r. Mark Ware, director of clinical research, Alan Edwards Pain Management Unit, McGill University Health Centre, has been studying them since 1999.
While working at a pain clinic, a patient of the physician casually mentioned that he thought cannabis was helping manage his achiness. The doctor became interested in knowing more. He found from all the papers he read that they seemed to conclude with the same observation — clinical trials are needed.

The search for answers

“I was a researcher and clinician interested in pain research and complementary therapies that were patient-driven ways to treat pain outside the classic pharmacological model,” he says. That provided the inspiration to study medical cannabis. “I’m interested in providing the data to assist physicians make informed decisions about its role in patient treatment.”

In December 2015, the findings of researchers, including Dr. Ware, now an internationally acclaimed expert, were published in The Journal of Pain. In a large-scale study, 215 patients with chronic pain from seven clinics across Canada were dispensed cannabis with a standardized amount of delta-9-tetrahydrocannabinol or THC (12.5 percent) and monitored for a one-yearperiod. It was the first and largest study of the long-term safety of cannabis. 

The data showed daily users had no greater risk of serious adverse effects than non-users.

“We’ve had an abundance of anecdotal evidence about the effectiveness of medical cannabis, but that’s not enough. Clinical research is critical because it gives the information needed to healthcare professionals so they can assess whether their patients would benefit from medical cannabis.”

In an earlier study designed by Dr. Ware and his team, published the Canadian Medical Association Journal in October 2010, the effectiveness of cannabis on patients with neuropathic pain was examined. The results supported claims that inhaled and properly dosed cannabis reduced pain, improved mood, and helped sleep.

This type of research is important for both patients and the medical community to have and to consider. “We need this data to make decisions. We believe that science can help,” says Dr. Ware.

Some old attitudes and myths still prevail. Having scientific information is needed to address them. “It will take a generation or two for attitudes about cannabis to change. We’ve been so entrenched in the thinking that cannabis is a drug and it’s bad. As we begin to know it more, we are realizing that it is a lot more nuanced and it has a wealth of potentially beneficial properties.”

Dr. Ware is turning his attention next to a new study, looking at the safety and efficacy of medical cannabis among patients with pain from osteoarthritis of the knee. The CAPRI Trial will explore the effect of varying levels of THC and CBD, two active compounds in cannabis, on pain management in vaporized form. Currently, patients are being recruited for it in Montréal and Halifax. Results are expected in 2017.

How science helps

Studies like this will advance medical cannabis research in Canada and that’s critical, according to Brent Zettl, President and CEO of Prairie Plant Systems Inc. and CanniMed Ltd., the first cannabis producer to be licensed under the new Marihuana for Medical Purposes Regulations (MMPR) enacted by the federal government in 2013.

“We’ve had an abundance of anecdotal evidence about the effectiveness of medical cannabis, but that’s not enough, says Zettl. “Clinical research is critical because it gives the information needed to healthcare professionals so they can assess whether their patients would benefit from medical cannabis.” He adds, “There is still so much we don’t know about how it works. There are so many discoveries yet to come.”

Clearly, the growing body of scientific evidence on medical cannabis is positive for physicians and patients alike.