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::::::::::::* Frequent use of cannabis, especially in adolescence, is associated with the development of schizophrenia, a chronic neurodevelopmental disorder. During adolescence, when schizophrenia typically presents, profound changes occur in the brain, often through synaptic pruning, a process that endocannabinoids help regulate. Using cannabis interferes with adolescent neurodevelopment, and imaging studies associate marijuana use with adverse development of the hippocampus and the cerebellum. Epidemiologic data associate heavy adolescent use of marijuana with both an earlier onset of schizophrenia and a 2-fold increased risk of developing schizophrenia.76 To be clear, the use of cannabis in adolescence does not cause schizophrenia but increases the risk of its onset, suggesting interplay between marijuana use and genetic predisposition for schizophrenia. For people who develop schizophrenia, ongoing use of marijuana is associated with more severe psychosis and impaired performance on tests of attention and impulsivity. Marijuana is a psychoactive substance whose psychiatric complications are known to increase with early onset and regular use. ::::::::::::* Frequent use of cannabis, especially in adolescence, is associated with the development of schizophrenia, a chronic neurodevelopmental disorder. During adolescence, when schizophrenia typically presents, profound changes occur in the brain, often through synaptic pruning, a process that endocannabinoids help regulate. Using cannabis interferes with adolescent neurodevelopment, and imaging studies associate marijuana use with adverse development of the hippocampus and the cerebellum. Epidemiologic data associate heavy adolescent use of marijuana with both an earlier onset of schizophrenia and a 2-fold increased risk of developing schizophrenia.76 To be clear, the use of cannabis in adolescence does not cause schizophrenia but increases the risk of its onset, suggesting interplay between marijuana use and genetic predisposition for schizophrenia. For people who develop schizophrenia, ongoing use of marijuana is associated with more severe psychosis and impaired performance on tests of attention and impulsivity. Marijuana is a psychoactive substance whose psychiatric complications are known to increase with early onset and regular use.
:::::::::::: We have at least four secondary reviews now. We don't need to add an exact quote from one of them to the lead, but we do need to add something. Could we please get busy coming up with text? ] (]) 17:54, 3 December 2013 (UTC) :::::::::::: We have at least four secondary reviews now. We don't need to add an exact quote from one of them to the lead, but we do need to add something. Could we please get busy coming up with text? ] (]) 17:54, 3 December 2013 (UTC)
:::::::::::::Nope. that material about schizophrenia did not come from the review of medical cannabis cited by the authors (Wang et al. 2008.) It's a bait and switch cited to a study that has nothing to do with medical cannabis use. It's extremely sneaky because this material is placed between a review of medical cannabis studies, making it look like that medical cannabis use is associated with schizophrenia. It's not, and the paper doesn't show that. Clearly, the abstract is misleading and the paper sensationalizes claims that have no bearing in fact. It's one thing to talk about adverse events from medical cannabis use in a controlled study. That kind of data is relevant to this article and should be encouraged. It's quite another to stick in off-topic adverse events from non-medical cannabis studies in the same paper and talk about "implications". Very sneaky and underhanded. ] (]) 04:45, 4 December 2013 (UTC)


