Self-medication with cannabis led to addiction in controversial trial
It has been free for the participants, says a Danish researcher who is critical of the study.
What are the advantages and disadvantages of medical cannabis for adults who struggle with anxiety, depression, pain or insomnia?
American researchers have investigated this by following 186 participants over three years. The research is published in the journal JAMA Network Open.
And it turns out that it is a serious risk: addiction.
There was also no improvement in illnesses: neither anxiety, depression nor pain. However, participants reported better sleep quality.
– It is a relevant study, says Kristina Bacher Svendsen, senior physician at Aarhus University Hospital and associate professor at the Department of Clinical Medicine at Aarhus University.
– In the US, major problems with addiction have previously been experienced when using tramadol for pain. The study can provide important knowledge about the risk of addiction when using cannabis medically.
But it is not surprising that it has had a side effect in the form of addiction – also called «cannabis use disorder» (CUD).
This is the opinion of Peter Christian Leutscher, head of research, professor and senior physician at the Center for Clinical Research at Aalborg University.
– It goes without saying that it is a significant risk. This is why the Danish trial scheme will be carried out in a different way. Cannabis should be prescribed under guidance to patients, he says.
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Leads to addiction
The participants in the study are patients who are using medical cannabis for anxiety, depression, chronic pain or sleep problems.
A lottery has determined whether they have either been allocated a card that allows them to collect medical cannabis or ended up on a waiting list.
After twelve reviews, the effect on the ailments sought to be alleviated is assessed.
According to Peter Christian Leutscher, the risk of addiction turned out to be significant.
– But it is predictable when the patients are left to themselves, Leutscher believes.
Criticism: Free forward
We can therefore use studies to learn more about the consequences of self-medication with medical cannabis and that it can therefore lead to addiction, believes Peter Christian Leutscher.
But he is critical of studies. For several reasons.
– It sounds as if the participants have been left to themselves, that they could decide for themselves how much they wanted, he says.
And the participants do not have the professional prerequisites for it.
– Treatment with cannabis requires medical knowledge and cannot be left to the patient himself. It poses a significant risk of addiction and side effects, he says.
Lars Arendt-Nielsen, professor at the Department of Medicine and Health Technology at Aalborg University, also criticizes studies.
– It is not checked for the doses they have taken. And the data were self-reported. At the same time, placebo treatment has not been studied with which the data could be compared, he says.
I also do not describe studies of cannabis products are CBD and/or THC.
– It is important to know whether we are talking about THC-dominated products. It would be unwise to use it for depression and anxiety, says Peter Christian Leutscher.
– In the case of psychiatric disorders, one should stay away from cannabis, which contains large amounts of THC. Because it’s anxiety-inducing.
There has been little research into the effect of medical cannabis on mental disorders, believes Kristina Bacher Svendsen.
– We don’t know much about the effect of cannabis against anxiety and depression. People have been reluctant to use cannabis with a psychiatric diagnosis because they are afraid of side effects, including worsening of psychological symptoms. These are patients who are particularly vulnerable, so it is important to pay extra attention, she says.
Valid in the United States
According to Kristina Bacher Svendsen, you are only studying a picture of the situation in the USA – and we therefore cannot use it in a Danish context.
– In Denmark, you cannot be given a card so that you can decide for yourself how much and what type of medical cannabis you want to be treated with. It is written out of play, she says.
– Yes, it is relevant in an American context, but we would never do it in Denmark, says Peter Christian Leutscher.
– It is difficult to see how the results from the studies can be used in a Danish context. Furthermore, it is an important basic principle for products that must be prescribed by a physician with close monitoring of the patients when there are side effects and risk of abuse.
Reference:
Jodi M. Gilman et al.: Effect of medical marijuana card ownership on pain, insomnia, and affective disorder symptoms in adults. JAMA Network Open2022. DOI: 10.1001/jamanetworkopen.2022.2106
© Videnskab.dk. Translated by Lars Nygaard for forskning.no. Read the original case on videnskab.dk here.
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