We need to stop sniggering and start thinking seriously about the use of marijuana in rheumatic diseases, experts have said during the first conference talk on the matter.
In a session called Medical Marijuana and the rheumatologist expert Jason J. McDougall, PhD, Associate Professor of Pharmacology and Anaesthesia at Dalhousie University in Halifax, Canada said cannabinoids could be very useful in the treatment of pain and inflammation in arthritis.
“There is a social stigma attached to cannabis that is not wholly justified,” he said.
“These are serious drugs and we need to take them seriously as a way of managing pain effectively.”
There were three forms of cannabinoids: phytocannabinoids – derived from cannabis sativa, synthetocannabinoids – man made, and endocannabinoids that were naturally present in our bodies, he told delegates.
“These endocannabinoids are serious contenders to try and alleviate pain and inflammation in rheumatic diseases, we need to stop sniggering about it and talk about it, and embrace them with the necessary caution of course, “ Dr McDougall said.
But according to co-presenter Mary-Ann Fitzcharles, an Associate Professor of Medicine at McGill University Health Center in Montreal, Canada, a lack of data was a major issue in evaluating the clinical use of marijuana.
There were no randomised trials on its use in rheumatic diseases, and nearly all patients who used it for pain relief typically smoked the herbal form.
The problem with this was herbal cannabis was a mixture of many physiologically active molecules with varied concentrations of active ingredients.
Most rheumatologists had anecdotal reports from patients attesting to the clinical benefits of herbal cannabis but there were no studies looking at dosing, efficacy or adverse events in individuals with rheumatic diseases.
And this was particularly important as the side effects were many and varied, Professor Fitzcharles said.
Studies of regular cannabis users showed side effects like memory loss, slow reaction times, selective attention, increased appetite and sometimes anxiety, she said.
While there were no easy answers, there was a need for academics to “forge ahead” with research on the cannabinoid-endocannabinoid system in health and disease.
“But rheumatologists and the larger medical community have got to advocate for a much more refined, pure, and predictable pharmacologic product to be tested as opposed to an herb that is a mish-mash of unknown constituents in unknown concentrations,” she concluded.
Pfizer Immunology proudly sponsored Nicola Garret’s attendance at ACR 2013