Outrage over medicinal cannabis stance


man holding 'no' sign

The RACP has been criticised over its MJA article calling for caution with prescription cannabinoids

A Sydney University academic has criticised an article published on behalf of the Royal Australasian College of Physicians (RACP), saying it underreported international evidence and exaggerated potential dangers.

In the original article, the authors wrote that while there is a growing community demand for prescription cannabinoids on compassionate grounds, the usual medical research standards have not yet been met.

“While the RACP understands the community interest in cannabinoids as a therapeutic product, it emphasises that the usual regulatory processes designed to protect patients from serious harms are incomplete for medicinal cannabinoids, and that evidence for their effectiveness for many medical conditions is at present limited,” wrote Professor Jennifer Martin, Associate Professor Yvonne Bonomo and Clinical Associate Professor Adrian Reynolds.

Professor Iain McGregor, academic director of the Lambert Initiative for Cannabinoid Therapeutics in the Brain and Mind Centre at the University of Sydney, has responded saying that the piece “stokes concerns” and “neglects facts”.

“For the vast majority of Australian patients, medicinal cannabis is little more than a pipe dream and part of the problem lies with the all-too-conservative approach that relies on specialist doctors.

“Rather than providing a coherent and balanced account of the current state of play, the [RACP] ‘perspective’ reads like a patronising and scaremongering diatribe, misrepresenting the literature to frighten off would-be prescribers,” Professor McGregor, who is also an NHMRC Principal Research Fellow and Professor of Psychopharmacology, writes in a Fairfax article.

“Most egregious of its falsehoods is the statement that medicinal cannabis is no better than placebo in treating pain,” he says.

“Oddly, when asserting this claim, the published piece cites two authoritative recent reviews from the US – reviews that in fact concluded the opposite.

“This misrepresentation is no trivial issue. Some 20% of Australians suffer chronic pain and surveys shows self-medication for back pain, arthritis and neuropathic pain are major drivers of illicit cannabis use in the Australian community.

“Those in unremitting pain are precisely the people who need their specialist doctors to have a nuanced and accurate knowledge of cannabinoid science.”

Professor McGregor says that the RACP chose to focus on reports of potential side effects of cannabidiol in children given extremely large doses of the compound to treat severe epilepsy.

“The RACP talks of a ‘precautionary principle’ and ‘do no harm’ – but in misrepresenting the facts of medicinal cannabis it promulgates a great deal of harm.”

He suggests that GPs, rather than specialists, could be the future gatekeepers of medicinal cannabis.

“Rumblings from Canberra – that regime change might indeed bring GPs into a new system where they act as medicinal cannabis gatekeepers – could be just what the doctor ordered,” says Professor McGregor.

“After all, if GPs are entrusted to prescribe opiates and benzodiazepines, why not medicinal cannabis products?”

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7 Comments

  1. Ricky
    23/02/2018

    Thank you, Professor Iain McGregor

    Nice to know others can recognize anti-pot propaganda.

  2. pagophilus
    23/02/2018

    ““This misrepresentation is no trivial issue. Some 20% of Australians suffer chronic pain and surveys shows self-medication for back pain, arthritis and neuropathic pain are major drivers of illicit cannabis use in the Australian community.”
    Surveys??? Is that good evidence? People use everything for back pain, from Nurofen Plus, to benzos, to pregabalin (which evidence shows is ineffective for this), to alcohol and illicit drugs. The RACP is saying the evidence is lacking. I would tend to agree. Medicinal Cannabis is being driven by emotion, and when that happens standards of evidence and standards of practice drop.

    • Ricky
      23/02/2018

      What drives prohibition?

      • pagophilus
        23/02/2018

        Prohibition in the US worked. It’s a misconception that it didn’t.

        • Ricky
          23/02/2018

          Oh it did? What did it accomplish? And better yet, how do you justify it?

        • Ricky
          24/02/2018

          Nothing? Can’t justify it? Can’t quantify how it worked?

        • D Carthew
          25/02/2018

          Prohibition has failed terribly everywhere. Last time I looked, drugs of all kinds are still readily available. Its why the police still have a unit called the DEA, which wastes billions of dollars adding further ruin to peoples lives. Its a misconception to say it has worked in any way at all. All this anti pot propaganda must end if any sensible conversations are to be had.

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