Towards evidence-based medical cannabis

Abstract

Medical cannabis (MC) is at a crossroads. The MC industry needs evidence-based medicine to sell MC as there is still some residual stigma among the medical profession. Furthermore, evidence is needed in order to persuade doctors to prescribe. The requisite papers must be high quality research: double- blind, randomized control trials, systematic reviews and meta-analyses. As it is, MC currently incorporates relatively few commercial products, and those that are developed and marketed with standardized ingredients and with the requisite quality control (e.g. nabilone) have been welcomed by the medical community as they permit proper trials. At the time of writing, evidence for the usefulness of MC is limited and MC is associated with significant side effects. Clearly, new products and more clinical trials are required. Product development and trialing will take time and will cost money. There is clearly a knowledge gap must be bridged if MC is to ever be treated as medicine and routinely prescribed. MC must meet the same exacting standards of quality, effectiveness and safety of any other prescription drug or it risks being ignored or marginalized by the medical community. For all of these reasons, including the many unanswered questions, the MC industry constitutes an exciting and lucrative opportunity for Malta.