Curiosity over medicinal cannabis grows, but not the evidence
Six out of ten doctors report they had at least one patient in the last three months ask about medicinal marijuana, according to a recent survey of 640 GPs.
But in a separate four-year study of 15,000 patients suffering chronic pain, it was found that such cannabis use does not improve their health.
Research published in Lancet revealed that while many medicinal marijuana users suffered higher levels of anxiety, their health outcomes were not improved, and neither was their opioid use reduced.
AMA President Dr Tony Bartone said evidence was not showing that cannabis was particularly helpful to patients.
“It doesn't give us the surety about how, when, and why to use it with complete comfort, even among the particular specialists involved in the particular disciplines who might use it – refractory, paediatric epilepsy, for example, where it's probably got its best level of indication and evidence supporting it, there is still conjecture about the right form and the right type to be using,” he said.
“But in other things like palliative care, some of the studies show a really poor level of evidence.”
Dr Bartone said while medicinal cannabis is available under certain schemes through the Therapeutic Goods Administration (TGA), to allow use the product in their field of practice, it is intensively laboursome.
“That's because there’s still not the rigour, the process, and the efficient data available about the narrow therapeutic windows that some of these products have,” he said.
“The evidence around the world is being reviewed and has been found to be particularly weak in parts, not robust enough, not precise enough, not clear enough. And we’re still in the process of using trials in our country to actually gather further data.
“That’s why some of these special access schemes, or other processes that are used, is to try and create a safety profile around the product that hasn't gone through the usual trials and safety testing that usually every product that comes to the Australian market has to undergo.
“When we look at some of the therapeutic reasons why these products would be prescribed, these are conditions which are really, really stressful, really difficult, really difficult to manage and are obviously of quite burdensome nature to the patients and to the families concerned.
“It's understandable that once it becomes something that’s discussed in the media, in the community space, of course people are going to have questions, of course people want to find out more about something which may potentially give them an option for a condition which is very difficult to manage.
“So, I'm not surprised that patients have questions. Unfortunately, this is a case where the cart came before the horse really significantly because of a considerable amount of political and media interest in pushing this product to the market before it's gone through its usual channels of preparation and supply and logistical surety.”
Published: 13 Jul 2018