:Ah yes, ye-olde-cannabis-causes-schizophrenia-canard. That one has been making the rounds for about thirty years and gets trotted out every time a new medical cannabis law is passed. The idea that cannabis increases the risk of developing schizophrenia has no sufficient evidentiary basis nor any causal link and is based on an associative hypothesis. The self-medication hypothesis (schizophrenics use cannabis to help them cope) has not been ruled out, nor have many other competing hypotheses. The ] has previously said: "In some instances cannabis use may lead to a longer-lasting toxic psychosis involving delusions and hallucinations that can be misdiagnosed as schizophrenic illness...This is transient and clears up within a few days on termination of drug use; but the habitual user risks developing a more persistent psychosis, and potentially serious consequences (such as action under the Mental Health Acts and complications resulting from the administration of powerful neuroleptic drugs) may follow if an erroneous diagnosis of schizophrenia is made. It is also well established that cannabis can exacerbate the symptoms of those already suffering from schizophrenic illness and may worsen the course of the illness; but there is little evidence that cannabis use can precipitate schizophrenia or other mental illness in those not already predisposed to it." I believe this statement still sums up the consensus on the matter today. Furthermore, the incidence of schizophrenia has continued to drop while at the same time, cannabis use has ''increased''. On the other hand, the Institute of Medicine of the United States National Academies says that cannabis is "moderately well suited for particular conditions, such as chemotherapy-induced nausea and vomiting and AIDS wasting." The bottom line is that we ''know'' cannabis helps certain medical conditions, but we do ''not'' have a handle on the adverse effects. We know that schizophrenics self-medicate with cannabis, many of whom happen to show the first symptoms (without cannabis) as young adults. The evidence is conflicting. But government agencies keep funding anti-drug studies and are determined to find one that shows a relationship between cannabis and mental illness, and every year someone trots out the old "cannabis causes schizophrenia" claim. But there remains no clear causal link between cannabis and schizophrenia. ] (]) 10:14, 3 December 2013 (UTC) :Ah yes, ye-olde-cannabis-causes-schizophrenia-canard. That one has been making the rounds for about thirty years and gets trotted out every time a new medical cannabis law is passed. The idea that cannabis increases the risk of developing schizophrenia has no sufficient evidentiary basis nor any causal link and is based on an associative hypothesis. The self-medication hypothesis (schizophrenics use cannabis to help them cope) has not been ruled out, nor have many other competing hypotheses. The ] has previously said: "In some instances cannabis use may lead to a longer-lasting toxic psychosis involving delusions and hallucinations that can be misdiagnosed as schizophrenic illness...This is transient and clears up within a few days on termination of drug use; but the habitual user risks developing a more persistent psychosis, and potentially serious consequences (such as action under the Mental Health Acts and complications resulting from the administration of powerful neuroleptic drugs) may follow if an erroneous diagnosis of schizophrenia is made. It is also well established that cannabis can exacerbate the symptoms of those already suffering from schizophrenic illness and may worsen the course of the illness; but there is little evidence that cannabis use can precipitate schizophrenia or other mental illness in those not already predisposed to it." I believe this statement still sums up the consensus on the matter today. Furthermore, the incidence of schizophrenia has continued to drop while at the same time, cannabis use has ''increased''. On the other hand, the Institute of Medicine of the United States National Academies says that cannabis is "moderately well suited for particular conditions, such as chemotherapy-induced nausea and vomiting and AIDS wasting." The bottom line is that we ''know'' cannabis helps certain medical conditions, but we do ''not'' have a handle on the adverse effects. We know that schizophrenics self-medicate with cannabis, many of whom happen to show the first symptoms (without cannabis) as young adults. The evidence is conflicting. But government agencies keep funding anti-drug studies and are determined to find one that shows a relationship between cannabis and mental illness, and every year someone trots out the old "cannabis causes schizophrenia" claim. But there remains no clear causal link between cannabis and schizophrenia. ] (]) 10:14, 3 December 2013 (UTC)
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{{od}}The article (PMID 23386598) says:{{quotation|The purpose of this article is to describe the pharmacology, therapeutic benefits and risks, and various dosage formulations that have been studied with medical cannabis. Specifically, medical cannabis for pain and muscle spasms, the most common uses of medical cannabis, will be evaluated using an in-depth evidence-based approach}}. ] <sup>]|]|]</sup> 11:07, 3 December 2013 (UTC) {{od}}The article (PMID 23386598) says:{{quotation|The purpose of this article is to describe the pharmacology, therapeutic benefits and risks, and various dosage formulations that have been studied with medical cannabis. Specifically, medical cannabis for pain and muscle spasms, the most common uses of medical cannabis, will be evaluated using an in-depth evidence-based approach}}. ] <sup>]|]|]</sup> 11:07, 3 December 2013 (UTC)
::Nope. You've been the victim of a bait and switch. It doesn't review medical cannabis and schizophrenia, and I have to say that the study authors were very sneaky because a casual glance at the abstract and study make it seem like they did, so I completely understand your confusion. The relevant material begins on p. 203, in a section called "Safety Concerns", subtitled "Adverse Effects, Drug Interactions, and Contraindications". It correctly starts off examining actual studies of medical cannabis users, which is referenced to Wang et al. 2008. Wang's data listing adverse effects can be found here. However, there's nothing here about schizophrenia. The authors continue until p. 204, where the bait and switch occurs. At the bottom of the page, in a subsection titled "Psychiatric Implications", they begin looking at the "Frequent use of cannabis, especially in adolescence" which they say "is associated with the development of schizophrenia" which they hedge by later following it with "the use of cannabis in adolescence does not cause schizophrenia but increases the risk of its onset, suggesting interplay between marijuana use and genetic predisposition for schizophrenia." Meanwhile, nothing here is based on any study with medical cannabis. But you're right, it sure makes it look like it is to outsiders. Very sneaky. ] (]) 04:36, 4 December 2013 (UTC)


