Re: Should doctors prescribe cannabinoids?
It should be a matter of great regret for all those interested in the pursuit of scientific truth that Prof. Michael Farrell and Prof. Wayne Hall have failed to declare their long running association with the National Cannabis Prevention and Information Centre (NCPIC).
The NCPIC is a government funded propaganda organisation concerned with supporting political policies. It has no relationship with science except that it funds, publishes and promotes scientists who provide evidence supporting its aims. Similarly, its presence on the campus of the University of New South Wales invalidates any claim by the University to scientific rigour in any aspect of cannabis research.
This submission fails to pass the necessary tests of objectivity and impartiality which should be the first requirements for publication in a journal of the reputation of the BMJ.
From its first sentence it demonstrates a determination to overlook great swathes of empirical evidence. The medicinal use of cannabis is well established in archaeological evidence dating back 10,000 years and in written evidence dating back 5,000 years. Interest was revived in the US in the 1970s and 1980s and is now supported by tens of thousands of doctors and medical professionals in the US, Canada, Europe, Israel, Australia and New Zealand - not to say millions of patients who greatly value its efficacy and safety.
Box 1 defines cannabis as a substance that is smoked and overlooks completely the widespread acceptance and preference for medical vapourising which eliminates the dangers of inhaling the products of combustion but facilitates very effective titration of dosage.
The narratives on antiemetic and appetite stimulating effects; effects on muscle spasticity or neuropathic pain in multiple sclerosis; other neuropathic pain; cancer pain are merely exercises in excluding evidence that does not suit the authors predetermined conclusions.
Box 3 details "probable" and "possible" adverse effects of chronic recreational cannabis smoking. These are nothing but speculative scaremongering more suited to the pages of a tabloid newspaper than a clinical journal. How are these relevant to the subject of the article which concerns administration of cannabinoids for a specified medicinal purpose within the strict regulation of a doctor's prescription?
All in all this is nothing but an exercise in drug war propaganda. It has nothing to do with a responsible assessment of the benefits and risks of cannabinoid medicine. Even in its own terms, the only conclusions it reaches are that the evidence is unclear but it is itself an exercise in obfuscation, cherry picking and excluding evidence to suit the authors' agenda.
This paper falls well below the minimum requirement that should be expected of a professional review of medical. It does nothing to assist in answering the question it poses and is seriously misleading.
Competing interests: President and elected leader of CLEAR Cannabis Law Reform