For patients in chronic pain, medical marijuana needs robust clinical research

August 11, 2016 | Janet Yale
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(Contributed to The Globe and Mail. Published Thursday, Aug. 11, 2016 7:00AM EDT.)

We all seem to have medical cannabis on our minds these days. As a product, it is popping up in dispensaries on street corners across the country: The Globe and Mail’s recent series explored what is – and what isn’t – to be found in cannabis purchased at dispensaries. As a therapy, cannabis is becoming more widely prescribed. Most importantly, it has emerged as a topic of debate in terms of policy-making, policing, health risks and even municipal zoning.

For all this attention, however, a serious discussion of its medical merits and proper utilization is often treated as an afterthought. In truth, what we actually know about medical cannabis based on rigorous, controlled and scientifically based medical trials is very little.

For The Arthritis Society, and a large number of the organizations we work with, this issue is of great importance. Chronic pain is a constant fact of life for many living with arthritis: Two-thirds of the prescriptions issued for medical cannabis in Canada are given to those seeking to manage arthritic symptoms. As a first step, the sudden ubiquity of medical cannabis dispensaries makes proper regulation and oversight an urgent matter. We must ensure patient safety by guaranteeing that the products sold by all providers are subject to regulatory oversight. Regulation, however, is only part of the answer. We must also focus on research.

The best sorts of debates are always those that are well informed. When it comes to medical cannabis, we should dedicate our minds and our money to learning more as we expand its reach and use.

Although evidence exists that medical cannabis can help people with pain management, Canada lacks a robust base of clinical trials and research because, for years, the federal government effectively blocked any effort to research in this arena.

With this in mind, The Arthritis Society joined a number of similarly concerned groups last year to form the Medical Cannabis Research Roundtable. Supported by Dr. Jason McDougall who chairs The Arthritis Society’s Scientific Advisory Committee, the roundtable is composed of a high-level group of physicians, clinicians, patients, health charities, experts and medical researchers dedicated to addressing the lack of scientific research and understanding of medical cannabis.

In June, the roundtable released its first report, which included a principal recommendation that the federal government invest $25-million over the next five years into research and trials related to medical cannabis. To lend momentum to this effort, The Arthritis Society has announced a doubling of its own commitment to medical cannabis research to a total of $720,000 between 2015 and 2019. The Arthritis Society has also announced a permanent annual commitment of at least $120,000 toward research into the impacts of medical cannabis.

To further guide collective research efforts, the roundtable made additional recommendations. First, we need basic research to better understand the role of the Endocannabinoid System (ECS) in disease. Second, we need to fund clinical research, including the evaluation of medical treatments with a focus on safety, efficacy, dosing and administration. Finally, we need to increase our understanding of related health care services and health policy implications, including matters such as equitable access to medical cannabis, how to manage and market medical cannabis in the context of legalization and knowledge transfer to health care workers.