Here is what a 2008 Cochrane review (considered by many the gold standard, YMMV, I have a Misplaced Pages subscription) says (note that the source Viriditas removed is five years newer, 2013 Borgelt): Here is what a 2008 Cochrane review (considered by many the gold standard, YMMV, I have a Misplaced Pages subscription) says (note that the source Viriditas removed is five years newer, 2013 Borgelt):
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: By the way, now I know how that text came to be added to the lead. Petra added one sentence from that source to the lead (why the lead), which is unbalanced, and the second source added by Petra is directly contradicted by the first, Borgelt 2013, but the text from the first was left out) so I expanded with the direct quote. And questioned why it was added to the lead. Can we not work on the lead last? ] (]) 12:04, 3 December 2013 (UTC) : By the way, now I know how that text came to be added to the lead. Petra added one sentence from that source to the lead (why the lead), which is unbalanced, and the second source added by Petra is directly contradicted by the first, Borgelt 2013, but the text from the first was left out) so I expanded with the direct quote. And questioned why it was added to the lead. Can we not work on the lead last? ] (]) 12:04, 3 December 2013 (UTC)
There is a fair bit of evidence that cannibals use is associated with the risk of psychosis. . There is disagreement if it is causal but there is still a concern ] (] · ] · ]) (if I write on your page reply on mine) 17:29, 3 December 2013 (UTC) There is a fair bit of evidence that cannibals use is associated with the risk of psychosis. . There is disagreement if it is causal but there is still a concern ] (] · ] · ]) (if I write on your page reply on mine) 17:29, 3 December 2013 (UTC)
:There is no such causal evidence only associations which have never borne fruit. Correlation does not imply causation. Some cannabis users are schizophrenic. Some schizophrenics are cannabis users. What does that tell us about the risks of cannabis? What about causation? Multiple alternative hypotheses have not been ruled out, and this claim has not been proven in /actual/ studies of people who take medical cannabis, such as Russo et al. 2002. Russo et al. observed "no consistent or attributable neuropsychological or neurological deterioration" in a study of medical cannabis users. In addition to many other tests, they employed "MRI scans, neuropsychological tests, P300 testing, history and neurological clinical examination." The study that is cited in the article does not cite use by medical cannabis, it cites recreational cannabis users who may have been misdiagnosed, who may already have mental illness, or who are suffering from other disorders. The idea that cannabis causes psychosis is not supported by good evidence and the study in question does not concern patients who use it. These sources are being misused to claim that medical cannabis users are at a greater risk of mental illness, when actual studies of medical cannabis users have found no such association. The fact remains, the numbers of schizophrenia cases have gone down while cannabis use has increased. We would expect to see more cases of schizophrenia as cannabis use becomes more prevalent. That has not happened. Where are the rising cases of schizophrenia caused by medical canabis? Surely, we should see it by now. In 2011, depending on how you count the numbers, there were anywhere from 1-2+ million medical cannabis users in the United States. Surely we should be seeing a huge uptick in mental illness if this claim of causation had merit. Are we? No, we are not. At least 70% of kids have used cannabis, but for all this time schizophrenia only affects 1%. The numbers have not increased. If you want to talk about a risk to patients, then cite reviews of medical cannabis studies. Russo et al. 2002 did the research and found no such risk or result. Citing cases that study cannabis use in adolescents who are of the age of onset for mental illness, and who may have not been screened properly or misdiagnosed, and who are not (in the majority of cases) likely candidates for medical cananbis use (i.e. adults) is playing hard and loose with the facts. Let's look at the known risks in relation to the facts: in just the years from 1999-2009, 300,000 Americans died from legal prescription drugs. And, according to the CDC, "more deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined." So, legal prescription drugs, legal tobacco, and legal alcohol are the big killers. Any idea how many people died from using medical cannabis last year? More to the point, how many people who had a prescription for medical cannabis were admitted to hospitals for adverse effects? If you don't know the answers to these questions, then tell me how you can possibly claim that medical cannabis can lead to mental illness? Please don't cite me irrelevant, associative studies of recreational drug use by teenagers or CYA, mandatory disclaimer legalese on the back of pharmaceutical boxes. Show me the evidence. ] (]) 03:30, 4 December 2013 (UTC)

