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Comment by eecc | Hacker News Reader

Weed might also be an effective pain killer but we’ll never know. The Reactionaries - God bless them - have already decided there’s no good use for it, there’s no need for controlled experiments and all that scientific devilry

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We do know, and it is. Medical marijuana is legal in about half the states, and is commonly prescribed for cancer, glaucoma, and MS.

It has no known medical uses, legally speaking.

Now, maybe one should question the value of a statement made by law and not by science. I personally do question it. But in other areas of law people treat statements by law as if it were scientific fact, so it doesn't surprise me that so many do in this case as well.

It is legal and commonly prescribed, but that doesn't mean it is effective. Anecdotes say it is, and the enjoyment of being high is worth it to some but no doctor should prescribe it until the alternatives we know work have been tried and found to not work. Proper medical treatments goes through many rounds of studies to prove that it works and is safe (which is unlikely in this case: smoke causes cancer in general).

If someone were to do a proper study (I'm not aware of any, but many countries don't have the US ban so I'd be shocked if none have been done) I'd change my position. For now it is a last resort though.

This seems to ignore the incredible numbers of testimonials from very sick patients who say marijuana improves their quality of life by reducing anxiety, and/or increasing appetite, and/or reducing pain with few long term side effects.

It also conveniently ignores that you can ingest cannabinoids in a variety of methods besides smoking.

And the fact that there are an absolute ton of “FDA Approved” products which have barely gone through any of the rigor you’ve talked about which is why there are all those commercials on TV about “have you or a loved one suffered acute bronchitis as a result of taking prophylactyse?”

As well as the incredible lists of side effects even well studied drugs seem to have which is why all the other drug commercials end with “Side effects may include internal bleeding, gastrointestinal distress, ...”.

All that being said, I’d love to see more research, why not?

Antidotes are not science. I have seen plenty testimonials for homeopathic treatments.

>Antidotes are not science.

Sorry, but that is a great typo.

The thing is, I'd be amazed if it had no medical effectiveness, but that's not because I'm some blown-out hippy who thinks it is a magical cure-all, but because I know researchers who specialise in the mammalian endocannabinoid system -

https://en.wikipedia.org/wiki/Endocannabinoid_system

I also know people who run medical drug trials and they are often busy running cannabis trials these days.

Here's a quick search for registered Sativex trials -

https://www.clinicaltrialsregister.eu/ctr-search/search?quer...

And here's an overview of evidence and research, hosted by the British Medical Journal -

https://www.bmj.com/sites/default/files/response_attachments...

There are proper studies, and meta-analyses:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549367/

https://www.jpain.org/article/S1526-5900%2815%2900837-8/full...

http://jalm.aaccjnls.org/content/2/4/485

The current findings appear to be that cannabis is modestly effective at chronic pain management and ineffective at acute pain management. There's some contradictory evidence as well; I'd be remiss in not pointing out this Lancet article finding zero to negative effect on chronic non-cancer pain:

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...

> until the alternatives we know work have been tried and found to not work.

I mean, opioids clearly work; but they come at an extremely high in terms of addiction and risk of overdose. Morphine works; we just only prescribe it at EOL now because we know its so addictive it will kill.

Where if cannabis or cbd have even an anecdotal placebo effect, it is not currently leading to high risk of overdose.

I think a lot more effort in public perception needs to be made in separating the actual drug from the most common method of absorbing it, which is recreationally smoking it. There has been a lot of advances in drug delivery over the past few decades, we probably should use one that doesn't fuck your lungs

until the alternatives we know work have been tried

Oh, you mean the alternatives Big Pharma claims to be effective? Because as TFA shows, they can totally be trusted...

Two wrongs do not make a right.

> which is unlikely in this case: smoke causes cancer in general

You do understand that you can get the effects of marijuana without smoking it right? Edibles do exist.

> Proper medical treatments goes through many rounds of studies to prove that it works and is safe (which is unlikely in this case: smoke causes cancer in general).

And opioids cause addiction and death. All medicine is poison. There is no such thing as "safe medicine" there is only a "relatively safe dosage".

I’d be surprised if anyone takes marijuana for medical purposes by smoking it. Try visiting somewhere like seattle where it’s legal - you can get it in useful forms like oils or tinctures that get dispensed out of a dropper, or you can buy e.g chocolates with a defined strength per piece.

I sure know, I have chronic kidney stones and voted to legalize it in my state. It provides a great deal of pain relief for me. I utilize opiates for the most extreme cases of pain.

You probably heard of this treatment, my co-worker got kidney stone relief from extracorporeal shock wave lithotripsy.

Yeah, I have had two of these and two laser lithotripsies.

I know the people who ran the stage three MS trials comparing whole plant vs sativex vs established medication, here in the UK. Trials are going forward and evidence is mounting up for THC and whole plant. Other than for THC, mostly via sativex, right now there is less evidence either way for CBD and other isolated cannibanoids as they have had far fewer trials.

I was under the impression that there is clear evidence/consensus that CBD is a great anti-inflammatory / painkiller.

The comment may refer to the fact that the US federal government categorizes marijuana s a Schedule I drug, which explicitly states it has no medical uses whatsoever. But yes, there are mountains of scientific evidence that marijuana has medical benefits.

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