A landmark paper published in The Lancet Psychiatry – the largest-ever review of the safety and
efficacy of cannabinoids across a range of mental health conditions –
found no evidence that medicinal cannabis is effective in treating
anxiety, depression or post-traumatic stress disorder (PTSD).
The study comes amid more than one million prescription approvals and a tripling of sales of cannabinoid medications (including both cannabidiol (CBD)
and tetrahydrocannabinol (THC) products) in Australia over the past four
years, often for the treatment of mental health and substance-use
disorders. In the United States and Canada, 27 percent of people aged 16–65 have used cannabis for medical purposes, with
about half using it to manage their mental health.
The study’s lead author, Dr Jack Wilson at the University of Sydney’s The Matilda Centre, said the results call into question the approval of medicinal
cannabis for the treatment of depression, anxiety and PTSD.
“Though our paper didn’t specifically
look at this, the routine use of medicinal cannabis could be doing
more harm than good by worsening mental health outcomes, for example a
greater risk of psychotic symptoms and developing cannabis use disorder, and
delaying the use of more effective treatments,” he said.
More than 700,000 Australians have
reported using medicinal cannabis to treat over 250 different health
conditions. The research found evidence to
suggest that medicinal
cannabis could potentially be beneficial for some
conditions – such as the treatment of cannabis use
disorder (otherwise known as cannabis dependency), autism, insomnia,
and tics or Tourette’s syndrome.
Dr Wilson
said: “But the overall quality of evidence for these
other conditions, such as autism and insomnia, was low. In the absence of
robust medical or counselling support, the use of medicinal
cannabis in these cases are rarely justified.
“There is, however, evidence that
medicinal cannabis may be beneficial in certain health conditions, such
as reducing seizures associated with some forms of
epilepsy, spasticity among those with multiple sclerosis, and managing
certain types of pain, but our study shows the evidence for
mental health disorders falls short.
“In the case
of autism specifically, while the study showed some evidence
medicinal cannabis could assist with a reduction in symptoms, it is worth
noting that there is no one – or universal – experience of autism, so
this finding should be treated with caution.”
The study found that medicinal cannabis
was not effective for every type of substance-abuse disorder. While
medicinal cannabis may help with cannabis dependence, it was
found to increase cocaine cravings among people with cocaine-use disorder
“Similar to how methadone is used to
treat opioid-use disorder, cannabis medicines may form part of an effective
treatment for those with a cannabis-use disorder. When administered alongside
psychological therapy, an oral formulation of cannabis was shown to reduce
cannabis smoking,” Dr Wilson said.
“However, when medicinal cannabis was
used to treat people with cocaine-use disorder, it increased their cravings.
This means it should not be considered for this purpose and may, in fact,
worsen cocaine dependence,” he said.
Researchers urge greater
regulation for prescribing of medicinal cannabis
The rapid expansion in medicinal
cannabis use and prescribing rates has raised concerns among major
medical bodies, including the Australian Medical Association (AMA), the Pharmacy Guild of Australia and the American Medical Association in the United States, about the largely
unregulated growth in prescribing and the uncertainty surrounding the
efficacy and safety of these products.
In response, the Therapeutic Goods
Administration (TGA) initiated a review of the regulatory oversight
of medicinal cannabis, with more than 500 responses published in February.
“Our study provides a
comprehensive and independent assessment of the benefits and risks of cannabis
medicines, which may support the TGA and clinicians to make evidence-based
decisions, helping to ensure patients receive effective treatments while
minimising harm from ineffective or unsafe cannabis products,” Dr
Wilson said.
Source: https://www.sydney.edu.au/research.html
Source: Huge study finds no evidence cannabis helps anxiety, depression, or PTSD – Scents of Science

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