Revision as of 04:45, 4 December 2013

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cannabis effective against cancer and not chemotherapy???

exists any study which compares chemotherapy success rate with and without cannabis? recent research indicates, that cannabis itself has anti-cancer properties..so it could theoretically be that chemotherapy does not work at all and the benefits aris from cannabis itself..

does anyone have information on this topic

=================================================

There is one clinical study that looked into clinical effects of cannabis in cancer patients. http://www.nature.com/bjc/journal/v95/n2/full/6603236a.html 9 patients with progression of a brain cancer called glioblastoma multiforme was treated. It wasn't a controlled study, so it is unknown if the benefits that were observed was an effect of cannabis or an effect of the natural history of their cancer. The bottom line is, that all nine patients died within a year. Not a single patient was cured.

This could be mentioned in the section on brain cancer. The referenced study (111) used tumour samples from these patients.

Jli Anax (talk) 13:02, 17 November 2013 (UTC)

PTSD anybody?

Why is Post Traumatic Stress Disorder not listed as a use? There are studies showing the effect of CBD on anxiety and depression, which are two major symptoms of PTSD.

Marijuana vending machine

A merge to medical cannabis has been proposed. I encourage you to weigh in and get it resolved so that we can remove the unsightly template at the top of medical cannabis as soon as possible.

Please see: Talk:Marijuana_vending_machine#This article as a section within another

Many thanks, Anna Frodesiak (talk) 01:56, 29 October 2013 (UTC)

Inserted graphic about medical cannibis use in the US

There has been a proposed graphic to recent reclassification of medical cannabis in the United States. Image was located via Wikimedia.Ktownnative (talk) 20:53, 15 November 2013 (UTC)

Long tagged, removed from article for citation

These have been tagged for years; I have removed them. SandyGeorgia (Talk) 00:31, 30 November 2013 (UTC)

  • During the 1970s and 1980s, six U.S. states' health departments performed studies on the use of medical cannabis. These are widely considered some of the most useful and pioneering studies on the subject.
  • In Spain, since the late 1990s and early 2000s, medical cannabis underwent a process of progressive decriminalization and legalisation. The parliament of the region of Catalonia was the first in Spain to have voted unanimously in 2001 legalizing medical marijuana; it was quickly followed by parliaments of Aragon and the Balearic Islands. The Spanish Penal Code prohibits the sale of cannabis but it does not prohibit consumption (although consumption on the street is fined). Until early 2000, the Penal Code did not distinguish between therapeutic use of cannabis and recreational use, however, several court decisions show that this distinction is increasingly taken into account by judges. From 2006, the sale of seed is legalized,
  • Several studies have been conducted to study the effects of cannabis on patients suffering from diseases like cancer, AIDS, multiple sclerosis, seizures or asthma. This research was conducted by various Spanish agencies at the Universidad Complutense de Madrid headed by Manuel Guzman, the hospital of La Laguna in Tenerife led neurosurgeon Luis González Feria or the University of Barcelona.

Not correctly sourced, removed

Removing text not sourced correctly, see WP:MEDRS-- much of this article is cited to primary studies. SandyGeorgia (Talk) 02:21, 30 November 2013 (UTC)

Also, full sections discussing primary studies, there are secondary reviews compliant with WP:MEDRS, pls find and use them. See also WP:UNDUE, WP:NOT (News) and WP:RECENTISM.

  • ALS:
  • Pain relief:
  • Brain cancer:

SandyGeorgia (Talk) 02:21, 30 November 2013 (UTC)

Diabetes

Entire section, WP:UNDUE, WP:NOT (news), WP:MEDRS. SandyGeorgia (Talk) 02:24, 30 November 2013 (UTC)

A study published on May 16, 2013 in the Journal of American Medicine revealed that regular marijuana use is associated with better glucose control. They found that current marijuana users had significantly lower fasting insulin and were less likely to be insulin resistant, even after excluding patients with a diagnosis of diabetes mellitus. Participants who reported using marijuana in the past month had lower levels of fasting insulin and HOMA-IR and higher levels of high-density lipoprotein cholesterol (HDL-C). These associations were weaker among those who reported using marijuana at least once, but not in the past thirty days, suggesting that the impact of marijuana use on insulin and insulin resistance exists during periods of recent use. The Study there were al

Crohn's Disease

A study published on May 6, 2013 in the journal Clinical Gastroenterology and Hepatology revealed that subjects with Crohn's Disease experienced benefits from inhaled cannabis use. At the completion of the study's treatment period, ten out of the eleven patients that received cannabis treatment displayed substantial improvements in disease-related symptoms, while five of these patients experienced complete remission. The study's authors wrote: "... all patients in the study group expressed strong satisfaction with their treatment and improvement in their daily function." The study was small, but was designed as a randomized placebo-controlled clinical trial, the gold standard for a clinical trial.

