Ma­ri­juan a’s me­di­cal at­tri­bu­tes vastly over sta­ted...

La Jornada (Canada) - - PORTADA -

Ma­ri­jua­na users want so­ciety to be­lie­ve the very thing they’ve told them­sel­ves for years - that the highs of ma­ri­jua­na far out­weigh its lows when it co­mes to health and the ef­fect on the mas­ses.

In­for­med minds that re­main so­ber and less tain­ted by per­so­nal bias reali­ze that’s pro­bably not the ca­se.

Can­na­bis is de­mons­trably help­ful for a li­mi­ted num­ber of con­di­tions and even then may not be the best cli­ni­cal first choi­ce.

Meanw­hi­le, tho­se dam­ned down­si­des re­main.

In Ca­na­da, me­di­cal ma­ri­jua­na use has grown dra­ma­ti­cally from just 7,914 re­gis­te­red users in 2014 to 201,398 in 2017. This pre­va­len­ce va­ries wi­dely, from just 0.07 per cent of the po­pu­la­tion in Que­bec to 1.7 per cent in Al­ber­ta. But as po­pu­la­rity has grown, many doc­tors have wan­ted mo­re gui­dan­ce as to when can­na­bis is an ap­pro­pria­te op­tion.

From a pu­blic re­la­tions pers­pec­ti­ve, me­di­ci­nal ma­ri­jua­na was a no-brai­ner for pot ent­hu­siasts. On­ce so­ciety con­ce­ded an up­si­de to ma­ri­jua­na, it be­ca­me dif­fi­cult to ar­gue for its prohi­bi­tion to pre­vent harm. It should sur­pri­se no one if ma­ri­jua­na’s be­ne­fits have been overhy­ped or overs­ta­ted, not only by po­li­ti­cal ad­vo­ca­tes but al­so by

re­sear­chers who­se bias may have hel­ped them find what they wan­ted to see. Per­haps so­me we­re blin­ded by the ha­ze of their own con­sum­ption.

Re­sear­chers at the Uni­ver­sity of Al­ber­ta found the po­si­ti­ve ca­se for pot was wea­ker than many have been led to be­lie­ve. G. Michael Allan and 18 co­llea­gues loo­ked at 31 sys­te­ma­tic re­views of the the­ra­peu­tic ef­fects of can­na­bi­noids, which al­to­get­her en­com­pas­sed 1,085 stu­dies. Allan’s team found that whi­le stu­dies we­re plen­ti­ful, qua­lity was ra­re. Ran­do­mi­zed cli­ni­cal trials we­re li­mi­ted or ab­sent. Small sam­ple si­zes and short du­ra­tions we­re com­mon, ma­king fal­se po­si­ti­ves mo­re li­kely. Im­por­tant qua­lity mar­kers we­re of­ten ab­sent, un­der­mi­ning the re­lia­bi­lity of the re­sults, if not crea­ting ou­tright bias.

Ear­lier this year, the Ca­na­dian Fa­mily Phy­si­cian pu­blis­hed Allan’s “Sim­pli­fied gui­de­li­ne for pres­cri­bing me­di­cal can­na­bi­noids in pri­mary ca­re.” Co­pies we­re sent to 30,000 doc­tors, re­com­men­ding that can­na­bi­noids be pres­cri­bed so­lely for “neu­ro­pat­hic pain, pa­llia­ti­ve and end-of-li­fe pain, che­mot­he­rapy-in­du­ced nau­sea and vo­mi­ting, and spas­ti­city due to mul­ti­ple scle­ro­sis or spi­nal cord in­jury.” Only the synt­he­tic can­na­bi­noid of na­bi­lo­ne or na­bi­xi­mols is re­com­men­ded, and even then only af­ter two ot­her op­tions have been tried.

