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Knowledge Of Marijuana's Health Effects Remains Incomplete

Ron Strider

Well-Known Member
A colleague recently told me that the therapeutic efficacy of marijuana (or cannabis) is "settled science."

That term always rubs me the wrong way.

Newton's Laws of Physics represented "settled science" until Albert Einstein's Theory of Relativity rewrote the rule book.

The Annals of Internal Medicine just published a review of "What We Do (and Don't) Know . . . ," written by Dr. Sachin Patel, and co-authors, updating physicians on marijuana.

Citing data from the National Academies of Sciences, Engineering, and Medicine, the article comments on a "general paucity of high-quality studies on the potential therapeutic effects of cannabis," indicating that future research is needed.

Most treatment strategies are directed at a handful of conditions, including HIV/AIDS, multiple sclerosis, glaucoma, seizures and epilepsy, and pain.

Cannabis use increased 45 percent between 2007 and 2014, with 22.2 million Americans 12 and older reporting usage within the previous month.

Compounds in marijuana that garner the most attention include tetrahydrocannabinol and cannabidiol.

The first is responsible for the major psychoactive effects of cannabis. The second is often cited as a biologically active compound class that may have therapeutic efficacy.

While 28 states and the District of Columbia have legalized marijuana, the Drug Enforcement Administration is not onboard.

Cannabis-based compounds are utilized as edibles, vaporized oils and as smoked marijuana in the traditional sense. A prescription form THC, dronabinol, is also available as a therapy for chronic conditions.

Patel and co-authors reviewed concerns with regard to respiratory effects of pot use: "Given the now well-established link between cigarette smoking and a range of adverse health outcomes, one critical question is whether cannabis smoking is associated with an increased risk for respiratory disease and cancer" the article reads.

Some "substantial evidence" appears to indicate that long-term cannabis smoking is associated with cough, wheeze and phlegm production. No clear evidence of an association between cannabis smoking and cancer has emerged.

Cannabis advocates, to be fair, often cite vaping or use of tinctures as alternatives for drug delivery. "The health effects from cannabis vaporization are not known," Patel et al point out.

"Adverse mental health outcomes" are also cited as a concern. An association between heavy cannabis use and social anxiety, schizophrenia and psychosis is mentioned.

We know that an "association" need not represent a causal relationship. Researchers express concerns with regard to adverse effects of cannabis use on younger persons, in other articles that I have read.

Marijuana advocates often state emphatically that not a single death has ever occurred due to marijuana use. I have heard that from doctors and commentators alike, but I remain skeptical of the assertion.

My concern derives from the concept of "statistical power," which requires large studies to exclude uncommon clinical outcomes.

Can we confidently assert that deaths due to bronchitis, or cancer, are wholly unrelated to cannabis use? "Absence of evidence is not evidence of absence" as the old saying goes.

In the absence of more thorough research on marijuana in large populations, our generalizations should remain muted.

Marijuana adversely impacts some neuro-cognitive skills, relative to operating machinery, or motor vehicles. Can we assert that none of the nearly 40,000 annual deaths in vehicular accidents in America are related to marijuana use?

I am sympathetic to a libertarian approach to marijuana use, advocating free choice for adults who are not engaged in driving or certain jobs.

Before we can advocate for its use for purely "medical" reasons, however, I think we need more data.

Calling something "medical" generally implies quality control, pharmaceutical precision and clear understanding of benefits versus side effects. Physicians might also consider the potential impacts of directly contradicting Drug Enforcement Administration policies.



News Moderator: Ron Strider 420 MAGAZINE ®
Full Article: Knowledge of marijuana’s health effects remains incomplete
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