Alert to the Scientific Community: The Use of Cannabis in People with Medical Conditions Does Not Produce Improvements and Causes Damage to Health.
The Congress of Chile is currently discussing a bill that aims to modify the National Health Code in order to incorporate and regulate the medical use of cannabis-derived products (see the Congress’s bulletin No. 11.327-11). In this context, Epistemonikos Foundation and the signatory organisations wish to share the scientific evidence available about the matter.
Those who make decisions informed by scientific evidence face an unavoidable task: to evaluate and, whenever possible, synthesize in a coherent whole the totality of the available research findings, and to do so following the best methodologies. Such approach makes it possible to weigh the evidence and reach valid conclusions, even when individual studies of a similar nature yield different or even opposite results.
For the last two years, Epistemonikos Foundation has worked together with a group of 31 academics and collaborators, from different disciplines and universities, on synthesizing the existing research on the effects of the medical use of cannabis and the products or drugs derived from it (including synthetic cannabinoids). The method used (GRADE, Cochrane, Epistemonikos) follows the highest methodological and transparency standards, and incorporates the continuous updating of the body of evidence.
Based on the existing scientific research, we conclude that there is no medical condition in which the benefits derived from the use of cannabis or cannabis-derived products are superior to its adverse effects and risks.
This conclusion was reached by analyzing more than 1,000 scientific articles, which evaluate dozens of medical conditions where the use of these drugs has been proposed, and by preparing a summary for each of those conditions.
The conclusions of the evidence summaries fall in one of these 3 categories:
- Cannabis or its derivatives are not effective and are associated with frequent adverse effects (as is the case with multiple sclerosis and anorexia nervosa).
- Cannabis or its derivatives may produce a low benefit, but also produce frequent adverse effects that exceed the benefits (as is the case with chronic pain and epilepsy).
- It is not clear whether cannabis or its derivatives are effective or not, because the certainty of the evidence is very low, and they are associated with frequent adverse effects (as is the case with fibromyalgia, insomnia, Tourette's syndrome, and the management of nausea and vomiting induced by chemotherapy).
It is important to emphasize that the ongoing research, including additional analyses by this group, is considerable and could add relevant information in the future. So it is not possible to rule out that, in the future, specific situations will be identified in which these drugs produce more benefits than risks.
It is equally important, however, to clarify that:
. The vast majority of current research deals with the use of products derived from cannabis and not with the consumption of the unprocessed plant, as contemplated in the current bill discussed by the Chilean Congress. There is no justification, from a scientific point of view, for increasing access to unprocessed forms of cannabis for medicinal use. Homemade marijuana preparations have an unknown composition and do not meet the standards that would allow their use as medicines.
. Chile’s current legislation already permits the authorization of selling, marketing and prescribing cannabis-derived drugs when specific requests are made. There is, then, no need for a new bill to regulate such cases. Current institutional processes are in place to ensure that the therapies provided to Chilean citizens meet the minimum standards of safety and effectiveness.
The evidence summaries for each medical condition are freely accessible at:
The scientific information we have analyzed and summarized is also freely accessible. It is organised in an interactive web repository, continuously updated, maintained by Epistemonikos. Please follow this link:
ACHED-CP - Asociación Chilena de Estudios del Dolor y Cuidados Paliativos
APCh - Asociación Psicoanalítica Chilena
CIESAL - Centro interdisciplinario de estudios en Salud - Escuela de Medicina Universidad de Valparaíso
CITUC - Centro de información toxicológica de la Pontificia Universidad Católica de Chile
COLMED - Colegio Médico de Chile A.G
Fundación Me Muevo
Instituto Alfa Adicciones
Instituto Médico Schilkrut
Médicos Sin Marca
SACH - Sociedad Chilena de Anestesia
SOCHIMEF - Sociedad Científica de Medicina Familiar y General de Chile
SOCHIPE - Sociedad Chilena de Pediatría
SOCHOG - Sociedad Chilena de Obstetricia y Ginecología
Sociedad de Geriatría y Gerontología de Chile
SONEPSYN - Sociedad de Neurología, Psiquiatría y Neurocirugía
SOPNIA - Sociedad de Psiquiatría y Neurología de la Infancia y Adolescencia
Frente por un Chile Saludable
Sochepi - Sociedad Chilena de Epidemiología
SOTOX – Sociedad de Toxicología de Chile
Signatory physicians and researchers:
Ana Marina Briceño
Andrés Borzutzky H
Camila Jiménez Olivares
Christian Nilo Schultz
Diego Lobos Urbina
Javier Peña Alvarez
Josè Luis Castillo
José Luis Contreras
Keryma Acevedo Gallinato
Luis E. Ortiz
Luis Felipe Gonzalez
Maria Antonieta Rico
María Ignacia Morales
María Isabel Ruiz
María Paz Acuña
María Paz Bertoglia
Mario Hitschfeld Arriagada
Matias Ignacio Rocco
Matías Irarrázaval D
Oscar Corsi Sotelo
Patricia Gonzalez Mons
Pedro Pérez Cruz
Rocio Bravo Jeria
Tania Contreras Labarca
Verònica Buròn Klose
Claudio Pérez Oliva
María Inés Brugal
Pamela Llantén Aroca
Marco Cornejo Ovalle
Fernando Peña Soto
Cecilia Castillo L
Henry Zambrano Velásquez
Fabiola de la Torre Altamirano
Felipe Reyes Zaldívar
Juan Pablo Seguel Careaga
Mariano Garcia Carrillo
Sebastian Robert Barros
Alvaro Jeria Durán
Matias Correa Ramirez
Jorge Rodriguez Rojas
Renato Sáez Zamora
Felipe Flores Umaña
Daniela Alvo Campeny
Nicolás Rodríguez Del Real
Felipe Navia González
Nicolas Zamorano Maldonado
Pía Nitsche Royo
Andrés Franzani Garcia
Juan Ignacio Reculé Rivera
Andrea Castillo Díaz
Diego Ignacio Barttlet González
Rocío Aedo Apara
Pedro Rojas Carvallo
Igor Aedo Campos
Danisa Torres Montenegro
Rodrigo Toro Toro
Carolina Pérez Ojeda
Patricia De La Maza