Even if it turns out to be ineffective for patients, buying cannabis products certainly gives a boost to the sales figures.

Below is a link to a fascinating article on research re the risks and benefits of cannabis in the treatment of various common mental health disorders. There’s another link in the body of the article to a summary in the journal Lancet Psychiatry, where you can purchase the full text if you’re interested.

Risks of cannabis use for mental health treatment outweigh benefits

I’ll let the authors explain their mission.

“We considered all studies examining any type and formulation of a medicinal cannabinoid in adults (≥18 years) for treating depression, anxiety, attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, post-traumatic stress disorder, or psychosis, either as the primary condition or secondary to other medical conditions.”

Their findings:

“There is scarce evidence to suggest that cannabinoids improve depressive disorders and symptoms, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis. There is very low quality evidence that pharmaceutical THC (with or without CBD) leads to a small improvement in symptoms of anxiety among individuals with other medical conditions.”

That seems clear enough. Research reviews of this type aren’t expected to yield a movie-style “thumbs up/ thumbs down”  verdict. They assess scientific evidence in terms of its quality and consistency. For instance, a rating of “very low quality” suggests weakness. It’s a cue to remain skeptical.

Based on the summary, it appears the enthusiasm around cannabis for mental health disorders is as yet unjustified. It actually reminds me of the irrational exuberance that Wall Street investors exhibit for certain highly speculative stock offerings. Then reality intervenes.

Given the lack of strong evidence, what accounts for the popular faith among users that cannabis will revolutionize the treatment of mood and anxiety disorders, PTSD, etc?  It’s based mostly on testimonials and anecdotal reports. That means the placebo effect could be in play.

That’s the beneficial effect that appears by virtue of the patient’s belief in a treatment. Safe to assume that somebody who went to the trouble of finding and purchasing cannabis in hopes of feeling better is already inclined to believe it will help. Who of us wants to feel like we blew our cash on the herbal equivalent of a sugar pill?

Even if some PTSD patients, for instance, benefit from THC, it’s quite possible most will not. Yet someone who’s afflicted with chronic anxiety is likely to welcome any relief at all. We can’t blame them. But neither can we assume those benefits will accrue to other users with similar problems.

And of course, the emerging cannabis industry is eager to convince us that their products are good for what ails us. Same as Big Pharma, and the nutritional supplement industry, and the patent medicines that flourished a century ago. It may not be much use for the patients, but it definitely boosts the company’s bottom line.

It may turn out that when it comes to mental health, cannabis is more trouble than it’s worth. Or it could be a reprise of the early days of the prescription drug epidemic, when addictionologists warned of the dangers of opioid use for chronic pain. They were mostly ignored. “They’re former addicts,” an orthopedist sneered in my presence. “Fanatics. Afraid of a pill, just because they couldn’t control themselves.”

Addiction feeds on that sort of arrogance.

As for opioid disorders: is smoking pot really part of an effective treatment program for heroin and fentanyl addictions, as I’ve seen claimed? Ironically, many addiction clinicians feel just the opposite. They believe pot smoking may actually interfere with recovery. And may well trigger relapse.

I guess we’ll find out.

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