Hard News by Russell Brown

widely reported under headlines like

Saw all that and wondered if some journos were having an A Ha! See! moment. When finding information that reinforced their prejudices, or the editors, or something...
Good to know the basis of the study Ta.

I haven't read the study but I suspect there is some reverse causation going on. As the pain gets worse people starting using cannabis rather than cannabis has no effect on bad pain.

I talked to a medical professional who had a close relative die of cancer. This person who died had used cannabis and had said that cannabis did not get rid of the pain but took the edge off it. This person was also on opioids. If that's really what's going on then you'd expect people with the worst pain to be the ones using cannabis the most and also saying it helps.

I was involved in a trial of the effect of blood lowering medication on stroke rates. The doctors were also allowed to prescribe anything else along side that medication so some patients were also on blood thinning medication. The patients on blood thinning medication were more likely to die of a stroke than those not on blood thinning medication. But that's not because blood thinning medication causes stroke but that the people most at risk of stroke got blood thinning medication - their risk of dying of stroke was still higher than those without the medication but not as high as it would have been had they not had the medication.

From a sceptics point of view, such findings do show that there's no universal panacea effect - but there rarely is with medications anyway. Media organisations have to spin a contraversial headline out of a story somehow, so not surprising when we get an over-dramatised & over-generalised summary appearing. It would help if user-groups lobbied on the basis of common ground experience, such as forming a group (if one doesn't yet exist) of all users who feel they have experienced benefits from usage. Then have that group nominate several members who are willing to speak publicly on their behalf.

I still haven't read the paper ... but in terms of evidence on the effect of cannabis the study is pretty low grade because it's an *observational* study. The people themselves *choose* to use cannabis and a lot of that choice isn't so much about need but about other characteristics - whether they have used it before, how comfortable they are with breaking the law, how connected they are to people who can supply etc.

(Better studies are when people are randomly allocated treatment and better still when they don't know what treatment they are getting.)