The whole article is worth reading but this caught my eye.
The Australian Medicinal Cannabis Association (AMCA) said that without suspected adverse events being published and investigated it was hard to draw conclusions about the safety of medicinal cannabis products.
If the only organisation representing cannabis prescribers is unwilling to comment on safety what does that say about the state of the industry?
29 Comments
givesomefucks@lemmy.world · 13 pts · 335d
600 sounds like a lot...
600 over 3 years sounds like not as much...
Bu 600 out of 13,000,000 is...
Well, that's a 0.0046% percent chance of something happening.
And that should explain why people who know what they're talking about aren't freaking out.
HalfEarthMedic@slrpnk.net · 3 pts · 335d
Do you think 13million individuals have cannabis prescriptions? Do you tink 100% of adverse events are reported? Do you think psychiatrists, emergency doctors and GPs who are reporting concerning rise in adverse events are lying?
Randomgal@lemmy.ca · 10 pts · 335d
Do you think you're not simply looking to confirm your pre-set beliefs?
wesker@lemmy.sdf.org · 3 pts · 335d
OP claims to be a GP in profile. This whole stance suggests a lot about the medical industry.
HalfEarthMedic@slrpnk.net · 1 pts · 335d
I would suggest that corporate practices going gungho prescribing medications without established safety data is more concerning than a potential prescriber impatiently waiting for the TGA to get their act together and assess these medications.
Randomgal@lemmy.ca · 0 pts · 335d
I agree. Assuming they're telling the truth to begin with.
HalfEarthMedic@slrpnk.net · 3 pts · 335d
No, I believe I approach the literature with an open mind and while I don't prescribe cannabis myself I do frequently refer patients who i think will benefit. The fact that there is legitimate use of cannabis in medical settings does not mean that it isn't being over-prescribed and under regulated.
Incidentally the reason i don't prescribe myself is purely as I don't have capacity to add another string to my bow in my already busy practice.
givesomefucks@lemmy.world · 1 pts · 335d
...
You think every single person only used one dose in three years?
You literally have no idea what you're talking about here.
If you're nicer, people might help you understand
HalfEarthMedic@slrpnk.net · 5 pts · 335d
I apologise for not being clearer. My point was that your calculation is wrong. You would need to calculate per patient which is not a published figure. Estimates are more like 1mil but I think that is based on faulty reasoning as my subjective experience is that most people remain on it for only a few months. Also that the vast majority of adverse events go unreported
HalfEarthMedic@slrpnk.net · 0 pts · 335d
guillem@aussie.zone · 2 pts · 335d
HalfEarthMedic@slrpnk.net · 2 pts · 335d
In my experience with people who have been prescribed cannabis according to this metric common side effects are acute intoxication and worsening of existing mental health issues. Uncommon side effects are diarrhoea, nausea/vomiting, abdominal pain. Rare is psychosis, I've seen it once in maybe 200 patients but it's probably not 0.5%.
We really need to define the risks if we're going to prescribe cannabis at these volumes. Hence the call for TGA to investigate.
HalfEarthMedic@slrpnk.net · 13 pts · 335d
Just putting this here as several commentors seem to have misread my intention posting this here
Most responses here seem to assume that I'm opposed to medical marijuana, I'm not. I am in fact in favor of it's use, appropriately, in select patients, as with any medication.
I also want to caution against conflating recreational use(which may be problematic but is usually fine) with medicinal use(which should be held to the highest standards of evidence as any medicine should).
Now, regarding the evidence to date, efficacy is well established for refractory epilepsy and spasticity in MS. It is quite well established to have a role in pain control. Evidence that it is superior to other treatments for anxiety is pretty scant, we hold antidepressants to a pretty low standard and cannabis fails to even be that good in the published studies.
In terms of safety we frequently see acute intoxication from prescribed cannabis and worsening of co-morbid mental health conditions is really common. Nausea, vomiting, diarrhoea, and abdominal pains are all fairly frequent and I have seen one case of psychosis from prescribed marijuana. What's more, we see these more commonly in emergency departments, psych wards and GP clinics now that it is easily available from unscrupulous corporate owned clinics.
The article isn't claiming that medical marijuana is inherently dangerous or that it doesn't have a role in medicine. It states, correctly, that the TGA has never actually assessed the safety of the vast majority of products on the market. This is concerning for anyone who might want to prescribe these with confidence.
