Cannabis is a plant that can be used in a wide range of settings such as medical purposes, a source of fiber and oils, or as a recreational drug. Growing evidence has been reported on the clinical benefits of medical marijuana (herbal form) for treating chronic pain. Currently, several countries in the world and almost half of all U.S. states authorize the use of medicinal marijuana.

According to a new article published in Nature entitled, “Medical marijuana: Showdown at the cannabis corral,” author Michael Eisenstein notes that current marijuana laws make assumptions concerning the medical benefits of cannabis that sometimes go beyond the scientific evidence available, opening the door to the creation of new, opportunistic markets that are selling unproven medicines to people with chronic diseases.

“Everybody is selling stuff, but the real professionals who are supposed to do the job are not there yet,” said in a news release Dr. Arno Hazekamp, the Head of Research and Education at Bedrocan in Veendam, the Netherlands, the country’s official provider of medical cannabis. Supporters of medical marijuana fear that this deregulation can undermine the efforts developed so far for the establishment of the medical legitimacy of the controversial plant.

Dr. Donald Abrams, an oncologist at the University of California, San Francisco, and colleagues have shown in a previous clinical trial with patients infected with the human immunodeficiency virus (HIV), that 52% of the patients using cannabis reported a significant reduction in HIV-associated neuropathic pain in comparison to 24% in the control group. Other clinical trials have obtained similar results in patients suffering from neuropathic pain caused by several medical conditions. On the other hand, other trials have reported no added benefit from cannabis use.

Concerning multiple sclerosis, medical marijuana has been found to help improve chronic pain and muscle spasticity in patients with this progressive neurodegenerative disorder.

The design and performance of clinical trials involving cannabis use can be challenging, as the range of doses tested is limited due to the levels of THC (tetrahydrocannabinol), the difficulty in finding an adequate placebo control and the subjectivity of conducting self-reported patient analysis. “It gets you high, and if you believe it’s going to cure everything under the sun, then when you smoke it you feel like it cures everything under the sun,” noted Dr. Margaret Haney, a neurobiologist at Columbia University in New York, in the Nature article. Furthermore, the costs, burocracy and the number of government agencies involved when conducting clinical trials on cannabis add an extra barrier.

U.S. policies are now changing and the National Institute on Drug Abuse has expanded the range of strains available on its unique authorized growing facility at the University of Mississippi.

The future of medical marijuana remains unclear, however. The interest of the scientific community, pharmaceutical companies and the general public in this field may accelerate the already present deregulation or force governments to apply a stricter control.

“There’s an opportunity for us to take a global leadership position — the world is crying out for some direction in managing not just medical, but also recreational cannabis, (…) This should stop being an issue for legal minds to wrestle over; it should be the scientists that are putting the evidence together that drive the policy,” concluded Dr. Mark Ware, pain specialist at McGill University in Montreal, Canada. “There are risks, but those can be modulated by careful patient screening and public health messaging, (…) and they should not stop progress in considering these drugs for middle-aged women with multiple sclerosis, or for men with HIV/AIDS.”