“I’d like to start helping people get their mind wrapped around what are we talking about today with a case,” Dr. Alan Ehrlich said, looking out over an auditorium packed with doctors, lobbyists and advocates for medical marijuana. They’d gathered for the Massachusetts Medical Society’s first continuing education course on the use of marijuana to treat medical issues.
“Marilyn is a 68-year-old woman with breast cancer,” said Ehrlich, the senior deputy editor at DynaMed, a website that reviews medical research for doctors.
Marilyn’s cancer had spread and she was undergoing chemotherapy. She did not have any energy, she’d lost her appetite and she was having a lot of back pain.
“So she comes in to a visit with you as a primary care physician,” Ehrlich continued, and “wants to talk about the possibility of using marijuana to alleviate the symptoms of nausea, pain and fatigue. How many people think this is a good woman to certify for the use of marijuana?”
About three-quarters of the audience raised a hand. Well, Ehrlich said, let’s look at the evidence.
For this course, Ehrlich gathered studies on the benefits and risks of marijuana for medical treatment. The U.S. government controls the use of medical marijuana for medical research. There are more studies on the risks than on the benefits.
For Marilyn, who wants to relieve nausea and vomiting, two effects of chemotherapy, there are “no randomized trials of smoked cannabis versus placebo,” Ehrlich said. “So everything I’m going to present from now on, if you’re thinking about using smoked marijuana for this, you’re talking about extrapolations.”
In other words, tests the FDA would require before approving a drug to treat Marilyn’s nausea have not been done for marijuana. Doctors may hear stories from patients who find that marijuana helps, Ehrlich said, but there is almost no scientific proof.