Breast cancer

According to a 2007 and a 2010 study at the California Pacific Medical Center Research Institute, cannabidiol (CBD) stops breast cancer from spreading throughout the body by downregulating a gene called ID1. This may provide a non-toxic alternative to chemotherapy while achieving the same results without the painful and unpleasant side effects. The research team says that CBD works by blocking the activity of a gene called ID1, which is believed to be responsible for a process called metastasis, which is the aggressive spread of cancer cells away from the original tumor site. According to findings released by the team in 2012, when the particularly aggressive "triple-negative" cells (which contain high levels of ID1 and account for 15% of breast cancers) were exposed to CBD, they "not only stopped acting 'crazy' but also returned to a healthy normal state". Human trial models are currently in development. Dr Sean McAllister, study co-leader, commented:

"The preclinical trial data is very strong, and there's no toxicity. There's really a lot of research to move ahead with and to get people excited".

Mental disorders

A study by Keele University commissioned by the British government found that between 1996 and 2005 there had been significant reductions in the incidence and prevalence of schizophrenia. From 2000 onwards there were also significant reductions in the prevalence of psychoses. The authors say this data is "not consistent with the hypothesis that increasing cannabis use in earlier decades is associated with increasing schizophrenia or psychoses from the mid-1990s onwards".

A 10-year study on 1,923 individuals from the general population in Germany, aged 14–24, concluded that cannabis use is a risk factor for the development of incident psychotic disorder symptoms, and the continued use might increase the risk. A study conducted by Thomas F. Denson and Mitchell Earleywine found fewer weekly users with symptoms of depression than those that did not use marijuana. They also reported that used marijuana for medical reasons were found to have been more depressed than recreational users, but reported fewer negative symptomatic issues.

However a medical study published in 2009 taken by the Medical Research Council in London, showed there was no significant effect of THC on -raclopride binding. Thus concluding, recreational cannabis users do not release significant amounts of dopamine from an oral THC dose equivalent to a standard cannabis cigarette. This result challenges current models of striatal dopamine release as the mechanism mediating cannabis as risk factor for schizophrenia.

Tourette syndrome

First, it's Tourette syndrome, not Tourette's. I pride myself on attempting to write neutral text, sourced to secondary reviews. This removal of two review sources made the text less neutral. There are positive findings wrt cannibinoids in TS; we need not completely sanitize the article to present evidence-based facts, and Cochrane Reviews are not the only game in town. If we are *only* going to cite the Cochrane review, then we need to go back and say more. Let me know, SandyGeorgia (Talk) 15:08, 30 November 2013 (UTC)

Sorry, an over-zealous revision on my part: I have restored the section with 3 sources as you had it. Alexbrn 15:19, 30 November 2013 (UTC)
Thanks, Alexbrn ... I will update those reviews as I come across newer things, but for the next few days, I'm going to be quite busy elsewhere! SandyGeorgia (Talk) 15:36, 30 November 2013 (UTC)

Criticism in the lede

The lede does need to contain notable criticism, but the FDA-centric stuff that's there presently probably isn't it as (yes) it is a bit US-centric. Attempting to make it seem otherwise by saying organizations "like" the FDA share its view, are unsourced. I'd favour removing this paragraph and re-visiting this when the article body is in better shape. Alexbrn 15:54, 30 November 2013 (UTC)

