There’s not enough research into how effective marijuana is as medicine, said multiple speakers at Missouri’s Saturday 17th Annual Health Policy Summit.
“Right now, we have very little evidence to guide us on the medical use of cannabis,” said Dr. Lucas Buffaloe, an associate professor of Clinical Family and Community Medicine at MU.
The annual summit is organized by MU’s Center for Health Policy and is aimed at health policymakers and health care stakeholders. Speakers addressed an audience of about 100 in the Hilton Garden Inn Conference Center.
Buffaloe, whose medical practice focuses on pain management and addiction medicine, said there is very limited information available on the medical use of marijuana. There are very few trials, a small number of participants and a lack of marijuana standardization, he said.
Under an amendment to the Missouri Constitution, passed by voters in November, Buffaloe, as a state-licensed physician, is allowed to recommend marijuana to patients with qualifying medical conditions.
Buffaloe said the most specific of these include cancers, epilepsy, glaucoma, HIV or AIDS and intractable migraines, unresponsive to other treatment. But he stressed that people shouldn’t assume there is evidence that marijuana would be an effective treatment.
“There is no cancer that is treated with cannabis, although cannabis can be helpful for chemotherapy-induced nausea and vomiting,” Buffaloe said.
“Part of the hope in these kinds of laws is that by legalizing cannabis for medical use, it might make it easier for this kind of research to be conducted and maybe a few years down the road we will have better data,” he said.
Debra Sprague, project director and researcher for the Missouri Institute of Mental Health, sat in the crowd, intently listening and asking questions.
For 35 years, Sprague has worked with people who abuse substances or are mentally ill. She said she would have liked to see a greater focus on the potential benefits of medical marijuana for people who suffer from anxiety, PTSD and other traumatic experiences.
“I know that we are limited in the research that we can do,” Sprague said. “However, there are some studies out there that were not presented here.”
Jane Drummond, general counsel and vice president of legal affairs for the Missouri Hospital Association, spoke to the audience about the legal aspect of medical marijuana in Missouri.
“We need more research,” she said. “We need federally sanctioned, vigorous, academic-driven data and research so providers feel comfortable and that they really understand the effects, benefits and can intelligibly talk about it with their patients.”
Drummond said in an interview that her job is to make sure hospitals are aware of what they legally can and cannot do with medical marijuana. She also wants physicians to focus on educating their patients, especially because there’s been a cultural shift around marijuana.
“I think the biggest impediment to good education is (that) the provider community is so split on this,” she said. “You have some providers that think the sky is falling ... , and then you have others that see potential therapeutic benefit in this, and they are excited to be able to address it with their patients.”
Buffaloe’s main advice for physicians working with medical marijuana is as follows:
- Become familiar with cannabis and cannabinoid products.
- Review the benefits, adverse effects and societal effects of cannabis and cannabinoids.
- Share patient perspectives on cannabis use.
- Discuss the best practices for recommending cannabis.
He also said uses that are evidence-supported do not correspond to the uses allowed under state law and that there are important risks associated with marijuana.
“Anytime that we are considering cannabis, it’s important that we weigh out these risk and benefits,” he said, “that we communicate those very clearly to our patients.”
Supervising editor is Tynan Stewart.