"Vagg told the Sydney Sunday Herald that chronic pain patients would benefit most from multidisciplinary pain management clinics that have as part of their basket pain management, physical reconditioning, biomechanics assessment, occupational therapy and evidenced-backed procedures or medicinal treatments."
I am becoming a vindictive old SOB lately.....and I really do hope that this wanker contracts a chronic, constant pain condition at some point in his life and see how that occupational therapy works out for him as they addict him to opioids.
Yeah, that's the ticket....."evidenced-backed procedures or medicinal treatments".....uh, like Fentanyl patches...maybe?
Australia’s leading pain advisory body has a recommendation for doctors in the country: Don’t use medicinal cannabis to treat chronic pain.
According to the Sydney Morning Herald, despite the approval of the 100,000th cannabinoid script in the country, the Faculty of Pain Medicine at the Australian and New Zealand College of Anaesthetists (ANZCA) is advising doctors to hold tight.
“Do not prescribe currently available medicinal cannabis products to treat chronic non-cancer pain unless part of a registered clinical trial,”
notes the recommendation posted on Choosing Wisely, a health educational campaign.
Emphasizing there is “a critical lack of evidence that it provides a consistent benefit for any type of chronic non-cancer pain,” ANZCA points out the lion’s share of special access scheme approvals (more than 90 per cent) “have been for chronic pain of various types.”
Beyond the lack of evidence regarding effectiveness, though, is the evidence that potential harms exist, “particularly in relation to sedative effects, interactions with other medications and neuropsychiatric effects” for products containing THC, the recommendation states.
What’s really needed, the group argues, is “evidence from gold-standard studies that prove cannabinoid products effectively treat these patients’ suffering,” the Sydney Morning Herald reports.
Professor Michael Vagg, dean of ANZCA’s pain medicine faculty,
wrote this week in The Conversation, that both the International Association for the Study of Pain and ANZCA “recommended against medicinal cannabis for people suffering persistent non-cancer pain.”
While some may regard the recommendations as controversial, Vagg noted some misconceptions persist around marijuana’s effectiveness when it comes to chronic pain.
“There isn’t a single published randomized controlled trial of a CBD-only product for chronic pain of any type,” Vagg wrote. That is key for Australia, given that the country often allows CBD-only medicinal marijuana products.
Australia allows CBD-only medicinal marijuana products. / PHOTO BY HIGH GRADE ROOTS/GETTY IMAGES /Getty Images/iStockphoto
As for study results around THC-containing products and pain, “clinical trials don’t give a reliable picture one way or the other because they involve too few participants, have major technical flaws in design, or have been judged to have an unacceptably high risk of producing biased results,” Vagg pointed out.
He also pushed back on the idea that medical cannabis may help ease the opioid crisis.
A study out of the University of New Mexico,
published in 2017, found the association between “medical cannabis program enrollment and opioid prescription cessation and reductions and improved quality of life warrants further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.”
Among others,
another study published in 2017 cited “preliminary evidence that patients with chronic pain using cannabis may benefit from an interdisciplinary chronic pain program.”
Vagg’s advice? “People wanting an alternative to opioid treatment for persistent pain will do best if they seek out treatment from a professional team of experts, rather than substituting cannabis for opioids,” he wrote in The Conversation.
Evidence of medicinal marijuana’s effectiveness when it comes to relieving chemotherapy-induced nausea or treating childhood epilepsy seem more convincing than for persistent pain, he suggested.
To date, about 64,000 patients have been prescribed cannabis-related substances by 2,500 prescribers. / PHOTO BY GETTY IMAGES
Still, the Sydney Morning Herald reports that the Therapeutic Goods Administration (TGA) is allowing doctors to apply for special access to prescribe medical cannabis products, suggesting the substances should be given the benefit of the doubt.
Iain McGregor, academic director of the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney, acknowledged that evidence is still developing, the paper reports. Nonetheless, McGregor pointed out: “This is a galloping horse heading off into the future with lots of patients already being prescribed medicinal cannabinoids and even more self-medicating.”
To date, about 64,000 patients have been prescribed cannabis-related substances by 2,500 prescribers, the paper quotes TGA boss Professor John Skerritt as reporting. Most applications were for chronic pain, including related to arthritis, neck or back pain, fibromyalgia and migraines.
Vagg told the Sydney Sunday Herald that chronic pain patients would benefit most from multidisciplinary pain management clinics that have as part of their basket pain management, physical reconditioning, biomechanics assessment, occupational therapy and evidenced-backed procedures or medicinal treatments.
Medicinal Cannabis Industry Australia has
established an advisory council to, among other things, “facilitate improved patient access supported by evidence-based decision-making and a community of appropriately trained physicians.”
“Given its promising results in animal models, along with its relative safety, non-psychoactive properties, and low potential for abuse, CBD is an attractive candidate to relieve pain,”
notes a blog by the Harvard Medical School.
“Unfortunately, there is a lack of human studies about the effectiveness of CBD,” the information adds.