"FDA-centric stuff" is not a correct description. It is a fact that many countries in the western world demand the drugs for medical use must be registered and approved by its own agency. Typically have persons from the medical profession a very strong position in those agencies. Approval of a drug as as medical drug is i those countries demand around 10 years of testing and documentation of the result and a strict quality control of the production and distribution after approval.Dala11a (talk) 20:37, 30 November 2013 (UTC)
I'm always all in favor of writing the lead last-- after the article has been developed-- because leads should summarize the article. I also don't view content in terms of "criticism" or not, unless we are talking about, for example, literary criticism or criticism of a film or work of art. Content is content, the facts are the facts, and a well written article will not be categorized along the lines of "criticism". See Misplaced Pages:Criticism. The article should be neither "pro" nor "con", which negates the need to view any part of it as "criticism". It should merely state the facts as supported by the highest quality, most recent sources, for example:
SandyGeorgia (Talk) 21:19, 30 November 2013 (UTC)
The way I see it, criticism is not necessarily adverse criticism; so perhaps "evaluative opinion" might be a better way of putting it. WP:LEDE does guide us include "any prominent controversies", and that might apply here. I'm not sure though, that the FDA stuff does that well - and agree it is better to focus on the body before writing a lede.
Has anybody got access to that new review article, BTW? Alexbrn 21:47, 30 November 2013 (UTC)
The introduction must give a balanced view of the situation in this matter. The vast majority of doctors do not recommend the smoking of marijuana, it is a very small minority of doctors who write for a very large proportion of all recommendations, most of them are made after a very brief survey, in practice, often only on the grounds that the patient states he needs pain relief. Dala11a (talk) 01:09, 1 December 2013 (UTC)

Gordon review

I have this paper now:

Excerpt:

Advocacy, opinion, and politics may cloud perception of the merits of marijuana’s legal use . However, the peer-reviewed literature is the most objective means to examine purported and realized health effects of marijuana exposure. In this review, we examined the recent (since 1998) literature regarding associations of the health effects to marijuana exposure. We found evidence that marijuana seems to have physical health effects in humans aside from mental health, behavioral, and societal morbidity, and there is a biological basis for many of these effects. For example, marijuana use is associated with diseases of the liver (particularly with co-existing hepatitis C), lungs, heart, and vasculature. For clinicians, knowing these associations will enhance their ability to address these incident (or on-going) physical illnesses that may occur secondary to marijuana use.

That is, it deals with the health effects of cannabis, not medical cannabis. It will be useful for updating the cannabis, effects of cannabis and long-term effects of cannabis articles, but less useful here. SandyGeorgia (Talk) 16:39, 1 December 2013 (UTC)

Request quote, Clark 2011

Text was added to the lead saying:

The alleviating benefits of cannabis has (sic) been shown to outweigh negative effects.

The source is:

The abstract says (emphasis mine):

These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug ...

which is not what our text says. Our text states as fact something that the source says is claimed by the studies. Full text of that source is available; which part of it supports the text in our article? SandyGeorgia (Talk) 21:56, 1 December 2013 (UTC)

Is this article a reliable source in any case? (I think not). The full text does contain: "Scientific research has shown that the benefits of medical marijuana greatly outweigh the burdens." Alexbrn 22:03, 1 December 2013 (UTC)
Well, sure, Jesuits know all about medicine (they know all about everything :) At any rate, if we're going to use sources, we need to use them correctly. There were two new reviews added to the lead, with neither of them used correctly (one cherry picked, this one misrepresents). I added the missing portions of PMID 23386598. Petrarchan47, when adding new sources, please do not use bare URLs and expect others to do all the cleanup. You can generate a citation template from a PMID by entering it here. Also, if you add a source to the lead (implying it is recent enough and high enough quality to be cited throughout) please make sure you include both sides of the coin as presented by that source. SandyGeorgia (Talk) 22:12, 1 December 2013 (UTC)

Merge discussion, Cannabis (drug)

Cannabis_(drug)#Medical_use is a poor summary of this article, and most of it should be removed, merged here, and rewritten in summary style. SandyGeorgia (Talk) 22:32, 1 December 2013 (UTC)

Yes agree Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:15, 2 December 2013 (UTC)

Review concerning glaucoma

I recently deleted a paragraph concerning Canasol, a drug that didn't turn up hits on pubmed, NHS or FDAs websites. The only review that seems to be from a main-stream journal is this one I found from 2002, is there any point in mentioning it? http://www.ncbi.nlm.nih.gov/pubmed/12182967 CFCF (talk) 19:34, 2 December 2013 (UTC)

Google Scholar turns up some stuff; not sure how notable it is overall. I believe it was a standalone article topic once (!) Alexbrn 19:37, 2 December 2013 (UTC)

Rearranged

Per WP:MEDMOS and deleted a lot of popular press / primary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:16, 2 December 2013 (UTC)

Need for more worldly viewpoint in Lede

The fourth paragraph of the Lede states that medical effects of cannabis are disputed, and cites the US DEA and a US medical organization. This is leaving out the rest of the world, and seems more fitting for an article dedicated to Medical cannabis in the US. petrarchan47tc 03:28, 3 December 2013 (UTC)

I've removed the entire paragraph. It was not cited to a reliable secondary source and was clearly labeled as an advocacy statement on both ends. Viriditas (talk) 05:09, 3 December 2013 (UTC)
This is the same discussion below under "Recent additions to the lead". SandyGeorgia (Talk) 09:06, 3 December 2013 (UTC)

Emperor Shen Nung

The Cannabis plant has a long history of medicinal use, with evidence dating to the Emperor Shen Nung in 2737 BCE.

