Cannabis: are there any benefits?

Area of Science:

• Pharmacology and Therapeutics
• Cannabinoid Science
• Evidence-Based Medicine

Background:

• Cannabis has a long history of medicinal use, but scientific investigation was hindered by prohibition.
• Three forms of cannabis exist: herbal, hemp products, and pharmaceutical-grade cannabinoid-based medical products (CBMP).
• The endocannabinoid system (ECS), discovered in the late 1990s, plays a crucial role in homeostasis and inflammation.

Purpose of the Study:

• To review the evidence for the clinical benefits and safety of pharmaceutical-grade cannabinoid-based medical products (CBMP).
• To differentiate between regulated CBMP and unregulated herbal cannabis products.
• To highlight the importance of real-world evidence in evaluating CBMP efficacy.

Main Methods:

• Analysis of existing systematic reviews and real-world evidence on CBMP use.
• Distinguishing between evidence for herbal cannabis and pharmaceutical-grade CBMP.
• Focus on quality end-points and clinical outcomes rather than large randomized controlled trials.

Main Results:

• CBMP have demonstrated clinical benefits in conditions such as multiple sclerosis, chronic neuropathic pain, chemotherapy-induced nausea and vomiting, resistant paediatric epilepsy, anxiety, and insomnia.
• CBMP are generally well-tolerated, with a low incidence of serious adverse events.
• Unregulated herbal cannabis products are unreliable sources of cannabinoids.

Conclusions:

• Pharmaceutical-grade CBMP offer proven clinical benefits and are a safe and effective medical option.
• Real-world evidence is crucial for understanding the benefits and potential harms of CBMP.
• Further research into other resistant chronic conditions is warranted.