Dr. Chou responds to Common Criticisms regarding Medical Marijuana Research

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Introduction

Hi there.  It’s Dr. Chou here with the Medical Marijuana Clinic of Louisiana (MarijuanaClinicLa.com) with another article and video about medical marijuana.

Many times, when I’m speaking about medical marijuana to health care professionals, there will be a few skeptics who ask me about the evidence to support medical marijuana as a medical treatment.

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Basically, they will mention concerns with at least one of the following:

  • Research that shows no benefit or a negative outcome
  • A focus on anecdotal or indirect evidence
  • Information not being publicized in a medical journal like NEJM or JAMA

So I want to address all 3 of these concerns today.

 

Current Research

One of the main complaints I hear from professionals who are skeptical of medical marijuana is that the research is not supportive of medical marijuana.

Either the studies show no benefit, or worse, negative outcomes.

But let’s look at why these studies may not show positive outcomes and why this should not necessarily be an indictment against medical marijuana, but rather the study itself.

 

Subconscious Biases

First, recognize that research is designed by human beings.  As human beings, we all have many subconscious biases.

For example, someone who has spent their whole life as a prosecutor likely sees the world one way, and someone who is a defense attorney likely sees the world a completely different way.

It’s no different for doctors and scientists.  We all have our subconscious biases that affect how we operate.

In the case of medical marijuana research, most research in the area of medical marijuana is not designed by specialists in medical marijuana like doctors or clinicians who treat patients with medical marijuana.

Rather, it is designed by people who have spent their whole careers looking at marijuana as a bad thing, like addiction specialists or anti-marijuana clinicians.

When you spend your whole life thinking of marijuana as a bad thing, can you truly create an unbiased study looking for the positive effects of marijuana?

 

Study Design

In addition, many medical research studies are designed with something called a primary end point in mind.

So an example using medical marijuana would be where a study is designed to see if medical marijuana helps with chronic pain.

So the research is designed with the sole objective of trying to determine if medical marijuana improves a patient’s pain.

But do you see the problem here?

We all know that medical marijuana does not have a single effect.  It has maybe half a dozen to a dozen positive effects per patient.

So the problem is that current study designs don’t take into account the multiple, and often co-existing, positive effects that medical marijuana can have.

A study that only looks for one effect will miss the other dozen positive effects that could occur.

 

Averaging Study Participants

Finally, another problem we see with medical marijuana research is that results are typically reported as an average, which is problematic.

Let’s take a simple example using you and Donald Trump.

If I were to put you in a room with Donald Trump, and said that the two of you had an average net worth of 5 billion dollars, that would be a ridiculous statement.

So as you can see, using averages in studies is often very misleading.

We know that with medical marijuana there are some people who respond very well to treatment, but when you average their results in with everyone else, then their outstanding positive effects get averaged away.

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Instead, what we should be doing is seeking out the positive outliers and trying to figure out what makes their response so outstanding, and trying to replicate it for others.

 

Anecdotal Evidence

Probably the 2nd common criticism that I hear about medical marijuana treatment is the emphasis on anecdotal evidence.

But what is anecdotal evidence?

It’s evidence that is provided directly by a patient to a doctor regarding symptoms and side effects.

The first think I say in response is “Why is that a bad thing?”

Shouldn’t it be good that patients are confiding in their doctors and talking honestly about their symptoms and side effects?

Shouldn’t these discussions be reported in the medical literature so other doctors and patients learn from them?

We talk about anecdotal evidence like it’s a bad thing, but health care providers rely on anecdotal evidence hundreds of times every day to take care of our patients.

Questions like “Tell me your symptoms” to “Are you feeling better” to “Are you having any side effects.”

Guess what?  Those are all anecdotes.

So again, I ask.  What’s so bad about anecdotal evidence?

 

Know Where to Look

Finally, when we get down to this part of the discussion, most of the skeptics have given up.  But there are still a few that persist.

So their final point is that “They haven’t seen the positive evidence in the journals they read or the conferences they go to”

It would be like me looking for information about heart transplants in a Dermatology text book.

You’re looking in the wrong place.

You might not find research or anecdotes about medical marijuana in New England Journal of Medicine or at the American Medical Association conference because that’s not the right place to look.

Instead, you need to look at the resources and journals Medical Marijuana Doctors use, like project CBD and O’Shaughnessy’s or go to the conferences that we go to, like MJ for MDs and CannMed.

Once you know where to look, then you will see there is a big wide world of cannabis scholarship out there.

 

Summary

So I hope that I’ve been able to convince you today that the commonly citied criticisms regarding medical marijuana research are just not true.

That if you know where to look, are discerning about study design, and acknowledge that anecdotal evidence is evidence, then a whole world of therapeutic cannabis knowledge will open up to you.

Thanks for reading

 

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Doctor Victor Chou, M.D.

Medical Marijuana Clinic of Louisiana

MarijuanaClinicLa.com

 

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