{"id":1621,"date":"2019-04-07T23:14:59","date_gmt":"2019-04-07T23:14:59","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=1621"},"modified":"2019-05-21T13:50:28","modified_gmt":"2019-05-21T13:50:28","slug":"medical-marijuana-the-next-snake-oil","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2019\/04\/07\/medical-marijuana-the-next-snake-oil\/","title":{"rendered":"Medical Marijuana: The Next Snake Oil?"},"content":{"rendered":"

Roberta Heale, Associate Editor of EBN, @robertaheale, @EBNursingBMJ<\/p>\n

Changes to regulation in many countries have opened up prescribing of medical marijuana. For example, recent changes in the UK allow prescriptions for medical cannabis. https:\/\/bit.ly\/2VntmKd \u00a0<\/a>Medical marijuana prescriptions are legal in more than half of the states and the District of Columbia in the US \"\"<\/a>https:\/\/wb.md\/2Vs6ZTZ<\/a>and \u201cthe FDA has only approved it for treatment of two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome.\u201d In Canada, medical cannabis has been available for two decades with a number of revisions the regulation, the most recent in 2016\u00a0https:\/\/bit.ly\/2G4DjqB<\/a>.<\/p>\n

The process for prescribing and dispensing medical marijuana varies. In my province of Ontario, patients typically attend the clinic of a cannabis vendor where they are assessed by, and receive a prescription from, a physician, who more than likely conducts the appointment by videoconference. Patients are prescribed marijuana to smoke, oil to ingest or pills from this clinic and receive their prescription through the mail.<\/p>\n

In addition to the prescription of cannabis for medical purposes, in 2018 recreational marijuana was legalized in Canada.\u00a0 This recent change seems to have legitimized cannabis with the general public and, subsequently, prescriptions are on the rise for a wide variety of ailments, including pain, anxiety and glaucoma, for which there is often little or no evidence \u00a0https:\/\/bit.ly\/2OqUbe0<\/a>.<\/p>\n

I work in a family practice and I\u2019ve been alarmed with the increasing number of patients who are taking medical marijuana.\u00a0 They receive prescriptions in the form of oil, or to smoke, for such things as fibromyalgia, insomnia and anxiety.\u00a0 My concerns were augmented the last day I was at the clinic when a patient asked if it was OK to take marijuana with a heart condition.\u00a0There was no information on his chart about his marijuana prescription and I struggled to find information to help him.\u00a0 I finally sent him back to the cannabis clinic for their input.\u00a0 This incident peaked my interest in the overall safety and efficacy of medical cannabis, prompting a deep dive into the available research.<\/p>\n

Some physicians echo my concerns about the wide spread use of this drug and have questioned the evidence to support its use https:\/\/bit.ly\/2OqUbe0<\/a>\u00a0 There is a difference in what is known about the effects and effectiveness of synthetic vs natural cannabis products.\u00a0 Nabilone is a man-made form of cannabis while marijuana is an herbal form (oil, smoke, edibles).\u00a0 There have been studies on nabilone, but there is very little research evidence about marijuana https:\/\/bit.ly\/2LaWdfa<\/a><\/p>\n

The Canadian Agency for Drugs and Technologies in Health (CADTH) is a not-for-profit, national organization that reviews evidence about medical treatments for use by health care providers. CADTH has compiled evidence about the use of nabilone for a variety of health issues. Their reports reveal that there is evidence to support the use of nabilone in very few conditions. Some of their reports demonstrate the following:<\/p>\n