By Sunil Aggarwal, MD
“Medical Marijuana: Clearing Away the Smoke” by Grant, Atkinson, Gouaux, and Wilsey published this month in Open Neurology Journal represents a milestone in the consolidation of knowledge and regularizing of clincal practice with regards to the medicinal use of cannabis. The authors, well-established faculty members or associates at leading American academic medical centers, have yet again reviewed the gold-standard, clinical-trials-based evidence for medical uses of cannabis and related cannabinoids and have found: 1) that it is inaccurate to say that cannabis lacks medical utility or that information on its safety is lacking, 2) that judgments on relative benefits and risks of cannabis and cannabinoids as medicines need to be viewed within the broader context of risk-benefit of other standard agents as well, many of which are associated with more serious adverse events, and 3) that enough information and clinical experience exists that an algorithm can be constructed to guide decision-making for physicians who may be considering recommending medicinal cannabis to patients with neuropathic pain, which the authors offer.
The authors conclude that ‘it will be useful if marijuana and its constituents can be prescribed, dispensed, and regulated in a manner similar to other medications that have psychotropic effects and some abuse potential’ and state that marijuana’s Schedule I classification is scientifically untenable and the greatest barrier to forward movement in this area of medicine and medical science. This conclusion is made all the more noteworthy given that the article’s first, second, and fourth authors disclose at the end of the manuscript that they have served as consultants and received financial support from major pharmaceutical companies. Bentham Science’s Open Neurology Journal is a five-year-old, peer-reviewed, National Library of Medicine-indexed and internationally edited publication.
Sunil Aggarwal, M.D., Ph.D., PGY-2, NYU Physical Medicine and Rehabilitation can be reached at cannabinergy.com