This date is not correct, which is why I previously removed it. Why was it added back? Viriditas (talk) 04:15, 3 December 2013 (UTC)

Well, also, Shen Nung is a mythical or semi-mythical figure, so the word "evidence" is probably too strong. This is pretty much like saying that medical cannabis was pioneered by Romulus and Remus. MastCell  05:09, 3 December 2013 (UTC)
Yep, and the first written evidence wasn't dated until 1-2 CE. New evidence of older medicinal cannabis use is now available. The Chinese claim is from the mid-1970s and is no longer true. Viriditas (talk) 05:19, 3 December 2013 (UTC)

Recent additions to lead

The medicinal value of cannabis is disputed. The American Society of Addiction Medicine dismisses the concept of medical cannabis because the plant fails to meet its standard requirements for approved medicines. The US Food and Drug Administration (FDA) maintains that cannabis is associated with numerous harmful health effects, and that significant aspects such as content, production, and supply are unregulated.

And editor recently added this content to the lead section. The statement by the ASAM is sourced to a primary advocacy piece while the statement by the FDA is sourced to a government propaganda press release published on a website by the Scholastic Corporation. Both of these statement have been thoroughly debunked in the literature and neither citation meets the reliable secondary source classification. It's funny how WP:MEDRS is invoked when an editor removes positive information about the efficacy of medical cannabis but ignored when editors add negative political propaganda. Viriditas (talk) 05:02, 3 December 2013 (UTC)

Viriditas, your insinuations are unhelpful; there are many people at work on the article, sometimes editors get crossways with each other with that much work happending; there is much work still to be done; attributing motives is a failure to AGF and doesn't help work advance. There is still a mountain of poorly sourced content in the article that needs to be deleted; that there hasn't been time to get to it yet isn't a reason to attribute motive. I usually work on the lead last and hadn't really looked. And I have no idea if Dala11a has invoked MEDRS for anything. Let's please focus on content and not be attributing motive.

This was the text addition by Dala11 that was subsequently copyedited into much better shape by someone before you removed it. The sentence The medicinal value of cannabis is disputed has been in the article all along, was not added by Dala11, it was merely joined with that information when someone later copyedited (I haven't followed through to see who did that copyedit, but it did improve the prose.)I can't see any reason for deleting that sentence, as it is an accurate, brief, and balanced summary statement.

This removal should be discussed. SandyGeorgia (Talk) 08:58, 3 December 2013 (UTC)

The medicinal value of cannabis isn't disputed by the Institute of Medicine of the United States National Academies or any other number of established mainstream medical institutions. That sounds like a fringe statement. Do you have a MEDRS-compliant source to support it or just a link to a self-published advocacy website? Viriditas (talk) 10:23, 3 December 2013 (UTC)

Israel

Israel is the leading country in terms of research, and should have its own section.

Here are some sources: NPR Science Daily Fox petrarchan47tc 08:03, 3 December 2013 (UTC)

There is an Israel section. (I'll note that the bottom of the article is still in bad need of a copyedit, rationalization, and consolidation, but I removed the copyedit tag because the top is in good shape and in the hopes others will take that on willingly.) SandyGeorgia (Talk) 08:25, 3 December 2013 (UTC)
Great. petrarchan47tc 08:39, 3 December 2013 (UTC)

Statement from DEA Judge

This was removed in the recent slew of fixes, but the information should be re-added.source petrarchan47tc 08:05, 3 December 2013 (UTC)

