Earlier this week the Faculty of Pain Medicine at the Australian and New Zealand College of Anaesthetists (ANZCA) published guidance for health practitioners recommending against the prescription of medicinal cannabis for the treatment of chronic non-cancer pain (CNCP).
The recommendation is based on the current lack of high-quality evidence demonstrating medicinal cannabis products are effective for treating CNCP conditions.
The fact that much more research needs to be conducted is indisputable. As is the fact that the current evidence – though promising – is still a far cry from the conventional data physicians are used to relying on.
Unfortunately, Dr Michael Vagg (Dean of the Faculty of Pain Medicine) in an article in The Conversation, went much further than this. And in doing so he made some arguments that do not stand up to logical scrutiny.
Dr Vagg’s article is structured around busting three “myths” about medicinal cannabis. These are:
- Evidence shows cannabis products are effective for chronic pain
- Cannabis products should be provided as a ‘last resort’
- Medicinal cannabis may help with the opioid crisis
Let’s interrogate some of the claims he makes in each of those sections.
1) Evidence shows cannabis products are effective for chronic pain
Several placebo-controlled randomised controlled trials (RCTs) have investigated the potential of THC-containing cannabis medicines to treat chronic pain and found that medicinal cannabis can, in some cases, be effective. Based on the clinical research we have so far, the Therapeutic Goods Administration (TGA) argues that:
“We can be moderately confident that CNCP patients receiving medicinal cannabis are more likely to achieve 30% and 50% reductions in pain and to report a reduction in pain ratings than patients given a placebo.”