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 That's in line with the large number of Americans who suffer chronic
pain and the strong scientific evidence that marijuana is an
effective pain treatment, the authors report in Health Affairs.
Thirty-three U.S. states and the District of Columbia have legalized
cannabis for medical use since 1996, and 10 states have legalized it
for recreational use since 2012, the study team notes. Patients
receiving cannabis for medical purposes need a license issued in
states where this is legal, and licenses require a doctor to certify
that patients have a condition that qualifies for treatment with
marijuana.
For the current study, researchers examined data from state
registries tracking the numbers of patients using medical marijuana
and the conditions they got the drug to treat. Twenty states and the
District of Columbia had registries tracking total patients using
medical cannabis, and 15 states tracked the conditions that
qualified patients for the drug.
Overall, 65 percent of medical marijuana patients used it for
chronic pain. After that, the most common reasons patients used
cannabis were for multiple sclerosis, nausea and vomiting caused by
chemotherapy, and post-traumatic stress disorder.
Based on a 2017 report by the National Academies of Science that
assessed the scientific evidence supporting the use of marijuana to
treat specific conditions, the study team also looked at how often
medical uses are evidence-based. They found uses had strong backing
86 percent of the time.
"The vast majority of conditions for which people use cannabis have
substantial or conclusive evidence of cannabis being an effective
treatment," said lead study author Kevin Boehnke of the University
of Michigan in Ann Arbor.
"However, that doesn't mean that it's going to necessarily be easy
for them to figure out how best to use cannabis or cannabinoids to
treat their conditions," Boehnke said by email.
That's because even though many states have legalized medical
marijuana, the federal government still classifies it as a "schedule
1" substance with no medical use and a high potential for abuse.
Unlike traditional prescription drugs, there are no clinical
guidelines for medical marijuana, Boehnke said.
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"Medical cannabis patients are placed in a position where they
typically have no choice but to experiment to find their optimal
dosing regimen," Boehnke added. "Safety is definitely a concern,
especially when smoking or taking high doses of THC."
"There are still many problems with how medical cannabis is actually
utilized in day-to-day medical practice, but this paper provides
some reassurance that it is being used in many cases to treat the
right medical conditions," said Dr. Kevin Hill, director of
addiction psychiatry at Beth Israel Deaconess Medical Center and a
researcher at Harvard Medical School in Boston.
A nationwide patient registry would make it easier to understand how
patients are using medical marijuana and whether it's safe or
effective for these conditions, the study authors conclude.
In the meantime, patients should consider cannabis an option to
discuss with a doctor after other traditional treatments fail, Hill,
who wasn't involved in the study, said by email.
"Many physicians in specialty cannabis clinics will give
certifications to anyone who will pay for it, and the level of
follow-up care is often poor," Hill said.
"One way we can change this is to improve the education that
healthcare professionals receive on medical cannabis so that they
will feel more comfortable certifying patients when appropriate and
be more likely to offer useful guidance to patients on what type of
cannabis to obtain, how to dose it, and what side effects to look
out for," Hill added.
"Right now, 'budtenders' often play a more important role in medical
cannabis than doctors do - and that needs to change."
SOURCE: https://bit.ly/2GcqdJp Health Affairs, online February 4,
2019.
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