De siste årene har det blitt publisert flere omfattende oppsummeringsstudier og fagrapporter som konkluderer med at cannabismedisin har effekt på ulike tilstander og diagnoser. For noen tilstander regnes dokumentasjonen allerede i dag som god nok, mens det for mange tilstander fortsatt mangler gode nok studier til å kunne konkludere med sikkerhet.
The Health Effects of Cannabis and Cannabinoids (2017)
I januar 2017 utgav National Academic of Science, Engineering and Medicine1 en omfattende rapport som gjennomgikk over 10 000 studier. Hovedkonklusjonene er som følger:
There is conclusive or substantial evidence that cannabis or cannabinoids are effective:
- For the treatment for chronic pain in adults (cannabis)
- Antiemetics in the treatment of chemotherapy-induced nausea and vomiting (oral cannabinoids)
- For improving patient-reported multiple sclerosis spasticity symptoms (oral cannabinoids
There is moderate evidence that cannabis or cannabinoids are effective for:
- Improving short-term sleep outcomes in individuals with sleep disturbance associated with obstructive sleep apnea syndrome, fibromyalgia, chronic pain, and multiple sclerosis (cannabinoids, primarily nabiximols)
There is limited evidence that cannabis or cannabinoids are effective for:
- Increasing appetite and decreasing weight loss associated with HIV/AIDS (cannabis and oral cannabinoids)
- Improving clinician-measured multiple sclerosis spasticity symptoms (oral cannabinoids)
- Improving symptoms of Tourette syndrome (THC capsules)
- Improving anxiety symptoms, as assessed by a public speaking test, in individuals with social anxiety disorders (cannabidiol)
- Improving symptoms of posttraumatic stress disorder (nabilone; one single, small fair-quality trial)
There is limited evidence of a statistical association between cannabinoids and:
- Better outcomes (i.e., mortality, disability) after a traumatic brain injury or intracranial hemorrhage
There is limited evidence that cannabis or cannabinoids are ineffective for:
- Improving symptoms associated with dementia (cannabinoids)
- Improving intraocular pressure associated with glaucoma (cannabinoids)
- Reducing depressive symptoms in individuals with chronic pain or multiple sclerosis (nabiximols, dronabinol, and nabilone)
Cannabis: The Evidence for Medical Use (2016)
I mai 2016 publiserte Professor Michael P. Barnes og Dr Jennifer C. Barnes en omfattende rapport2 som så på evidensen for en rekker sykdomstilstander. Rapporten konkluderer med følgende:
«In this paper we have analysed and graded the evidence for efficacy of cannabis and various licenced cannabis products for a number of different indications. We have found good evidence for one or more of the cannabis products or “natural” cannabis in; the management of chronic pain, including neuropathic pain; spasticity; nausea and vomiting, particularly in the context of chemotherapy; and in the management of anxiety. We have found moderate evidence in; sleep disorders; appetite stimulation in the context of chemotherapy; fibromyalgia; post-traumatic stress disorder; and for some symptoms of Parkinson’s disease. We have found some limited evidence of efficacy, but further studies are required, in; the management of agitation in dementia; epilepsy, particularly drug resistant childhood epilepsies; bladder dysfunction; glaucoma; and in Tourette’s syndrome. We have found that there is a theoretical basis, but so far no convincing evidence of efficacy; for the management of dystonia; Huntington’s disease; headache; brain protection in the context of traumatic brain injury; depression; obsessive compulsive disorder; gastrointestinal disorders; anti-psychotic agent (CBD); and a role in cancer/tumour control.»
Cannabinoids for Medical Use: A Systematic Review and Meta-analysis (2015)
Høsten 2015 utgav det internasjonalt anerkjente medisinske tidsskriftet JAMA meta-analysen Cannabinoids for Medical Use: A Systematic Review and Meta-analysis3. Konklusjonen er som følger:
«A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47% vs 20%; odds ratio [OR], 3.82 [95% CI, 1.55-9.42]; 3 trials), reduction in pain (37% vs 31%; OR, 1.41 [95% CI, 0.99-2.00]; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference [WMD], −0.46 [95% CI, −0.80 to −0.11]; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, −0.12 [95% CI, −0.24 to 0.01]; 5 trials).»
Fotnoter
- Rapporten kan leses gratis på nett.
- Rapporten kan lastes ned i sin helhet som PDF.
- Meta-analysen kan leses i sin helhet på JAMAs nettsider.