What did the 2017 National Academies of Sciences’ 468-page report conclude about cannabis?
The Institute of Medicine Report on the Health Effects of Marijuana
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
When some misinformed people hear of the grand opening of a new plant-based medical practice, one plant in particular may come to mind. Over the years, I’ve gotten a lot of questions about cannabis, and I figure it’s high time to try to clear the haze. I didn’t want to just take a pot shot, tokin’ effort, and end up with some half-baked puff piece. There are burning issues about a growing industry, with so much buzz and smoke and mirrors, the science can really take a hit. I mean, are there acute chronic effects? Blunt trauma from impaired driving, perhaps? I wanted to give the straight dope; weed out any doobieous research, and it’s been quite a trip. 420 articles published within just the past few months!
This is the review everyone was waiting for: “The [2017] Current State of Evidence” from the Institute of Medicine, “tasked with conducting a comprehensive review [on] the health effects of…cannabis.” Started out with 24,000 sources; whittled it down to about 10,000 to produce this 468-page document. What did they find?
I think it’s fair to summarize that they found the purported benefits to be much smaller and weaker than are often reported, but so too the purported risks. So, good news for the recreational user, who is mostly just worried about not getting cancer, but bad news for the patient who actually wants it to help their cancer. The only three benefits they could find “substantial evidence” for was as a treatment for “chronic pain in adults,” “chemo…-induced nausea and vomiting,” and relieving self-reported muscle tightness in patients with MS. Even archetypal medical marijuana indications, like glaucoma, failed to live up to expectations.
“Despite popular belief to the contrary, extensive research over decades has documented that marijuana is not effective in the management of clinical glaucoma,” a disease of increased pressure within the eyeball. I mean, it does lower pressure, but only for “about an hour.” And so, you’d have to smoke a dozen joints a day—and even if you did smoke those few thousand a year, your body gets used to it. And so, what little benefit there is disappears within a few months in most patients.
On the other hand, conspicuously missing from this list of adverse side effects of long-term or heavy use is any mention of chronic obstructive pulmonary diseases, like emphysema, which you can get from smoking tobacco. And similarly, it doesn’t look like smoking marijuana increases the risk of respiratory cancers, like lung cancer, or head and neck cancer—though cannabis may increase the risk of testicular cancer. There have been three studies so far on marijuana use and testicular cancer, appearing to increase risk about 50%—but only, it seems, for those smoking once a week or more, or for ten years or longer.
So, what did they conclude overall? Were they for legalization; opposed? Basically, they concluded, there simply isn’t enough research—”leaving patients, health care professionals, and policy makers without the evidence they need to make sound decisions” either way. Further: “This lack of evidence-based information…poses a public health risk.”
That’s one thing everyone on both sides can agree on: “the need for definitive clinical research.” Otherwise, we’re just left with “[a]necdotes,…blogs, and ad[s], which don’t “provide a sound basis for assessing the safety and efficacy of pharmacologic agents.” “Because cannabis is [just] a naturally occurring plant, and cannot be patented,” the pharmaceutical industry is MIA.
What we need are large clinical trials. Until then, we’re all just going to be “scratching our heads.” But, where’s the funding going to come from? For drug companies, interest in the plant is scant—where’s the payback?
Big Pharma is interested in “a reasoned approach,” however. “[T]he development of newer…cannabinoid modulators” in profitable pill form will, one day, writes this pharmacology professor, “make…the use of herbal cannabis a thing of the past.”
Please consider volunteering to help out on the site.
- Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014 Jun 5;370(23):2219-27.
- Mack A, Joy J. Marijuana as Medicine? The Science Beyond the Controversy. Washington (DC): National Academies Press (US); 2000.
- Cohen PJ. Medical marijuana, compassionate use, and public policy: Expert opinion or vox populi? Hastings Cent Rep. 2006 May-Jun;36(3):19-22.
- Huang YH, Zhang ZF, Tashkin DP, Feng B, Straif K, Hashibe M. An epidemiologic review of marijuana and cancer: an update. Cancer Epidemiol Biomarkers Prev. 2015 Jan;24(1):15-31.
- National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington (DC): National Academies Press (US); 2017 Jan. The National Academies Collection: Reports funded by National Institutes of Health.
- Sun X, Xu CS, Chadha N, Chen A, Liu J. Marijuana for Glaucoma: A Recipe for Disaster or Treatment? Yale J Biol Med. 2015 Sep 3;88(3):265-9.
- Lieberman MF. "Recredicinal" Marijuana. Am J Ophthalmol. 2017 May;177:xv-xviii.
- Kalant H. Cannabis in the treatment of rheumatic diseases: suggestions for a reasoned approach. J Rheumatol. 2015 Feb;42(2):146-8.
- Wade L. Biomedical research. Canadian registry to track thousands of pot smokers. Science. 2015 May 22;348(6237):846.
- Roehr B. Review fails to advise on cannabis use because of poor research. BMJ. 2017 Jan 16;356:j248.
Icons created by Randomhero, Aly Dodds, Rockicon, Satisfactory, Pundimon, Nikita Kozin, and Pete Baker from The Noun Project.
Image credit: By Original uncropped image from Laurie Avocado (Cropped version of [1]) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)] via Wikimedia Commons. Image has been modified.
Motion graphics by Avocado Video.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
When some misinformed people hear of the grand opening of a new plant-based medical practice, one plant in particular may come to mind. Over the years, I’ve gotten a lot of questions about cannabis, and I figure it’s high time to try to clear the haze. I didn’t want to just take a pot shot, tokin’ effort, and end up with some half-baked puff piece. There are burning issues about a growing industry, with so much buzz and smoke and mirrors, the science can really take a hit. I mean, are there acute chronic effects? Blunt trauma from impaired driving, perhaps? I wanted to give the straight dope; weed out any doobieous research, and it’s been quite a trip. 420 articles published within just the past few months!
