its more than 465 compounds are found to have medical benefit and can be extracted or replicated synthetically. Two of these, already available by prescription, are dronabinol and nabilone.
Marijuana, like many plant and animal matter, contains compounds that, when isolated and purified, can have therapeutic effects. Today we find that even the deadly poison causing botulism has been isolated for therapeutic use. However, no one would suggest recommending the bacteria causing botulism for self-medication. And several drugs have been developed from snake venom but that doesn’t mean a bite from the snake is safe. There are myriad examples but the one thing they don’t have in common is the psychoactive and addictive effects of marijuana. And it is marijuana’s psychoactive properties that are its real attraction.
William M. Bennett. MD, MACP
Professor of Medicine & Clinical Pharmacology, Oregon Health & Sciences University, retired
Past President, American Society of Nephrology
