The American Society of Regional Anesthesia and Pain Medicine (ASRA) issued a formal statement calling for the rescheduling of marijuana and called for more research to determine its safety and effectiveness this week.
The organization notes that there is a lack of evidence regarding the long-term effects of marijuana use, and overlapping state and federal laws create huge obstacles for physicians who may want to prescribe it. Under the current federal law, clinical research on marijuana is hindered, and physicians are faced with difficult ethical and legal questions.
“Many patients could potentially benefit from its use,” said ASRA Board member Samer Narouze, MD, PhD. “Neuropathic pain is probably the indication with the most convincing clinical evidence,” he said.
“Other indications with promising results include anxiety, depression, seizures, cancer pain, and HIV-related pain. However, because medical marijuana lacks the FDA quality and safety oversight, there is inconsistency in doses, which can pose potential risk to patients,” Narouze added.
The ASRA Board of Directors approved the “ASRA Statement on Cannabis” at a recent meeting of its board of directors. In the statement, ASRA “pleads to the National Institutes of Health (NIH) to implement special guidelines to encourage grant applications and the conduct of well-designed clinical research on the medical utility of various Cannabis preparations.”
Marijuana is classified as a Schedule 1 substance with “no currently accepted medical use and a high potential for abuse,” according to federal law. As a result, it cannot be readily studied in clinical trials. There is a dearth of information regarding the long-term effects of marijuana use, specifically its effects on learning and cognitive function. “Cannabis use disorder” is a recognized disorder in patients who continue to use cannabis despite clinically significant impairment.
With respect to pain management, the statement noted, “a small evidence base is available in the peer-reviewed literature and consists of clinical studies and systematic reviews/meta-analyses evaluating cannabis as an analgesic to alleviate pain associated with clinical conditions, including (but not limited to) neurological disorders, cancer, and rheumatic diseases.”