Why Don’t More Doctors Prescribe Cannabis to Their Patients? Even as support for medicinal cannabis gathers momentum among voters, physicians often remain hesitant or firmly opposed to recommending cannabis to their patients. Mostly, their hesitation stems from a lack of supportive data and strong clinical trials. But when it comes to cannabis, is the science really not sufficient to support its clinical use?
Even as support for medicinal cannabis gathers momentum among voters, physicians often remain hesitant or firmly opposed to recommending cannabis to their patients. Mostly, their hesitation stems from a lack of supportive data and strong clinical trials. But when it comes to cannabis, is the science really not sufficient to support its clinical use?
To better understand why many doctors hesitate to embrace cannabis, let’s consider the factors that have plagued the pro-cannabis argument:
- First, a lack of available scientific studies on many health outcomes leaves us with mostly anecdotal reports of its medicinal abilities. While these stories certainly have value in guiding the scientific investigation, they’re ripe with bias and a spectrum of confounding factors, so they’re not sufficient on their own.
- Next, when results suggest that cannabis is ineffective at treating a condition or may have small benefits but substantial side effects, it’s hard to support using cannabis for that clinical condition.
- Lastly, inconsistency in cannabis’ effects across published reports reduces confidence in the predictable and consistent therapeutic benefits of cannabis.
Let’s break these points down.
Why Are There Few Scientific Studies Into Cannabis’ Clinical Benefits?
The reason for the relative scarcity in clinical cannabis studies stems largely from its Schedule I classification by the Drug Enforcement Agency. This classification regulates how cannabis can be studied, the access scientists have to cannabis and the financial and institutional resources that can be devoted to studying cannabis.
You won’t be surprised that it’s especially challenging to acquire funding to study a drug with “currently no accepted medicinal use,” according to the definition associated with its classification. It doesn’t matter that the same drug is one of the earliest known medicines. Most scientists’ careers live and die by grant funding, and the United States government is the single largest source of science funding in the world.
So if the government is resistant to funding medicinal cannabis research, it has a major impact. (And when they do commit to funding, not everyone is happy about it. For instance, Professor Michael Morgan of Washington State University in Vancouver received funding to study the interaction between THC and morphine on pain. This research was listed in Tom Coburn’s (R-OK) list of the top 100 Wasteful Stimulus Projects).
Is the Research Truly Not Available?
It turns out, there’s a trove of clinical research studies that the public doesn’t see. Because of the federal restrictions on research in academic institutions, private companies have taken it upon themselves to gather their own data, often with the support of nurses or physicians. The data gathered are being used to optimize the therapeutic effectiveness of their own products and are revealing, so we’re told, exciting and promising results.
Because these companies aren’t gaining approval through the same institutional review boards that are required for academic institutions, they’re often precluded from publishing in the peer-reviewed journals that are publicly available. Another downside is that they don’t receive the same scrutiny for the validity of their results.
Nonetheless, this privately collected trove of clinical data likely represents a significant source of clinical cannabis studies that could be used to transform the industry. But for now, few are showing their hands.
Why Is the Effectiveness of Cannabis Inconsistent Across Studies?
Beyond the challenge of acquiring research funding, it’s not easy—or in many cases possible—to get cannabis for clinical trials that’s consistent with what’s available to consumers.
The inability to systematically test different strains and products has traditionally led to an inability for the clinical research to support many claims by cannabis patients.
For decades, the University of Mississippi has been the only licensed facility to produce the plant for research purposes. But some researchers claim that the cannabis they receive doesn’t resemble the appearance or smell of traditional cannabis, it may be moldy, and has between 8-12% THC.
That may be fine if you’re trying to draw conclusions about the health benefit of that one particular strain, grown at that one particular site. But if that sub-optimal product also has sub-optimal medicinal benefits, is it valid to conclude that all cannabis strains and products similarly don’t have medicinal benefits? Of course not. The inability to systematically test different strains and products—many of which have been optimized for certain conditions—has traditionally led to an inability for the clinical research to support many claims by cannabis patients.