Whether you’re a parent or not, you’re probably pretty familiar with Calpol. You’ve either loved it as a kid or given it to a teething baby or small child with a fever. It’s a medicine you’ll see in millions of homes and, because it’s for sale in every supermarket and pharmacy, we assume it’s perfectly safe to use.
But the fact is, it’s not.
That innocuous pink paracetamol and preservative-laden liquid has some pretty shocking side effects, including hallucinations, liver damage, nausea, bleeding and hepatic necrosis. The same goes for the paracetamol you now take as an adult. The main difference is yours doesn’t contain more than four times as much sugar as there is in an equivalent amount of Coca-Cola, which is partly why a family GP in a BBC documentary told us “We have children now who are almost addicted to paracetamol, to Calpol”. And additives that are linked to hyperactivity and cancer.
There’s not much in the modern-day medicine cabinet that really is all that safe – or certainly not free from potentially extremely harmful side effects, even death. So it’s a little strange that there’s so much concern over the safety profile of medical cannabis that we’d sooner see people suffer and die without it than take the risk, don’t you think?
Regardless of the disparity between ‘big pharma’ owned drugs that rake in billions upon billions in profit, and a plant, I think it’s fair to say that most people do want to know their medicine is safe to use. So, Calpol may not be as safe as we hoped – but is cannabis? Given the way it’s treated, you’d be forgiven for thinking it’s incredibly dangerous. But, according to 41,000+ studies, millions of daily users, 1000s of years of real-world evidence, and records from over 50 countries across the world who already have cannabis fully licensed and available as a medicine, it would appear that cannabis is actually a very safe medicine.
Unlike almost every other medication we take, cannabis has been shown to produce an extremely low incidence of any serious side effects, and it has never been the direct cause of a single death. Ever.
Cannabis has been shown to produce an extremely low incidence of any serious side effects, and it has never been the direct cause of a single death. Ever.
So, why are we repeatedly being fed the line ‘we need stronger evidence on safety’ before cannabis can be made widely available whose lives could literally be saved by it? Just like the decision to make it illegal in the first place, there is absolutely nothing (repeat: nothing) to back this up.
When probed further, the ‘lack of clinical evidence and randomised controlled trials’ is the bit that comes next. But, as anyone even vaguely familiar with cannabis will tell you, this is not a single compound – this is a very complex organism with lots of therapeutic parts and actions to take into account. It doesn’t lend itself to the same type of testing as standardised, synthetic pharmaceutical drugs. Even so, cannabinoid researchers have found ways to get a chunk of these done, once again demonstrating each time that cannabis has a stellar safety profile and massive medicinal benefit – something that is no longer in any doubt. In December 2020, the UN Commission on Narcotic Drugs (CND) re-classified cannabis and cannabis resin under an international listing that recognizes its medical value.
Furthermore, Dr Mark Ware, cannabis advisor to the Canadian government and pioneering cannabinoid researcher with over 100 publications in peer-reviewed journals pointed out that these Randomised Control Trials we’re waiting on are notoriously bad at long term safety profiling. He explains “Medical literature is filled with drugs that got through the clinical trial phase, got out into the market and then ended up having all kinds of problems once being used by hundreds of thousands, even millions of people.”
It would seem that, when it comes to safety, real-world evidence (RWE) is the only way to know for sure – and we have more of that on cannabis than any other drug in the world. Yet this is exactly the kind of research we’re seeing rejected.
Dr Ware says “It’s not good enough to say we won’t make decisions until we have ‘that sort of data’ as people are using cannabis anyway. Do we need to bring a broader body of evidence in to consider what are we really trying to protect? If it’s really safety that’s the concern, then RWE is an amazing opportunity to inform safety decisions.”
One hopes that the big agencies that review data, like NICE in the UK, will start to look at the RWD, observational studies and very large data sets of cohorts of patients using cannabis now and how they’re using it. But right now, they’re not.
From the vast amount of information gathered about cannabis, we do know that there’s one area that can make use of this substance less safe: prohibition.
While cannabis remains illegal for most people in the UK, we’re left with a number of issues. The risk of using cannabis as a medication without guidance (perhaps resulting in something using a dose that is too high, or too low or an inappropriate ratio of cannabinoids for their condition). People are being forced to buy cannabis that may or may not be grown using harmful chemicals. Lack of cannabis education both in the population and medical professionals. Those who developed an unhealthy relationship with cannabis feeling unable to seek help. Distribution and cultivation being left in the illegal market, And the risk of being arrested or fined, which often comes coupled with an immense strain on mental health and wellbeing.
Cannabis might not be right for everyone, but it is an undoubtedly safe, effective medicine for millions of others. It’s not using cannabis that poses the greatest risk to our health, but the lack of access to it.