A study published last week in the Journal of Clinical Oncology aimed to determine if cannabidiol (CBD) can help ease the symptoms of patients with late stage cancer receiving end of life care.
Conducted by the University of Queensland and the Mater hospital in Australia, the double-blind study involved 144 patients who received their usual palliative care alongside a dose of CBD oil or the placebo. Neither the patient nor the researchers knew who received the placebo or the CBD.
Researchers used standardised methods to assess the level of distress caused by symptoms such as overall quality of life, fatigue, pain and others at day 14 of the study, and at the end.
The study concluded, V
Researchers based their conclusions on the scores from the standardised tests, and from the results of secondary outcomes such as individual symptom scores, opioid use, depression, anxiety, quality of life, and adverse events.
The study was led by Professor Janet Hardy, who has been involved in previous studies exploring cannabis and palliative care and is the director of palliative support and care at Mater.
Prof Hardy told The Guardian, “The trial found there was no detectable effect of CBD on change in physical or emotional functioning, overall quality of life, fatigue, nausea and vomiting, pain, dyspnoea or appetite loss.”
Australia has strict drug control laws which vary between states. In Queensland where the study took place, it is illegal to possess even a small amount of cannabis with a maximum sentence of 15 years imprisonment for being found guilty of possession of anything below 500 grams.
The sale of bongs and pipes is also illegal in Queensland.
Medicinal cannabis can be prescribed to any patient with any condition as long as the clinician has the relevant authorisation from the Commonwealth and deems the treatment to be necessary and appropriate.
One of the reasons why the only cannabinoid used in the study was CBD relates to Australia’s laws surrounding driving and cannabis. The size of Australia means a patient’s ability to drive must be taken into consideration when deciding on a medicine, and in Australia it is forbidden to drive while using prescribed medicinal cannabis. It is legal, however, to drive while using CBD.
Prof Hardy said, “The cannabis plant is very complex and contains a large number of cannabinoids and other compounds. The two most prominent cannabinoids are CBD, which is cannabidiol, and THC, which is the one that makes you high when you smoke a joint.”
“Our next study will look at a combination of CBD and THC to see if you need to have THC to get any benefit from medicinal cannabis. The problem with that is CBD is very popular because it doesn’t have the psychoactive effects. It means you can drive and do other activities while on it, whereas it’s illegal to drive on THC, whether it’s taken for recreational or medicinal purposes.”
Despite the absence of strong supporting evidence, over a third of the participants when questioned said they had bought a medicinal cannabis product once the trial had finished. The researchers believe that this may be the result of an “overall feeling of general wellbeing, even if it did not improve specific symptoms”.
Prof Hardy went on to comment on how there is a lack of strong evidence supporting the use of medicinal cannabis to relieve symptom distress.
“Everyone wanted it, but there was little evidence to guide its usage. Usually, new products entering the market have gone through extensive pre-clinical studies regarding best dosage and usage, however, medicinal cannabis entered the market with very little guidance.”
