In Colorado, medical marijuana is approved to treat a number of ailments, including cancer, glaucoma and HIV/AIDS, as well as symptoms – such as cachexia (wasting disease), persistent muscle spasming, seizures, severe pain, nausea and vomiting – that arise from chronic or debilitating conditions.
At Acme Healing Center in Durango, budtender Kayla Zambricki said she sees patients come in every day, grateful for a medication that effectively addresses their symptoms.
“We’re medical-use only,” Zambricki said. “I don’t deal with retail marijuana customers. But as someone who deals first-hand with medical marijuana patients every day, it does seem clear that they’re really experiencing good benefits from the marijuana they use.”
Yet according to a new meta-analysis of 79 randomized clinical studies of cannabinoids involving 6,462 patients published in the Journal of the American Medical Association, science isn’t anywhere near substantiating the benefits of medical marijuana attested to by ACME’s patients.
In fact, JAMA’s meta-analysis found that, at this point, clinical studies have yielded very little strong evidence that medical marijuana provides any statistically significant benefit to patients who suffer from diseases and symptoms that Colorado has approved it to treat.
Though some media reports have construed the findings published in JAMA as proof that cannabinoids have no medical benefits and states have been too quick to legalize it, Dr. David Hughes, director of emergency medicine at Mercy Regional Medical Center, said it was more accurate to interpret the study’s findings as indicting the inadequate state of scientific research into medical marijuana.
The study found that just four of the 79 clinical trials it analyzed were at “low risk of bias,” meaning that by design the majority of the 79 trials were deemed likely to provide unreliable results.
While the majority of the 79 trials showed improvement in symptoms treated with cannabinoids, these associations “did not reach statistical significance in all trials.”
The study concludes that overall, “there was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity.”
Patients using medical marijuana to treat nausea as a side effect of chemotherapy will find little succor in the science, according to the meta-analysis.
“There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders and Tourette’s syndrome,” the study concluded.
The meta-analysis did find that cannabinoids were associated with an increased risk of short-term adverse side effects, such as impaired thinking and memory.
Mercy’s Hughes said the big takeaway from the JAMA meta-analysis is that the research that’s so far been done into medical marijuana is conflicted, indecisive and insufficient.
At this point, Hughes said, medical marijuana would likely flunk the Food and Drug Administration’s test for approving new drugs.
The FDA requires “at least two well-powered studies to really approve a drug,” he said.
Studying the medical efficacy of cannabinoids is very difficult, he said, because like many natural medicines, when people smoke or eat marijuana to treat their afflictions, there are various chemical compounds in play, and “they tend to work in conjunction. So isolating the compounds to study their effects is a huge challenge,” he said.
“But the JAMA article shows, right now, the scientific evidence is really shabby,” Hughes said.
Scientists interested in researching medical marijuana have long been straight-jacketed by the federal government, which labels marijuana a Schedule 1 drug, meaning it has no currently acceptable medical use.
Without more comprehensive, ambitious and better-funded clinical studies to clarify cannabinoids’ medicinal potential, “a lot of the evidence for medical marijuana’s benefits is just anecdotal,” said Hughes, adding the American Medical Association supports efforts to conduct high-powered research into medical marijuana “to really find out the truth of it.”
Hughes said it’s time for the FDA to relax the restrictions it has placed on research dollars into medical marijuana.
“The FDA needs to help – it can fund big studies,” he said. “Otherwise, like any medication, there are definitely benefits to medical marijuana, as well as adverse side effects. People turning a blind eye to that fact are really doing a disservice.”
At Acme, Zambricki said the gap between patients’ lived experience of medical marijuana as a therapeutic breakthrough and the scientific community’s lack of consensus was beguiling.
“It reminds me of prescription drugs – for some patients, they’ll work, for others, they won’t – but it changes on a person-to-person basis,” she said. “With marijuana, so much more research needs to be done.”