was a watershed moment for the study of medical marijuana. This past December, Canadian university researchers, federal and provincial officials, patient advocates and
industry representatives met in Vancouver to set priorities
for evidence-based inquiries into a drug long overshadowed
by its reputation as an illegal way to get high. The two-day,
invitation-only meeting – convened by the Arthritis Society and partly funded by licensed growers of cannabis for
medical purposes – is the latest sign that investigations of
medical cannabis are moving into the research mainstream.
So, is the stigma lifting on the potential therapeutic value of a drug
that has stirred more than its share of skepticism? Possibly, say established researchers and health advocates, but they also caution that this
will only happen if all stakeholders, including federal research granting
agencies, commit to removing roadblocks and boosting funding for evidence-based inquiry.
The federal Liberal government’s election promise to legalize marijuana for personal use is viewed by researchers as a separate issue from
research into cannabis for medical treatment. Nonetheless, researchers
say the government’s commitment is raising public awareness about the
need for evidence-based research, too.
Cannabis has been available for medicinal purposes over the past 15
years under strict conditions set by Health Canada. The department’s office of clinical trials approved six clinical trials on cannabis between 2001
and 2015, including studies on chronic pain and osteoarthritis. According
to the Arthritis Society, citing data from Health Canada, some 65 percent
of Canadians who’ve received access to medical marijuana said they suffer from severe arthritis.
That statistic may partly explain why the Arthritis Society has
emerged as a leading campaigner for research on cannabis for pain and
disease management. It issued a position paper on medical cannabis in
2014, calling for clear options for arthritis patients. “We don’t have the answers,” says Joanne Simons, chief mission officer for the Arthritis Society,
citing a “massive vacuum of information” on safety, efficacy and dosing.
Even though cannabis is available to patients through Health Canada, the
research has not caught up, she says.
“It is not like the traditional way that medicines have been brought
to market with all of the rigour of clinical trials,” she observes. “We don’t
actually know a number of things about medical cannabis, both for those
who are using it and from the physicians’ perspective.” The Arthritis So-
ciety wants to build momentum for evidence-based inquiry and to blunt
“the stigma associated with medical cannabis around people’s actual in-
tent in using it,” says Ms. Simons.
In 2015, the charity awarded $360,000 over three years to Dalhousie
University’s Jason McDougall, a professor of pharmacology and anesthesia who is examining the role of nerves in controlling joint inflammation and pain. “We are trying to understand the potential pain-relieving
and anti-inflammatory effects of cannabis and cannabis-like compounds,”
says Dr. McDougall, who became interested in arthritis after witnessing
the excruciating pain suffered by his grandfather. In theory, Dr. McDougall’s preclinical study could lead to new treatments for knee arthritis,
with chemicals from cannabis in a cream or patch applied directly to the
arthritic joint to reduce the pain at its source. “Smoking, of course, is not
the best way of administering any drug – not the safest way certainly,” says
At the Vancouver stakeholder meeting, one of the keynote speakers was
Ethan Russo, a pioneer in the field of cannabis research and now medical
director of Phytecs, a Los Angeles-based company investigating the human
body’s endocannabinoid system for new therapies. (The body’s natural
compounds resemble the main psychoactive component of cannabis, explains Dr. Russo: endocannabinoids bind to cell receptors in the brain and
the rest of the body, regulating mood, appetite, sleep and digestion.) Dr.
Russo says the meeting was “a template for future developments internationally” and notes that Canada is already a research leader in the field.
One of the recognized Canadians is chronic-pain researcher Mark
Ware, director of clinical research at the Alan Edwards Pain Management
Unit of the McGill University Health Centre and an associate professor
in family medicine and anesthesia at McGill. He is also executive director of the Canadian Consortium for the Investigation of Cannabinoids.
In September, using funds granted in 2004 by the Canadian Institutes
of Health Research, Dr. Ware and his co-investigators published the first
multicentre study on the efficacy and safety of medical marijuana on
chronic pain involving experienced users. “It’s a very important piece in
the data bank we have around medical cannabis,” says Dr. Ware. The study
found that the drug was relatively safe – for example, experienced users
did not have more adverse events than the control group of non-users, an
important insight for physicians and patients.
“We were able to follow a large number of patients using cannabis in a
real-world context and compare them to a group of control subjects in the
same clinics who were not cannabis users.” The study includes 80 pages