Pubdate: Fri, 29 Jul 2016
Source: Globe and Mail (Canada)
Pages: A8-A9
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Carly Weeks

True Relief?

A Globe and Mail investigation is raising alarming questions about 
the safety of cannabis being sold illegally in unregulated 
dispensaries. But for the thousands of Canadians who use regulated 
and tested medical cannabis, there is another urgent issue 
researchers are scrambling to address: Does it work?

Background and regulations

Health Canada has not approved the use of medical cannabis, but a 
court ruling requires the government to "provide reasonable access to 
a legal source of marijuana when authorized by a health-care practitioner."

Producers must pass Health Canada's application and inspection 
process in order to sell medical marijuana. According to the 
department, there are currently 34 licensed producers in Canada. More 
than 53,000 clients were registered with licensed producers during 
the period between Jan. 1 and March 31, 2016.

There are also an unknown number of Canadians who are allowed to grow 
their own medical marijuana at home as a result of a 2014 court 
decision. A ruling earlier this year struck down a ban on homegrown 
medical marijuana; the government is expected to bring in new rules 
by the end of the summer.

Doctors can decide if and when patients should qualify for medical 
marijuana. But this puts them in a difficult situation, as it has not 
been approved by the government to treat any medical condition.

Canadian Medical Association president Cindy Forbes said in a 
statement that the current regulatory environment is "a serious 
challenge for physicians in providing the best care to patients."

Unanswered questions

There's no shortage of anecdotal evidence from individuals who claim 
cannabis lessens their pain, combats the symptoms of chemotherapy or 
reduces their anxiety. But there are no large high-quality scientific 
studies to back any of those statements.

"We need to see if, in fact, it's legitimate by the standards of 
medical science," said M-J Milloy, an assistant professor of medicine 
at the University of British Columbia.

The active ingredients of cannabis that are believed to have 
therapeutic effects are called cannabinoids. They include compounds 
such as tetrahydrocannabinol (THC) and cannabinol (CBN). Although the 
mechanisms aren't entirely clear, it's believed cannabinoids work by 
binding to receptors found in the body.

The major obstacle that has long stood in the way is the lack of 
funding along with the stigma associated with studying cannabis. 
Governments wouldn't allow researchers access to it, few funds were 
available for studies and most researchers didn't want their names 
tied to the drug. There are a number of cannabis producers who are 
also becoming involved in medical research, and some experts have 
warned about the potential conflict of interest this could pose.

Although things have started to change, there's still a long way to 
go, Dr. Milloy said.

So far, the research into medical cannabis has produced mixed 
results. In June, 2015, the Journal of the American Medical 
Association published an analysis of 80 studies looking at its efficacy.

Researchers found some evidence that cannabinoids can reduce chronic 
pain and the muscle contractions or involuntary movements suffered by 
many with multiple sclerosis. But there was little proof it helps 
reduce anxiety, nausea and other symptoms of chemotherapy or sleep 
disorders. Researchers also couldn't find evidence to show cannabis 
promotes weight gain in HIV patients.

The future

The research is still in its infancy. Experts believe that, as more 
work is done in this area, the true usefulness of medical cannabis 
will finally become clear.

Jason McDougall is one of the scientists hoping to answer some of 
those questions. The Dalhousie University professor and pain 
researcher is currently conducting a trial studying the effectiveness 
of cannabinoids for osteoarthritis pain. The study was funded by the 
Arthritis Society, an example of how patient groups are moving to 
embrace the potential medical uses of cannabis.

Like many other researchers in the field, Dr. McDougall isn't 
studying marijuana that's smoked, vaporized or eaten. He's looking at 
specific cannabis molecules isolated from the plant. Many researchers 
believe that, once the research is complete, cannabinoids will be 
made available in pill form.

What's needed now, experts say, is more research funding to clarify 
what medical cannabis can be used for and to provide doctors with 
much-needed guidance.

Dr. Forbes said in a statement that the Canadian Medical Association 
"calls on Health Canada and research agencies to fund the scientific 
research needed" to provide evidence for medical marijuana.

Dr. Milloy agrees, saying the work needs to be done in order to give 
patients the answers they deserve. "I think the time has passed where 
medical researchers can say this is all malarkey," he said. "It's not 
malarkey. There is something here. Our responsibility is to try and 
test it with all the rigour it demands."
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MAP posted-by: Jay Bergstrom