When we meet people that are moving the cannabis industry in the right direction, we take note and listen up. We’ve written on Ms. Bisiani before, and she continues to write more content. She has a focus on older populations, and this time she has written about medical cannabis as an alternative for management of chronic pain in older Australians.

Medicinal Cannabis: A Therapeutic Alternative for Management of Chronic Pain in older Australians

Our thoughts:

Mainstream pharmaceutical drugs are accepted because they have clinical trials to back up their efficacy, but alternatives do not have the same evidence. There is, however, significant anecdotal evidence to suggest efficacy of cannabis in pain management. We think the most immediate solution, is publicly funded backing for clinical trials.

Opiates cause harm, have high risks of dependence, and cause downstream public health issues. People die from opiate overdose, and the withdrawal symptoms are reported to be extreme. When comparing the factors of addiction and health risks between opiates and cannabis, it becomes difficult to ignore cannabis as an option.

We agree that reproducible formulas are key to moving cannabinoid therapies forward. But, again, under a clinical setting. Right now, cannabis products have significant variation between different cultivation sites, and this leads to higher variation. As a result, patients have to hope the products they consume will be consistent batch-to-batch. Data presented by Dr. Meiri from the Technion suggests that variation in cultivation environment causes variation in the cannabis plant’s cannabinoid expression profile, that then, with certainty, changes the therapeutic outcome. This doesn’t even account for the multiple different ways of administering cannabis, and variation in the manufacturing processes of those (extract) products.

We also agree on healthcare provider education, but I think they are at a loss without the clinical evidence. I have spoken with doctors who recommend cannabis, but they are hesitant to prescribe it. They don’t have the clinical data that they rely on to make decisions. This is why Germany is going through a “clinical preparations” route for providing cannabis to those who could benefit from its therapeutic use.

Again, this circles around to the need publicly funded basic research and then clinical trials in order to properly educate health care practitioners. For now, they have to rely on direct observation of patients and the anecdotal evidence they gather through experience. Monitoring patients cannabis use will be the key for future clinical studies, and health care professionals collaborating will be the best first step for the therapeutic benefits to be validated.