A review of studies by Swedish researchers has found that cannabis is just as good as placebo for pain management. The study examined the influence of positive media attention on cannabis and how this contributes to a placebo response to pain. It emerged that the superiority of cannabinoids over placebo in pain management is limited, as the researchers concluded. The placebo response also appeared to be magnified when the risk for bias in studies was low. The verdict arrived at, in not so many words, was that cannabis for pain is overhyped but there’s no science to back it up. Unfortunately, this is influencing regulatory decisions, clinical trials, as well as clinical practice.
According to Ted J. Kaptchuk, professor of Medicine at Harvard Medical School, “the findings from this well-done study aren’t surprising. With the exception of opioids, most pain-relieving medications are barely better than a placebo,” he said, speaking to Harvard.edu. However, he went further to explain that this does not mean that the active ingredients in cannabis and other non-opioid medications lack physiologic effects. It is just that these effects rival the placebo effect.
The aim of the study (meta-analysis) was to investigate cannabinoid placebo response to pain and relate it to media attention. Cannabis studies seem to be more hyped by the media compared to non-cannabis studies. The researchers conducted a systematic review of RCTs published until September 2021 using the Embase and MEDLINE databases. Double-blind and placebo controlled cannabis studies on pain were included but those involving patients with HIV/AIDS or severe skin conditions were excluded. The data was extracted by independent and uncompensated reviewers. 20 studies with a total of 1459 participants were included. The results revealed a strong placebo response for pain in cannabinoid clinical trials. Media attention and dissemination seemed to be high in all trials but there was no association with clinical outcomes.
Going by this, it seems appropriate to question whether media attention is raising lofty expectations of medical cannabis. Let us know what you think.