Pubdate: Fri, 13 Jan 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Mike Hager
Page: S1
Referenced: http://mapinc.org/url/vdGIf4tT

REPORT SPURS CALL TO STUDY POT'S POTENTIAL IN OPIOID-CRISIS FIGHT

A new U.S. government-funded report showing clear evidence cannabis is
an effective remedy for those with chronic pain underscores the need
for more research into how marijuana can help fight the deadly opioid
crisis ravaging North America, according to one of Canada's leading
pain researchers.

A report released Thursday by the National Academies of Sciences,
Engineering and Medicine outlined nearly 100 conclusions about the
benefits and harms of cannabis on a range of public health and safety
issues.

Drawing on studies published since 1999, the report by the federal
advisory panel stated that marijuana can almost certainly ease chronic
pain and might help some people sleep, but it may also raise the risk
of developing schizophrenia and trigger heart attacks.

It ended with a call for more scientific information about cannabis so
that health-care professionals and policy makers can make sound
decisions because the current lack of evidence "poses a public health
risk."

Last year, data from Veterans Affairs showed fewer Canadian veterans
have sought prescription opioids and tranquilizers in recent years,
while at the same time prescriptions for medical marijuana have
skyrocketed.

Mark Ware, a McGill pain researcher and vice-chair of Canada's recent
federal panel on marijuana legalization, said one of the biggest
takeaways from the new report, which he reviewed before publication,
is that new research must now be funded to see whether cannabis can
pare down the use of some opioids, a class of legal and illicit
painkillers that has led to an ongoing crisis that has killed hundreds
of Canadians over the past year.

"So far it's an association that's been reported on between states
that have legalized cannabis and reductions in opioid mortality and
use of other medications," Dr. Ware said in a telephone interview
Thursday. "How can the medical cannabis sphere overlap with the opioid
epidemic?

"Those associations need to be explored urgently."

Jeff Blackmer, vice-president of medical professionalism at the
Canadian Medical Association, echoed Dr. Ware's call for more research
into the subject, noting funding of more cannabis research is expected
after the Liberals introduce legislation legalizing the drug this spring.

"There's a lot of discussion about the substitution therapy [of
cannabis for opioids] and, again, the challenge for physicians is:
There is no evidence or very little evidence," said Dr. Blackmer.

Dr. Blackmer, who works half a day each week at the Ottawa
Rehabilitation Centre treating people with spinal-cord injuries and
multiple sclerosis, said at least half of his patients have asked him
for a marijuana prescription. He said he rarely prescribes cannabis
because he has a host of concerns about the lack of evidence
surrounding the drug, including how it could react with other
medications and its effect on driving.

For marijuana users or those considering it, "there's very little to
guide them" on amounts and health risks, said Dr. Marie McCormick of
the Harvard School of Public Health, who headed the committee behind
the report.

Committee members cautioned that most conclusions are based on
statistical links between use and health, rather than direct
demonstrations of cause and effect. The review found strong evidence
that marijuana and similar compounds ease nausea from chemotherapy,
with varying degrees of evidence for treating muscle stiffness and
spasms in multiple sclerosis.

Limited evidence says marijuana and its chemical analogues can boost
appetite in people with HIV or AIDS, and ease symptoms of
post-traumatic stress disorder, the report concluded. But it said
there's not enough research to say whether they're effective for
treating cancers, irritable bowel syndrome, epilepsy or certain
symptoms of Parkinson's disease, or helping people beat addictions.

On potential harms, the committee concluded strong evidence links
marijuana use to the risk of developing schizophrenia and other causes
of psychosis.

There is a strong indication that using marijuana before driving
increases the risk of a traffic accident, but no clear link to
workplace accidents or injuries, or death from a marijuana overdose.
There is limited evidence for the idea that it hurts school
achievement, raises unemployment rates or harms social functioning.
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