Medical cannabis is no 'wonderdrug' and should be used as last resort - MAM

Medical cannabis is not a wonderdrug, but should be used in specific situation when all other treatment has failed, the Medical Association of Malta said today.

In a press conference this morning, the association agreed with the government's and president's position on medical cannabis, as well as with the World Medical Association (WMA) statement, issued in October 2017, intended to provide a position on legalisation of cannabis for medical use and highlight the adverse effects associated with recreational use.

MAM general secretary Martin Balzan said that medical cannabis was far from a wonderdrug, as the scientific evidence which showed the drug's medical effects and side effects were very low. On the other hand, its known side-effect profile and long term effects were well-known. Because of this, He said that if it were available in Malta, medical cannabis should only be prescribed to very specific cases by doctors after all other treatment is tried.

“Cannabis is an addictive drug, there have been various studies which resulted in the side effects and even mental illness,” Balzan said.

The drug’s (cannabinoids) side effect profile is very strong, including heart, lung and addiction problems. The known long-term side effects have not been studied in long term studies to truly identify how effective the drug is.

In the light of the low-quality scientific evidence on the health effects and therapeutic effectiveness of cannabis, more rigorous research involving larger samples is necessary before government decides whether or not to legalise medical cannabis for medical use. Research should also examine the public health, social and economic consequences of cannabis use.

“There are a lot of drugs which are safer and more effective,” Balzan said. Because of this, following WMA lesignation, the MAM believes that medical cannabis should only be prescribed by a doctor once all other treatment options have been exhausted.

“Cannabis must be prescribed by an authorised physician, after treatment with approved conventional drugs is undertaken before cannabis products are used for treatment,” Balzan said.

The MAM also agreed that cannabis should not be used recreationally and insisted that the procedure for purchasing cannabis be thorough in order to avoid recreational use. “The legislation is restrictive, the cannabis shouldn't be allowed to be used recreationally,” Balzan said.

Cannabis for medical use refers to the use of cannabis and its constituents, natural or synthetic, to treat disease or alleviate symptoms under professional supervision; however, this is no single agreed upon definition.

Medical cannabis has been used for the treatment of severe spasticity in multiple sclerosis, chronic pain, nausea and vomiting due to cytotoxics, and loss of appetite and cachexia associated with AIDS. however, evidence supporting use of cannabis for medicinal purposes is of low to moderate quality, and inconsistent.

“In considering policy and legislation on cannabis, governments, NMAs, policymakers, and other stakeholders, should emphasise and examine the health effects and therapeutic benefits based on the available evidence, while also recognising various contextual factors such as regulatory capacity, cost-effectiveness…and the public health and safety impact on the wider population,” the WMA statement said.