"Recent years have seen substantial shifts in cultural attitudes towards marijuana for medical and recreational use. Potential problems with the approval, production, dispensation, route of administration, and negative health effects of medical and recreational marijuana are reviewed. Medical marijuana should be subject to the same rigorous approval process as other medications prescribed by physicians. Legalizing recreational marijuana may have negative public health effects.

Unlike any other prescription drug used for medical purposes, marijuana is not subject to central regulatory oversight. It is grown in dispensaries, which, depending on the state, have regulatory standards ranging from strict to almost non-existent. The crude marijuana plant and its products may be contaminated with fungus or mold.

This is especially problematic for immunocompromised patients,8 including those with HIV/AIDS or cancer. Furthermore, crude marijuana contains over 60 active cannabinoids, few of which are well studied. Marijuana growers often breed their plants to alter the concentrations of different chemicals compounds. For instance, the concentration of tetrahydrocannabinol (THC), the principal psychoactive ingredient, is more than 20-fold more than in marijuana products used several decades ago.

Without rigorous clinical trials, we have no way of knowing which combinations of cannabinoids may be therapeutic and which may be deleterious.

In some states, patients are permitted to grow their own marijuana. In addition to contributing to problems such as contamination and concentration as discussed above, this practice also invites drug diversion. Patients seeking to benefit financially may bypass local regulations of production and sell home-grown marijuana at prices lower than dispensaries. We do not allow patient to grow their own opium for treatment of chronic pain; the derivatives of opium, like marijuana, are highly addictive and thus stringently regulated.

The question of recreational marijuana is a broader social policy consideration involving implications of the effects of legalization on international drug cartels, domestic criminal justice policy, and federal and state tax revenue in addition to public health. Yet physicians, with a responsibility for public health, are experts with a vested interest in this issue. Recent legislation, reflecting changes in the public’s attitudes towards marijuana, has permitted the recreational use of marijuana in Colorado and Washington. Unfortunately, the negative health consequences of the drug are not prominent in the debate over legalizing marijuana for recreational use. "

"While enthusiasm for medical marijuana is very strong among some people, good-quality research has not caught up," said Mike Allan, director of evidence-based medicine at the University of Alberta and project lead for the guideline.

The guideline was created after an in-depth review of clinical trials involving medical cannabis and will be distributed to roughly 30,000 clinicians across Canada. It was overseen by a committee of 10 individuals, supported by 10 other contributors, and peer reviewed by 40 others, each a mixture of doctors, pharmacists, nurse practitioners, nurses and patients. The review examined cannabinoids for the treatment of pain, spasticity, nausea and vomiting, as well as their side-effects and harms.

Researchers found that in most cases the number of randomized studies involving medical cannabis is extremely limited or entirely absent. The size and duration of the studies that do exist are also very narrow in scope.

"In general we're talking about one study, and often very poorly done," said Allan. "For example, there are no studies for the treatment of depression. For anxiety, there is one study of 24 patients with social anxiety in which half received a single dose of cannabis derivative and scored their anxiety doing a simulated presentation. This is hardly adequate to determine if lifelong treatment of conditions like general anxiety disorders is reasonable.

According to the guideline, there is acceptable research for the use of medical cannabinoids to treat a handful of very specific medical conditions. They include chronic neuropathic (nerve) pain, palliative cancer pain, spasticity associated with multiple sclerosis or spinal cord injury, and nausea and vomiting from chemotherapy. Even in those specific cases, the benefits were found to be generally minor."

For more information on vaping & smoking effects COVID. click here.

For more information on how to celebrate safely. Click Here.

"A new medical marijuana guideline developed by Edmonton researchers warns physicians that the risks may outweigh the benefits for the vast majority of patients.

Family doctors face increasing pressure from patients asking for medicinal pot. But the study authors suggest there is little data for physicians to rely on before making that decision.

Alberta doctors prescribing marijuana jump 50% in 4 months

Guideline authors found that, in most cases, the number of randomized studies involving medical cannabis was extremely small.

He said mental health problems such as anxiety, depression and post-traumatic stress disorder (PTSD) are the number two reason medical marijuana is prescribed, but research doesn't support its use for those patients.

"In many areas, the research was actually absent or so limited that you really couldn't make a call," said Allan.

"This guideline may be unsatisfactory for some, particularly those with polarized views regarding medical cannabinoids," Allan said.

"Better research is definitely needed — randomized control trials that follow a large number of patients for longer periods of time. If we had that, it could change how we approach this issue and help guide our recommendations."

Merry Christmas & Happy Hanukkah from Coalition Rx!

We're also working on Zoom lessons if parents, teachers or students are interested in joining please email coalitionrx@gmail.com and we will get some class times set up!