The legalization of marijuana in one form or another in more than half of the nation has left doctors scrambling to help their patients understand its medicinal benefits, along with its potential harms. But there’s a problem: There’s just not a ton of solid research on cannabis, at least in America.
The blockade on research stems from the decades long war on ‘drugs,’ which caused many researchers to avoid testing cannabis out of fear of losing federal funding for studying a federally prohibited substance. That lack of research is now being felt by millions of Americans who are begging their doctors for advice – but how can a medical professional offer advice without solid evidence? That’s the quandary facing doctors from coast to coast.
“We need to make sure we don’t deprive a community of a substance that could be beneficial,” says Dr. Wesley Clark, the former director of the Center for Substance Abuse Treatment and former chief of substance abuse programs for US veterans. “So we have to have a full picture of whether it’s good or bad.”
Still, others argue doctors needs to take more time to simply learn from their patients, because even though anecdotal evidence isn’t science; it’s still important.
“We have to listen to our patients. It doesn’t matter what a research paper says about the efficacy of a drug. If it doesn’t work for a patient, that is the most important data point,” argues Dr. Rachel Knox, an endocannabinologist and cannabinoid medicine specialist. Knox argues the confluence of marijuana legalization and a new era of medicine couldn’t be happening at a better time, because the two go together
“We are entering into a new era of total medical health care, one where we regard the patient as just as credible a witness and participant in their medical care,” she said. “Legalization before education has forced us as doctors to catch up and learn something about the endocannabinoid system.”
Historically, in the US to even get funding for any cannabis research, you had to go negative, because the government prized anti-cannabis studies over positive ones. It’s still an uphill battle for many researchers, which continues to frustrate doctors and researchers alike. It’s also left a lasting impact on the medical community.
“There might be positive aspects, but no one was interested,” Clark said. “The orientation of the public health community was hostile.”
In the US, CBD has been essentially deregulated and is being marketed for all that ails you, which Dr. Clark calls a public health problem in itself because there is no proof it’s a panacea. It’s also being marketed by some as a solution to the coronavirus pandemic, which is a position that is unsupported by research, thus New York’s attorney general even ordered Finest Herbalist to cease marketing its CBD oils as cures for COVID-19.
“We should be doing more research, especially as an anti-inflammatory agent.” Dr. Clark said.
There’s also a racial component. The stigma that exists around cannabis has discouraged Black patients from engaging with the medical system to get the advice they need.
”As a therapeutic option, it does not exist in the same way as our white counterparts,” Dr. Knox said. “We have not made headway on this gap.”
Ultimately, fairness must rule. That’s why many experts continue to wait for research to catch up with reality.