National Academies report on health effects of cannabis and cannabinoids

A new report released on January 12 by the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine examines the health effects of cannabis and cannabinoids.

The report was produced by a committee of 16 experts from various medical and public health fields, and was sponsored by a number of governmental and nongovernmental organizations. It offers a comprehensive review of over 10,000 scientific studies to evaluate various therapeutic, medical, and other health effects of cannabis. It also identifies current barriers to cannabis research, and provides recommendations for future research.

Conclusive evidence for many health effects is currently hard to establish due to research gaps resulting from barriers to research. However, absence of evidence is not evidence of absence, and future research will be better able to answer these questions.

With that in mind, here are some highlights from the report:

Therapeutic effects

Substantial evidence was found to support the use of cannabis for treating chronic pain, counteracting nausea and vomiting induced by chemotherapy, and improving multiple sclerosis symptoms, as well as moderate evidence for the plant’s use in helping with sleep disturbance related to MS, fibromyalgia, chronic pain, or sleep apnea.

Health Risks

Cancer

There is evidence that cannabis is not associated with lung, head, or neck cancers, which are often associated with tobacco use. And no evidence currently supports the use of cannabis for treating any cancers.

Cardiovascular and respiratory health

Limited evidence suggests that cannabis use may trigger a heart attack in vulnerable individuals, or be associated with strokes. Long-term cannabis smoking is also associated with worse respiratory symptoms and more frequent chronic bronchitis episodes.

Injury and death

There was substantial evidence supporting a link between cannabis use and increased risk of motor vehicle accidents, along with some evidence of a link between cannabis use and increased overdose-related injuries in young children, particularly in states where cannabis is legal.

Birth

There is an established link between maternal cannabis use and lower birth weight, while limited evidence suggests it may also be linked to pregnancy complications and admissions to the neonatal intensive care unit.

Mental health

Substantial evidence was found for a link between cannabis use, especially when frequent, and the development of schizophrenia or other psychoses. There was also moderate evidence that cannabis is associated with a small increased risk of depressive disorders, and that regular use is linked to social anxiety disorder.

Substance use disorders

Various risk factors for developing “problem cannabis use” were noted, such as being male, smoking cigarettes, early initiation of cannabis use, parental substance use, major depressive disorder, and others. Stimulant treatment of ADHD was found to not be a risk factor for developing problem cannabis use. There was also some evidence for a link between problem cannabis use and increased severity of PTSD symptoms.

There was also some evidence that cannabis use is associated with developing substance abuse disorders for alcohol, tobacco, or other drugs.

Barriers to Research

The scheduling of cannabis was identified as a major impediment to cannabis research, with “substantial layers of bureaucracy” discouraging researchers from pursuing important lines of work. It is also often difficult for researchers to get access to the quantity, quality, or type of cannabis they need to conduct their research. There is also a need for more diverse sources of funding to support a more comprehensive cannabis research agenda, and for improvements in the methodology of cannabis research.

Recommendations

#1: Address research gaps by creating a comprehensive cannabis research agenda which gathers data to better understand the short and long-term health effects, both beneficial and harmful, of cannabis use. Such an agenda could study various at-risk and under-researched populations, different kinds of cannabis products, methods of ingestion, and the effects of cannabis use on public health systems.

#2: Develop research standards to ensure high-quality cannabis research, including guidelines for data collection and standards for study design.

#3: Improve public health surveillance systems by incorporating cannabis-related questions into major public health surveys, establishing testing facilities to analyze the chemical composition of cannabis products, and developing technology to detect cannabis impairment.

#4: Review the impacts of regulatory barriers to cannabis research with a team of experts and propose new strategies to expand access to research-grade cannabis. Also identify funding sources to support a national cannabis research agenda, and investigate ways of improving research-grade cannabis products.

Source: Lift News