ASAM Weekly Editorial Comment
William Haning, MD, DFASAM, DFAPA
Demonstrates several distortions that can and do arise with the current enthusiasm for cannabis as a panacea. It is provided to reflect on the justifications needed for therapeutic recommendations. The journal is an online open access periodical, Cannabis and Cannabinoid Research, published by an enterprise that captures specialty niches, Mary Ann Liebert, Inc., Publishers. The article, and the accompanying polemical editorial which asserts “…that cannabis is a safe, non-addictive product,” suffer from the illusion of balanced scientific inquiry. Of the population surveyed, the response rate was all of 4.3%. Respondents were incentivized by an offer of a vaporizing device, suitable for a variety of chemicals and herbs, via lottery. There was no control population, either active (employing opioid analgesics) or inactive (those receiving neither cannabis nor opioids). The authors correctly identify other limitations, including risk of selection bias by having provided the title of the study to potential participants. Those whose patients have feet in both of two worlds, pain and addiction, have long been aware that there is no completely benign, or even “safe” analgesic. All human pharmacotherapy is a matter of balance; choices must be made between levels of risk and types of risk. The difficulty as we read it is that the authors’ zeal for the possibility of a lower-risk analgesic has outpaced the rigor of their research. There are articles which, however well intended, do not justify therapeutic conclusions.
Editor-in-Chief: William Haning, MD, DFAPA, DFASAM
Nothing to add that would not be redundant, great summary!