Lack of quality science on cannabis and pain leaves room for fake news and myth

Written by CBD Intel

Evidence deficit manifests in many ways, reports CBD-Intel

“It’s a myth that cannabis relieves pain,” declared the Daily Mail. But – for all that the opinion of the Mail on such matters should be respected, given its rich institutional tradition of myths – that is not what the study it was reporting said at all.

In reality, the evidence review from Oregon Health & Science University (funded by the US government and published in Annals of Internal Medicine) concluded that while THC and CBD in certain formulations do seem to alleviate neuropathic pain, there was simply insufficient good-quality data to conclude whether other cannabis products could help.

Indeed, the lead author was quoted as saying: “We saw only a small group of observational cohort studies on cannabis products that would be easily available in states that allow it, and these were not designed to answer the important questions on treating chronic pain.”

This evidence deficit comes up again and again in the world of cannabis, particularly with CBD and even more so with novel cannabinoids. We just don’t know for sure. The lack of trustworthy information is pervasive, manifesting itself not only in science but also (for example) in the well-known mislabelling of many CBD products (on which we had to report yet again recently), or in the absence of a reliable test for cannabis impairment.

The problems created by this haze of uncertainty are not always directly felt by individual companies or by consumers, of course. Rightly or wrongly, many people do trust cannabis and cannabinoid products to achieve certain ends, and buy them without rigorously examining the science, exactly as they buy countless other products. That’s what people do, and they’re not going to change – unless, of course, there’s a major health scare or they read too many stories like the Daily Mail’s.

Those are indeed threats to be aware of. While cannabis itself is probably sufficiently ingrained in (some parts of some countries’) culture to be relatively scare-proof at the consumer level, the last few years’ love affair with CBD could easily turn to distrust and then detestation.

But even if that never comes to pass, the data drought already indirectly affects both brands and consumers by delaying or affecting regulatory decisions – as in, for example, the European Food Safety Authority’s concerns over incomplete information on the physical effects of CBD.

Part of the issue in that particular case is that the bulk of scientific research on CBD has addressed therapeutic, not consumer, uses (and even then it leaves important questions unanswered, as the Oregon study shows). But there is a broader problem as well. Good science takes time; it requires funding, too, and researchers interested in the subject.

The absence of obvious very serious health risks from cannabinoids is one reason they are not studied more frequently; equally, while they might have wide-ranging health benefits, no single one is so obviously beneficial at a population level that it commands intensive attention. The result is science as fragmented as the industry it describes – with such a wide variety of actual and potential applications for cannabinoids, what research effort exists in many areas is spread very thin.

Pain is the obvious contender for a really major therapeutic application, and hence (presumably) the subject of the Oregon evidence review. But even there, as it found, research has a way to go yet.

Meanwhile, high-quality science on consumer applications of cannabinoids risks remaining even more elusive. The silver lining to this cloud is that regulatory obstacles like EFSA’s concerns, even if they are problematic for the industry in the short term, might in the longer term prove helpful by focusing attention on those data gaps, and encouraging researchers and their funders to step in.

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