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There were no significant impacts on physical or emotional functioning, and low-quality evidence of improved sleep and patient global impression of change. Evidence for effectiveness of cannabinoids in CNCP (Chronic Non-Cancer Pain) is limited. Effects suggest that number needed to treat to benefit is high, and number needed to treat to harm is low, with limited impact on other domains. It seems unlikely that cannabinoids are highly effective medicines for CNCP.

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9th Feb 2020 

Psychosis link to high potency drug must be investigated, warn mental health chiefs 

Rethink Mental Illness charity warns over damaging effects of cannabis on the mind. Photograph: David Bebber/REUTERS 

One in 20 adults would take cannabis on a regular basis if it were legalised, similar to the number of people who currently use it, according to a poll for a leading mental health charity.

A particular concern is the use of high potency cannabis, or “skunk”, which increases the risk of developing psychosis. Psychosis can be a symptom of mental illness, including schizophrenia and bipolar disorder.

Sir Robin Murray, professor of psychiatric research and chair of the Rethink Mental Illness Clinical Advisory Group, said high potency cannabis was responsible for a third of all new patients in London being diagnosed with psychosis. “This is a clear indicator that our current system is not working,” Murray said.

Many pro-legalisation groups argue it would see the potency levels capped, reducing harmful effects, but Murray is dubious. “In the US, states that have legalised cannabis for recreational purposes have seen an increase in the use and potency of cannabis, and even more cannabis-related problems. 

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Cannabis-based medicinal products were abruptly decriminalised in November 2018 CREDIT: PA

Cannabis-based drugs controversially legalised by the government have been blocked by NHS watchdogs because there is insufficient evidence they are safe.

The National Institute for Health and Care Excellence (Nice) yesterday called for fast-tracked clinical trials after concluding it could not recommend cannabis-based medicinal products (CBMP) for routine use.

The drugs were decriminalised by Sajid Javid last November following the high-profile campaign in support of Alfie Dingley, a severely epileptic child whose mother was being forced to seek treatment abroad.

However, without Nice approval only a tiny handful of doctors are qualified and willing to prescribe CBMPs, meaning they are virtually impossible to obtain in practice.

Last night patient charities were left devastated by the Nice decision, saying it denies effective treatment to thousands of people.

Any accompanying report by NHS England blamed last year’s “rapid-rescheduling” of CBPMs for leading to a “very high expectation from patients and their families that they would be able to access these medicines on the NHS”.

The criticism echoes findings published last month by the Health Select Committee.

As well as blocking the routine use of cannabis-based epilepsy treatments on the NHS, the Nice draft guidance also refused to recommend Sativex, a cannabis-based epilepsy medicine, on the grounds it is not cost-effective.

However, the body did approve Nabilone, a synthetic cannabis-based medicine for cancer patients struggling with side-effects of chemotherapy.

Last year’s redesignation of CBPMs from Schedule 1 to Schedule 2 of the Misuse of Drugs Regulations means specialist doctors are permitted to prescribe them.

In the absence of Nice guidelines, however, they may be personally liable if something goes wrong.

Dr Keith Ridge, chief pharmaceutical officer at NHS, said: “Without sufficient evidence to help them balance potential benefits against potential harms when they are deciding whether to prescribe medicinal cannabis to children with very severe epilepsy, it is clear that clinicians are very reluctant to prescribe.”

Nice is considered arguably the most rigorous agency of its kind in the world because it demands copious evidence from clinical trials before signing off drugs as safe, effective, and good value for money.

Because use of cannabis-based drugs was banned under all circumstances until so recently, so such evidence exists.

NHS England yesterday pledged to begin “one or more” randomised control trials looking at CBMPs for severe treatment-resistant epileptic children. 

Nabilone, the first cannabis-drug to be approved for routine use in the NHS, is a synthetic product that mimics the effects of tetrahydrocannabinol (THC), the component that makes recreational cannabis users “high”.

Already licensed, It will become available to patients suffering with chemotherapy-induced nausea and vomiting which has not responded to conventional medicine

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Bieber revealed that he first tried marijuana when he was just 13 after rocketing to fame as a child when he was discovered on YouTube.

After becoming dependent on weed, Justin began to drink lean — a narcotic substance often called purple drank or sizzurp — as well as taking pills, doing Molly, and trying mushrooms.

Justin eventually decided to get sober because he was 'dying', and said people aren't aware of how 'serious' his addictions were.

He explained: 'I was, like, dying. People don't know how serious it got It was legit, crazy scary.

'I basically said to myself, 'God, if you are real, you get me through this season of stopping these pills and stuff, and if you do, I'll do the rest of the work.' I never did the actual work. I got off the pills but never went to the root of everything so I just circled back around which most people do.'

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QUESTION: What do these deadly poisons have in common: arsenic, radium, mercury, thallium, cyanide?

ANSWER: At one time they were all considered by physicians and the public as useful medications and/or healthy supplements. They were taken in a wide variety of lotions, potions, notions, tinctures, tonics, and pills. These poisons were recommended, sold, and prescribed freely by physicians.1 It took thousands of deaths and many decades before the harmful nature of these substances was perceived by physicians and the general public.  

For source: Missouri Medicine Library Volume 117 Jan 2020




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