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Cannabis and cannabis-based medicines: Potential benefits and risks to health,

A new report, Cannabis and cannabis-based medicines: Potential benefits and risks to health, a working party report published by the Royal College of Physicians, London, was released today.

A report of a Royal College of Physicians (RCP) working party states that the active ingredient of cannabis, Δ9-tetrahydrocannabinol (THC), appears to provide some benefit in the treatment of certain illnesses but recommends further clinical trials.  The group studied the evidence around the medicinal uses of cannabis and reviewed the benefits and risks associated with its use.

Cannabis and cannabis-based medicines: Potential benefits and risks for health recognises that there is scientific evidence to support further studies of the use of THC in multiple sclerosis and in the management of other forms of chronic pain.  The report, which is designed to inform both doctors and patients, considers the pharmacological effect of cannabinoids (a number of natural and synthetic compounds), their efficacy in comparison with other medicines, the results of clinical trials, the safety of cannabis and possible links between cannabis and psychosis.

The report strongly discourages smoking cannabis as this may carry similar risks to the lungs as smoking tobacco and recommends that clinical trials to address the therapeutic value of THC should be based on alternative methods of administration such as in a capsule by mouth or by mouth spray.  There is a narrow window between the desired and undesired effects of THC, which varies between individuals.  Patients in clinical trials who have been allowed to adjust the dose according to their symptoms were able to avoid undesirable side effects and did not show dependence on the drug.

One of the major concerns, which has arisen from studies of the recreational use of cannabis, is the risk of developing psychosis, particularly amongst young people.  The age group most likely to receive cannabis-based medicines for therapeutic use are older but nonetheless care should be taken in administering these medicines to anyone with a history of severe mental illness.

The working party also looked at research regarding the body's production of cannabis-like substances.  These substances play a role in the regulation of appetite and of factors that might influence heart disease and bone strength.  This research has the potential for the development of new medicines for the treatment of obesity, heart disease and osteoporosis.

Professor Martin Wilkins, Chair of the Working Party and Professor of Clinical Pharmacology at Imperial College London, said:

"Cannabis-based medicines are an active area of research and may offer new treatments for the symptoms of multiple sclerosis, pain, cardiovascular disease and osteoporosis.  It is appropriate that these medicines are examined and developed through carefully controlled clinical trials, in line with the regulations governing the approval of new drugs."

The terms of reference for the working party specifically excluded a review of the recreational use of cannabis.
 
Summary and conclusions 
 
Executive summary
 
Patient information
 
The full version is not presently available via the Internet. If you are interested in getting a copy of the report youŽd have to buy it. Further info at https://www.rcplondon.ac.uk/booking/publicationorders.asp