De-busting the myths about medical cannabis – – pharmaphorum
Medical cannabis has quickly become the most socially disruptive phenomenon of the new millennium, and it is showing no signs of slowing. In fact, by 2026 it is estimated that the global medical cannabis market will reach $148.35 Billion.
To date over thirty countries have established medical cannabis laws or strict guidelines for the use of cannabis-derived pharmaceuticals, embracing its capacity to treat a diverse array of ailments. However, despite Europe being among the most progressive with countries including Norway, Poland and Italy all legalising medical access for patients – the UK is coming up short.
As we approach the first anniversary of the legalisation of medical cannabis in the UK, society is rife with misinformed perceptions and medical apprehension. This misinformation and miseducation of the many benefits of cannabis medicines serves as a hurdle for it to be more broadly accepted and hinders awareness. This especially affects the patient access and prescription process and links to the fact that the UK still lacks a dedicated medicinal cannabis regulatory system and medical professionals must rely on interim legislation which is widely open to interpretation.
Given that until November 2018 cannabis had been classified as a Class A drug, very little research into its medicinal properties existed. Therefore, there are currently no restrictions on the type of product that can be prescribed, except that it can’t be smoked, and medical professionals still lack clarity regarding the appropriate format or dose to prescribe.
With such a vague framework many doctors and pharmacies alike still don’t feel adequately informed and therefore are reluctant to risk their license by providing access to medical cannabis, instead choosing to err on the side of caution.
The patients in need of the medicine ultimately pay the price.
So, at a time when the western world is embracing medical cannabis and the benefits it can bring, confusion and negative cultural associations are continuing to shape perceptions in the UK.
How do we differentiate the truths from the fallacies?
CBD vs. THC
One of the most common misconceptions is that CBD (Cannabidiol) and THC (Tetrehydrocannabinol) are one in the same. Therefore, a clearer understanding of the cannabis plant is needed to alleviate the widespread confusion over what medical cannabis actually is and whether it will get you high.
Cannabis in fact contains over 400 different chemicals, of which CBD and THC are two.
CBD is one of the most prolific chemicals and is extracted via distillation to produce a panacea-like herbal drug that is devoid of any side effects. As it’s a naturally occurring herbal substance and doesn’t contain any psychoactive compounds, CBD products are available without a prescription.
To date, CBD is best known for its effectiveness in easing chronic pain and helping individuals struggling with depression, anxiety and insomnia. However, there is also hope that it will be able to help patients struggling with Parkinson’s disease, Crohn’s disease and even opiate addiction.
Due to strong anecdotal evidence the US government is currently financing several dozen clinical trials into measuring the effectiveness of CBD as a medical treatment, suggesting a promising future for non-psychoactive medical cannabis products.
What is still illegal for all but a few on prescription is THC. THC is a psychoactive compound, meaning it has the potential to alter perceptions and thinking. However, when administered in very small and regulated doses it can also make a significant medical contribution. From treating seizures in epilepsy and chemotherapy-induced nausea to alleviating muscle spasms caused by multiple sclerosis, the medical market for THC-dominant strains of cannabis is even more developed than the market for CBD rich varieties.
The case for psychosis
As the case for medical cannabis grows, so too does the concern that it can trigger psychotic disorders.
Whilst an incomplete observation of just 20 trial patients taking part in a Kings College London pilot programme has suggested that individuals can experience cannabis-related psychosis, as of yet there haven’t been any randomised clinical trials to warrant the argument for such a causal relationship.
In fact, whilst some studies have suggested that marijuana use can induce schizophrenia, the number of people diagnosed with the disorder has stayed consistent at a time when cannabis use is at an all-time high across the world.
Furthermore, some studies have suggested that cannabis can actually be beneficial in the treatment of schizophrenic patients. A clinical trial in Germany in 2012 showed similar results between patients treated with amisulpride, a common medication prescribed to treat the illness, and those treated with CBD. Not only was the CBD as effective as the standard treatment option, it was also free of the typical side effects patients usually experience on these drugs.
Ultimately, whilst we know that marijuana use can cause temporary psychosis, so too can caffeine, alcohol and nicotine. However, there is by no means enough substantial evidence to conclude that it can trigger psychotic disorders such as schizophrenia. There are no genetic tests currently available to inform someone with certainty that they are at risk of developing psychosis. One thing is certain, though – the overwhelming number of people who use medical cannabis do not develop psychosis.
Risk of addiction
Whilst the therapeutic benefits of medical cannabis have led to a tsunami of social acceptance across North America, there is still a reluctance in the UK with concerns rife over the risk of addiction.
Cannabis had been classed as an illegal drug in the UK since 1928 and was escalated to a Class A classification under the Misuse of Drugs Act in 1971. With such a long-standing taboo against cannabis it is understandable that there is still a negative sentiment and a great deal of confusion surrounding the potential effects of the drug.
However, this is where greater education is needed alongside the ground-breaking legislation change.
Most research so far has suggested only a very low risk of addiction in some cases where medical cannabis, with low levels of THC, is taken in the recommended therapeutic doses.
In fact, a recent argument has suggested that medical cannabis can even provide a viable alternative to opioids in managing chronic pain, void of the life altering health implications.
Whilst commonly accepted as a form of pain relief, opioids can also cause trigger life altering and sometimes fatal addictions. However, recent statistics suggest that prescribing medical cannabis instead has the potential to prevent around 25% of the deaths associated with opioid addiction in the UK each year.
With more and more anecdotal evidence building in support of medical cannabis as a viable alternative, without the risk of addiction, it is only a matter of time before the negative stigma associated with the drug is dismissed.
Fact vs fiction
The media has been abuzz the past few years with personal accounts and campaigns for legislation creating a medical cannabis hype.
However, given that until twelve months ago cannabis was still recognised as a Schedule 1 Drug under the Misuse of Drugs Regulations 2001 in the UK – meaning that it had never been considered for its medicinal purposes – it is unsurprising that there are such widespread misconceptions.
At each turn it seems that there is a new myth regarding medical cannabis. For example, that all strains are created equally and smoking medical cannabis will damage the lungs. In these instances, there are large variations in strains of medical cannabis and medical practitioners in the UK do not prescribe smoking as a delivery method.
Therefore, what is now needed is clear and concise advice to cut through the rumour mill.
The National Institute for Health and Care Excellence (NICE) guidelines due in November are expected to provide greater clarity on these common misconceptions. The hope then is that as medical professionals and decision-makers become more confident in their own knowledge and expertise, that this will disseminate through society and work to overhaul the misconstrued assumptions.
In a nation where society may be divided on medical cannabis, ultimately the evidence is stacking up to disprove the myths and re-direct misinformed perceptions – and instead suggests that it isn’t so dangerous after all.
About the author
Marc Davis is the president of Capital Markets Media (CMM) and co-founder of the “Women, CBD and Medical Cannabis” Conference.
This article originally appeared here in https://pharmaphorum.com/r-d/views-analysis-r-d/de-busting-the-myths-about-medical-cannabis/