DESPITE the United Nations recently recognising the medical benefits of cannabis, an influential global body says there is insufficient evidence to endorse it for the treatment of pain.
In what many will see a blow to progress of medical cannabis across the globe the The International Association for the Study of Pain (IASP) says further research is needed.
Its impacts may be immediately felt in the UK after the Advisory Council for the Misuse of Drugs (ACMD) recently said the IASP’s report would have a ‘powerful influence on the practice around prescribing cannabis-based medicines for the treatment of pain’.
A Lack Of Research
The announcement by the IASP’s Presidential Task Force on Cannabis and Cannabinoid Analgesia received a mixed response with leading clinician Prof Mike Barnes describing it as a ‘setback for millions of people’.
However, other leading UK medical cannabis figures have welcomed the IASP’s call for further research.
In an announcement late last week from its Washington DC headquarters the IASP said that: “Due to a lack of evidence from high quality research, it (the IASP) does not endorse the general use of cannabinoids to treat pain.”
It went on to say: “The IASP has also published a list of research priorities which need to be addressed in order to properly determine the potential efficacy, and to confirm the safety of, cannabinoids when used in the treatment of pain.”
In addition to the statement, the IASP has published a series of 13 linked scientific articles reviewing the relevant laboratory and clinical research used as the source material for its findings.
These reviews took place over the last two-and-a-half years and represent the work of IASP’s Presidential Task Force on Cannabis and Cannabinoid Analgesia.
Pain is the most common ailment for medical cannabis prescribing with figures from Germany, Europe’s most advanced market, showing almost three-quarters of scripts are for its treatment.
Leading UK cannabis expert Professor Mike Barnes, an Honorary Professor of Neurological Rehabilitation, said: ”This yet another example of a deeply conservative medical body denying the overwhelming real world evidence of efficacy of cannabis for pain. It’s very sad and such a setback for several million people worldwide who would benefit from the medicine.
“The IASP should spend some time actually reading the evidence.They should recall that cannabis is a plant and not a pharmaceutical product and one that has been used for millennia with great effect.”
Not Closing The Door
The chair of the IASP Presidential Task Force is Andrew Rice, Professor of Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London.
He said: “While the IASP cannot endorse the general use of cannabinoids for treatment of pain at this time, we do not wish to dismiss the lived experiences of people with pain who have found benefit from their use.
“This is not a door closing on the topic, but rather a call for more rigorous and robust research to better understand any potential benefits and harms related to the possible use of medical cannabis, cannabis-based medicines and synthetic cannabinoids for pain relief, and to ensure the safety of patients and the public through regulatory standards and safeguards.”
This point was picked up by Dr Andy Yates, the Pharmacy Lead at the UK’s Centre for Medicinal Cannabis. He said: “I agree there is a lack of evidence but we shouldn’t dismiss the individual patient who has tried everything else and gets relief from cannabis medicines.
“We welcome registries and trials which will provide more evidence to see if cannabis medicines are suitable for use in broader populations.”
Randomised Controlled Trials
Cannabis and tech entrepreneur Gavin Sathianathan, co-founder of LSE-bound Oxford Cannabinoid Technologies (OCT), said: “The IASP recognises that the lived experience of the millions of people treating pain symptoms with cannabis can no longer be ignored, and calls for more rigorous research to be done. I agree.
“What the medical cannabis industry needs is Randomised Controlled Trials to definitively prove that cannabinoids are safe and effective in the treatment of severe pain.
“Notably, GW Pharmaceuticals took this regulatory pathway to get Epidyolex approved for the treatment of neurological conditions; at OCT, we intend to pursue the same approval pathway with a series of drug candidates in neuropathic and visceral pain indications. We want to give hope to the millions of people using opioids to treat chronic pain.”
The International Association for the Study of Pain (IASP) is the largest multidisciplinary international association in the field of pain.
Founded in 1973, IASP is a non-profit professional organisation dedicated to furthering research on pain. It currently has over 5,800 members representing 134 countries.
In December last year the United Nations’ Commission on Narcotic Drugs recognised the medical properties of cannabis for the first time.