The­se op­tions ex­clu­de ac­tual pot-smoking, partly be­cau­se the che­mi­cal com­po­si­tion of an in­di­vi­dual plant al­ways va­ries - so­me­ti­mes subs­tan­tially. Can­na­bis has mo­re than 500 com­pounds and over 100 can­na­bi­noids have been iden­ti­fied. Te­trahy­dro­can­na­bi­nol ( THC) is the pri­mary psy­choac­ti­ve com­po­nent. Can­na­bi­diol (CBD) is al­so sig­ni­fi­cant and seems to pre­vent so­me of the ad­ver­se ef­fects of THC.

Ma­ri­jua­na has grown in po­tency in both Ame­ri­ca and Eu­ro­pe. One study of Ame­ri­can pot sho­wed that in the 20 years fo­llo­wing 1995, THC con­tent had tri­pled whi­le CBD drop­ped. Whe­reas THC con­tent had been 14 ti­mes that of CBD, by the end of 2014, that num­ber was 80.

Allan pre­fers that doc­tors pres­cri­be can­na­bis as a third op­tion at best, due to such po­ten­tial harms as brain da­ma­ge.

En­do­can­na­bi­noids help sy­nap­ses (which con­nect neu­rons) form pro­perly as brains de­ve­lop, a pro­cess of­ten in­com­ple­te un­til age 25. Re­gu­lar ma­ri­jua­na use in ado­les­cen­ce al­ters brain con­nec­ti­vity and re­du­ces vo­lu­me, in­hi­bi­ting me­mory, lear­ning and im­pul­se con­trol.

One 25-year study of 4,000 young adults found that ma­ri­jua­na lo­we­red ver­bal me­mory. A study in New Zea­land found that fre­quent ma­ri­jua­na use in ado­les­cen­ce led to a loss of six IQ points in mid-adult­hood, even if con­sum­ption stop­ped in adult­hood.

High can­na­bis use al­so co­rre­la­tes with men­tal health pro­blems. Use in ado­les­cen­ce in­crea­ses the risk of schi­zoph­re­nia-li­ke psy­cho­ses and can ac­tually trig­ger them. Can­na­bis users de­ve­lop psy­cho­sis two or th­ree years ear­lier than ot­hers - an ef­fect not seen from al­cohol or ot­her subs­tan­ce use.

Amo­ti­va­tio­nal syn­dro­me is a chro­nic di­sor­der first re­cog­ni­zed in the 1960s by pa­tients with long­ti­me can­na­bis use. This in­vol­ves chan­ges in per­so­na­lity, emo­tions and brain fun­ction cha­rac­te­ri­zed by in­ward-tur­ning, apathy and blun­ted af­fect.

The po­ten­tial for lung da­ma­ge and can­cer due to ma­ri­jua­na smoking is grea­ter than that for to­bac­co. One study even su- gges­ted that smoking one joint a day cau­sed the sa­me lung da­ma­ge and can­cer risk as 20 ci­ga­ret­tes. Hig­her car­ci­no­ge­nic con­tent is part of the reason but a grea­ter de­gree of in­ha­led smo­ke is the ot­her. THC al­so sup­pres­ses the im­mu­ne sys­tem.

Can­na­bis can al­so cau­se acu­te pan­crea­ti­tis, though the exact me­cha­nism is un­clear.

In ad­di­tion, ma­ri­jua­na’s cu­re for bud­get de­fi­cits has been overs­ta­ted. The fe­de­ral go­vern­ment has al­ready spent $800 mi­llion to pre­pa­re for le­ga­li­za­tion, gob­bling mo­re than the first year’s tax re­ve­nues.

Now youth can carry fi­ve grams (se­ven joints) without cri­mi­nal pro­se­cu­tion and re­turn to ho­mes with four plants pro­du­cing 300 grams each.

The ma­jo­rity of health and so­cial costs won’t be bor­ne for de­ca­des. By then, his­tory books will show how ma­ri­jua­na le­ga­li­za­tion was the suc­cess­ful pres­crip­tion to mo­bi­li­ze the mi­llen­nial vo­te. Lee Har­ding is re­search fe­llow for the Fron­tier Cen­tre for Pu­blic Po­licy.

Pot’s be­ne­fits have been overs­ta­ted by po­li­ti­cal ad­vo­ca­tes and scien­tists, who­se bias may have tain­ted re­search re­sults

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