Utahmarijuana.org is the online arm of a Utah medical group that specializes in helping qualifying patients obtain their medical cannabis cards. According to their medical providers, chronic pain is the most cited condition for which cards are obtained. Unfortunately, patients are still faced with the reality that doctors remain wary of cannabis as a treatment.
Why is that? The simple answer lies in a lack of clinical evidence showing that cannabis genuinely relieves pain. But there is more to it than that. The number one reason, the thing that concerns pain doctors the most, can be encapsulated in a single word: placebo.
Marijuana No Better than Placebo
If you follow medical cannabis news, you’re probably familiar with a study released in late 2020, a study demonstrating that marijuana is no better than placebo for relieving pain. This particular study was a meta-analysis of 20 previous studies looking into the same subject. It was published in the American Medical Association journal.
The 20 studies involved nearly 1,500 patients in total. Said patients were relying on medical cannabis to treat a variety of pain types, including neuropathic pain. The patients also utilized a number of delivery methods including smoking, concentrated oils, and pills.
In the end, the researchers found “no significant difference between cannabis and a placebo for reducing pain.” Their data lines up fairly well with a number of previous studies reaching the same conclusion.
Placebo Rate Is Too High
The fact that placebo seems to work just as well as actual medical cannabis is not enough to refute cannabis’ effectiveness as a pain reliever. If patients generally experience pain relief, the mechanism behind a given medicine is less important than the relief experience itself. Still, doctors are concerned with the high placebo rate where pain management is concerned.
Back in 2021, the International Association for the Study of Pain (IASP) released an official statement outlining their position on using cannabis to treat chronic pain. They came out firmly against cannabis pain management based on a lack of clinical evidence in support of the practice.
In subsequent interviews, one IASP representative acknowledged a volume of anecdotal evidence in support of cannabis as a chronic pain treatment. This doctor acknowledged that anecdotal evidence is worth considering. It should never be ignored. But he also went back to the placebo issue. He explained that the IASP is concerned about placebo rates that can be as high as 40%.
Some Placebo Effect Is Expected
In any kind of study involving new medical therapies, some placebo effect is expected. The placebo effect is directly related to the link between the mind and body. If a person expects to feel better as a result of a given therapy, the chances are pretty high that he will. It is common knowledge within the medical science community.
As such, a placebo rate of 10% would not be alarming. But when rates start approaching 30% or 40%, they raise red flags. Placebo rates that high suggest there is something else going on. That is the concern with cannabis as a treatment for chronic pain.
So, what does this all mean? It means that some doctors are concerned that patients who experience pain relief when using cannabis are only benefiting from the placebo effect. They remain suspicious of whether the drug is actually doing anything.
The other side of the coin is that cannabis could be triggering the same endocannabinoid response as placebo, thereby accomplishing the same thing. And if that’s the case, isn’t it more important that patients are finding relief?