This is the review everyone was waiting for: “The [2017] Current State of Evidence” from the Institute of Medicine, “tasked with conducting a comprehensive review [on] the health effects of…cannabis.” Started out with 24,000 sources; whittled it down to about 10,000 to produce this 468-page document. What did they find?
I think it’s fair to summarize that they found the purported benefits to be much smaller and weaker than are often reported, but so too the purported risks. So, good news for the recreational user, who is mostly just worried about not getting cancer, but bad news for the patient who actually wants it to help their cancer. The only three benefits they could find “substantial evidence” for was as a treatment for “chronic pain in adults,” “chemo…-induced nausea and vomiting,” and relieving self-reported muscle tightness in patients with MS. Even archetypal medical marijuana indications, like glaucoma, failed to live up to expectations.
“Despite popular belief to the contrary, extensive research over decades has documented that marijuana is not effective in the management of clinical glaucoma,” a disease of increased pressure within the eyeball. I mean, it does lower pressure, but only for “about an hour.” And so, you’d have to smoke a dozen joints a day—and even if you did smoke those few thousand a year, your body gets used to it. And so, what little benefit there is disappears within a few months in most patients.
On the other hand, conspicuously missing from this list of adverse side effects of long-term or heavy use is any mention of chronic obstructive pulmonary diseases, like emphysema, which you can get from smoking tobacco. And similarly, it doesn’t look like smoking marijuana increases the risk of respiratory cancers, like lung cancer, or head and neck cancer—though cannabis may increase the risk of testicular cancer. There have been three studies so far on marijuana use and testicular cancer, appearing to increase risk about 50%—but only, it seems, for those smoking once a week or more, or for ten years or longer.
So, what did they conclude overall? Were they for legalization; opposed? Basically, they concluded, there simply isn’t enough research—”leaving patients, health care professionals, and policy makers without the evidence they need to make sound decisions” either way. Further: “This lack of evidence-based information…poses a public health risk.”
That’s one thing everyone on both sides can agree on: “the need for definitive clinical research.” Otherwise, we’re just left with “[a]necdotes,…blogs, and ad[s], which don’t “provide a sound basis for assessing the safety and efficacy of pharmacologic agents.” “Because cannabis is [just] a naturally occurring plant, and cannot be patented,” the pharmaceutical industry is MIA.
What we need are large clinical trials. Until then, we’re all just going to be “scratching our heads.” But, where’s the funding going to come from? For drug companies, interest in the plant is scant—where’s the payback?
Big Pharma is interested in “a reasoned approach,” however. “[T]he development of newer…cannabinoid modulators” in profitable pill form will, one day, writes this pharmacology professor, “make…the use of herbal cannabis a thing of the past.”
Please consider volunteering to help out on the site.
- Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014 Jun 5;370(23):2219-27.
- Mack A, Joy J. Marijuana as Medicine? The Science Beyond the Controversy. Washington (DC): National Academies Press (US); 2000.
- Cohen PJ. Medical marijuana, compassionate use, and public policy: Expert opinion or vox populi? Hastings Cent Rep. 2006 May-Jun;36(3):19-22.
- Huang YH, Zhang ZF, Tashkin DP, Feng B, Straif K, Hashibe M. An epidemiologic review of marijuana and cancer: an update. Cancer Epidemiol Biomarkers Prev. 2015 Jan;24(1):15-31.
- National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington (DC): National Academies Press (US); 2017 Jan. The National Academies Collection: Reports funded by National Institutes of Health.
- Sun X, Xu CS, Chadha N, Chen A, Liu J. Marijuana for Glaucoma: A Recipe for Disaster or Treatment? Yale J Biol Med. 2015 Sep 3;88(3):265-9.
- Lieberman MF. "Recredicinal" Marijuana. Am J Ophthalmol. 2017 May;177:xv-xviii.
- Kalant H. Cannabis in the treatment of rheumatic diseases: suggestions for a reasoned approach. J Rheumatol. 2015 Feb;42(2):146-8.
- Wade L. Biomedical research. Canadian registry to track thousands of pot smokers. Science. 2015 May 22;348(6237):846.
- Roehr B. Review fails to advise on cannabis use because of poor research. BMJ. 2017 Jan 16;356:j248.
Icons created by Randomhero, Aly Dodds, Rockicon, Satisfactory, Pundimon, Nikita Kozin, and Pete Baker from The Noun Project.
Image credit: By Original uncropped image from Laurie Avocado (Cropped version of [1]) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)] via Wikimedia Commons. Image has been modified.
Motion graphics by Avocado Video.
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The Institute of Medicine Report on the Health Effects of Marijuana
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I have a whole treasure chest of cannabis videos. If you want to see them all in one place, I put the whole series in a DVD download.
If you’d like to learn more about the effects of marijuana on health, check out:
- Researching the Health Effects of Marijuana
- Is Marijuana Addictive?
- Does Marijuana Cause Health Problems?
- Does Marijuana Cause Permanent Brain Damage in Teens?
- Does Marijuana Cause Permanent Brain Damage in Adults?
- Pesticides in Marijuana
- Effects of Smoking Marijuana on the Lungs
- The Effects of Marijuana on Fertility and Pregnancy
- Does Marijuana Cause Lung Cancer?
- Does Marijuana Cause Schizophrenia?
- Will Cannabis Turn into Big Tobacco?
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