@givesomefucks@lemmy.world @wesker@lemmy.sdf.org @Taleya@aussie.zone @Randomgal@lemmy.ca
Taleya@aussie.zone · 10 pts · 335d
I'm not sure if I'm misreading your intent here? The AMCA is literally saying "If you don't give us actual proof and studies we can't validate or disprove them". It's a very different thing to "unwilling to comment on safety"
HalfEarthMedic@slrpnk.net · 4 pts · 335d
I disagree, this wording from a professional organisation is concerning. The usual standard of evidence for medication is that the companies or organisations promoting provide proof of safety.
For example ANZCA (specifically the Faculty of Pain Medicine) state
With regards to psychotropic med the RANZCP say
AMCA regarding the safety of cannabis say
givesomefucks@lemmy.world · 3 pts · 335d
OP is apparently shocked that something that happens 0.0046% of the time isn't a huge concern...
And that's not even getting into how those "adverse reactions" includes such debilitating conditions as coughing.
Taleya@aussie.zone · 5 pts · 335d
600 over three years jesus. I'm pretty sure antibiotics have 100x that
HalfEarthMedic@slrpnk.net · 5 pts · 335d
Don't get me started on antibiotic overprescribing.
HalfEarthMedic@slrpnk.net · 8 pts · 335d
As a GP I know very few doctors who don't accept that cannabis or cannabis derived products have a role to play in medicine. I know even fewer who don't see the recent rapid explosion of cannabis prescribing as reckless and dangerous.
Squiddork@lemmy.world · 5 pts · 335d
As a GP are you for legalisation (similar to alcohol) or for more tightly controlled prescriptions?
HalfEarthMedic@slrpnk.net · 6 pts · 335d
Whenever this is raised the argument about legalisation for recreational use is conflated. Alcohol, cocaine, oxycodone etc all have medicinal and recreational uses and we appropriately treat then differently.
If we are using it as medicine, at a minimum we should see prescription tracking and monitoring with implications for doctors prescribing inappropriately similar to the way we treat other medications with potential for abuse.
My opinion, for what it's worth is that there should be legalised cannabis for recreational purposes.
What we definitely shouldn't have is a situation where I am having people turning up to my clinic expecting a prescription for recreational doses of flower to smoke.
ozeng@aus.social · 2 pts · 335d
@HalfEarthMedic now let’s talk about alcohol-related adverse events
HalfEarthMedic@slrpnk.net · 5 pts · 335d
When prescribed as medicine, alcohol related adverse events are effectively zero
ozeng@aus.social · 2 pts · 335d
@HalfEarthMedic touche
Gold_E_Lox@lemmy.dbzer0.com · 2 pts · 335d
genuinely curious, is that a thing?
No1@aussie.zone · 6 pts · 335d
In the movies, they always show the injured character take a huge swig of alcohol, and then splash it all over their fatal wound and that fixes everything, so it must be true!
HalfEarthMedic@slrpnk.net · 5 pts · 335d
I believe that ethanol infusion is still standard treatment for methanol poisoning but outside my expertise
SaneMartigan@aussie.zone · 3 pts · 334d
Heavy alcoholics can't safely quit drinking cold turkey, so may be prescribed a number of drinks a day while drying out.
guillem@aussie.zone · 1 pts · 335d
Angelusz@lemmy.world · 2 pts · 335d
Not every drug is suitable for every person, we are each slightly different and that's okay. If it doesn't work for you, don't use it.
DavidDoesLemmy@aussie.zone · 1 pts · 334d
I am prescribed medical cannabis, but I only use it occasionally when needed. I have no doubt it is over prescribed, but I'm not sure how much of a problem that is. I think many people who want it could get it on the black market if they tried. So having medical cannabis might not create more overall cannabis users.
beeng@discuss.tchncs.de · 1 pts · 335d
Many aussies think one joint will drop you into lifelong psychosis. Go to Amsterdam where its legal to buy and they just think its another part of the range of substances there.
The expectation has a lot to do on perceived effects. No way a doctor is gonna get to the bottom of expectations, same way they don't when they prescribe other drugs with their other dependencies and side effects.
User beware.