International Association for the Study of Pain Issues Medical Cannabis

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Conor O’Brien
19th March

Cannabis is used for medicinal purposes by millions of people around the world every year. Among these patients, millions get their cannabis without any medical supervision, mainly due to the cannabis ban in these countries. Among the patients who use medicinal cannabis, the most common reason is for relief from pain conditions. Chronic pain affects up to 1 in 3 people in developed countries, defined as pain that is most common or daily for 6 months.

Below is a graphic from our upcoming European Cannabis Report that details the indications for medicinal cannabis in different regions.

The results of the IASP

The global research consortium released a statement earlier this month on the results of the efficacy and safety of medical cannabis for pain.

The group stated:

“Due to the lack of high quality clinical evidence (IASP), the general use of cannabis and cannabinoids for pain relief is not currently endorsed.”

This was the result of a review of several clinical studies and meta-analyzes of those studies, including a number of results from over 7,000 patients. The statement goes on to say:

“The evidence does not support or disprove the use of cannabinoids, cannabis, or cannabis-based drugs in pain management.”

The group also points out: “There is an urgent need for preclinical and clinical studies to fill the research gap and for education on the subject.”

The reaction

Articles by members of the IASP, as well as other academic figures, have suggested not prescribing medicinal cannabis to patients based on these findings. Prior to a review of the medical cannabis pilot program in Denmark, a member of the IASP told the Danish media that cannabis was being prescribed in the country based on the approval of politicians and not through the normal route of drug approval.

Similarly, Professor Vagg, a pain researcher in Australia, has argued that the IASP’s results show that cannabis should not even be prescribed as a last resort as there is no evidence of effectiveness.

On the other hand, many have also spoken out in favor of defending cannabis use in the medical environment. For example, doctor and clinic operator Tina Horstead told local Danish media that the results of the IASP are just one of many such reviews of the effectiveness of medical cannabis for pain that contradict other reviews that have found different results, including an upcoming publication co-authored in Danish patients.

Industry analyst Rhys Cohen has also made arguments for the existence of experimental designs and compassionate avenues of medical, if not full, medical cannabis access in response to the findings.

Prohibition partner

The following is the opinion of author Conor O’Brien, industry analyst for Prohibition Partners:

The IASP has made a valuable contribution to ongoing efforts to understand the medicinal potential of cannabis and cannabinoids, but I disagree with the implications for ongoing patient care. There are many patients around the world who claim that medicinal cannabis is a viable pain treatment and a cheap alternative to opiates. Prescribing drugs without full health authority approval is not optimal, of course, but it is probably a better solution than a total ban.

As mentioned earlier, regulators need not necessarily be certain of the medical benefits of cannabis if they allow its use under legal, supervised conditions. Whether or not cannabis should be prescribed as an approved drug depends on the results of further studies and their interpretation by health authorities. If empirical evidence of cannabis / cannabinoids’ use for pain is not established, it begs an interesting question how best to support the millions of people who use the plant for this purpose, regardless of it.

Currently, medical cannabis access systems are benefiting users by providing safe, regulated products that are administered under the direction of healthcare professionals rather than unregulated products being prescribed by patients themselves.

Prohibition Partners supports all research efforts that advance our understanding of the specific benefits and risks of medical cannabis for pain, as well as the efforts of all medical cannabis patients to obtain the best medical advice and most reliable products possible.