Doctors should think twice before prescribing medical marijuana: guideline

A new medical guideline suggests family doctors should think twice before prescribing medical marijuana to their patients.

The Simplified Guideline for Prescribing Medical Cannabinoids in Primary Care, published Thursday in the medical journal Canadian Family Physician, says there is limited evidence to support the reported benefits of medical marijuana for many conditions. (Read the guideline below).

It adds that any benefit could be balanced or even outweighed by the potential harm.

“While enthusiasm for medical marijuana is very strong among some people, good quality research has not caught up,” project leader Mike Allan, director of evidence-based medicine at the University of Alberta, said in a news release.

READ MORE: Doctors alarmed over lack of medical pot research, highlight evidence suggesting harm

The guideline was created by a committee of 10 researchers after an in-depth review of clinical trials. It was peer reviewed by 40 others, including doctors, pharmacists, nurses and patients.

They looked at medical marijuana for treatment of pain, muscle tightness and stiffness, and nausea and vomiting, as well as at its side effects.

The committee found acceptable research for use of medical marijuana for some conditions including nerve pain, palliative cancer pain, muscle stiffness related to multiple sclerosis or spinal cord injury, and nausea and vomiting from chemotherapy.

READ MORE: Medical marijuana risks may outweigh benefits for children, Canadian pediatricians say

Allan said the benefits were generally minor.

“Medical cannabinoids should normally only be considered in the small handful of conditions with adequate evidence and only after a patient has tried a number of standard therapies,” he said.

The researchers suggested pharmaceutical cannabinoids be tried before smoked marijuana to ensure proper dosing.

The committee also found that side effects — including sedation, dizziness and confusion — were common and consistent.

Allan said some people might not like the guideline.

“Better research is definitely needed,” he said. “If we had that, it could change how we approach the issue and help guide our recommendations.”

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The guideline will be distributed to about 30,000 doctors across Canada.