An assessment of cannabis safety is medical content, isn't it? How is an opinion from a judge in 1988 in line with WP:MEDRS? Alexbrn 08:17, 3 December 2013 (UTC)
Because this edit replaced three journal sources with a laypress news source (!!), I've spent some time searching PubMed on the topic. As an aside, the three journal sources were primary sources that shouldn't have been used to begin with, but replacing them with a laypress source was even worse. From what I can determine in PubMed, it looks to me like we're weasling around the issue by quoting the judge, and we can do better. Someone with full journal access might opine; if you are willing to relax MEDRS to quote a judge in the laypress, then we might also relax MEDRS to quote primary journal sources that discuss documented deaths. SandyGeorgia (Talk) 08:22, 3 December 2013 (UTC)
Interesting, so these are equally valuable in your view? The DEA judge did a review, for over a year, of all available research at the time. I thought his statement about the therapeutic ratio was especially relevant to this article. This is also history. But really, this isn't about scoring points and it feels as if it has become a game. The POV is obvious by these replies, sorry to say. petrarchan47tc 08:48, 3 December 2013 (UTC)
I'm talking sources. You're talking motive. Let's talk content. I did not say anything was equally valuable. I said the three primary journal sources shouldn't have been used, but replacing them with lay press was even worse. And we can do better. SandyGeorgia (Talk) 09:01, 3 December 2013 (UTC)
SandyGeorgia - This source has a section on marijuana-related fatalities (you'll need full access to see page 902). Money quote: "Few reports of marijuana-related fatalities appear in the medical literature; the etiology of those fatalities is not well documented." Cited in support is http://dx.doi.org/10.1037/1064-1297.2.3.244 Alexbrn 08:52, 3 December 2013 (UTC)
That no one has died from cannabis is not disputed, and was echoed by Sanjay Gupta, in his 2013 CNN documentary called "Weed". He said he spent a year going over all the evidence, and one thing he found was that there exists no documented deaths attributed to cannabis. This isn't fringe theory. Lester Grinspoon is a Harvard doctor who spent 30 years researching the dangers of cannabis for the government. His statements can appear anywhere and constitute RS because of his status. I have to warn you, if you decide to state that people have died from cannabis, you're going to make wikipedia look like an idiot. petrarchan47tc 09:00, 3 December 2013 (UTC)
Why are we quoting Sanjay Gupta anyway? Petra, please lower the rhetoric. No one is talking about stating that people have died. We are talking about whether to include statements that people "haven't died" from questionable sources. Two different things. SandyGeorgia (Talk) 09:03, 3 December 2013 (UTC)
@Alexbrn, yes, I understand from PubMed that the etiology of deaths isn't well documented. That is what I find weasly about quoting the judge. SandyGeorgia (Talk) 09:04, 3 December 2013 (UTC)
I propose either using Barceloux then, or saying nothing at all - this doesn't seem to be a topic covered much in the secondaries, after all. Alexbrn 09:11, 3 December 2013 (UTC)
Barceloux? Can we get a standard in here for how we refer to studies? You tend to cite DOIs, I cite PMIDs, I don't know who Barceloux is. And readers who come along three days from now are even less likely to know. SandyGeorgia (Talk) 09:20, 3 December 2013 (UTC)

By "Barceloux" I mean Chapter 60 of Medical Toxicology of Drug Abuse: Synthesized Chemicals and Psychoactive Plants (i.e. the statement about few deaths and poorly documented etiology). For the other journal, I know you like PMIDs and I tried to find one for you, I truly did, but could only see a DOI. Alexbrn 09:25, 3 December 2013 (UTC)

I guess you mean this 2012 book (which I had to look up in my ISBN finder-- Google book links don't work for everyone). OK, if that's what you mean, then a 2012 source is better than a 1988 statement from a judge, IMO. Next time, please lay out your source more clearly on the first post-- we've got a lot of work to do in here :) SandyGeorgia (Talk) 09:35, 3 December 2013 (UTC)
Sorry, I had absolutely no idea that Google Books wasn't everywhere! Is there a problem accessing the .co.uk Google Books links from outside the UK? Alexbrn 09:39, 3 December 2013 (UTC)
I will explain on your talk so as not to fill up this page. SandyGeorgia (Talk) 10:44, 3 December 2013 (UTC)

Summarizing, I prefer this recent source over a 25-year-old statement from a judge:

  • Barceloux, Donald G. (2012). "Chapter 60: Marijuana (Cannabis sativa L.) and synthetic cannabinoids". Medical Toxicology of Drugs Abuse: Synthesized Chemicals and Psychoactive Plants. Wiley. p. 902. Few reports of marijuana-related fatalities appear in the medical literature; the etiology of those fatalities is not well documented. {{cite book}}: Unknown parameter |ISBN13= ignored (help)

Can we get a page number?

And why are we quoting Sanjay Gupta, a TV-doc commentator, in an encyclopedia? SandyGeorgia (Talk) 11:47, 3 December 2013 (UTC)

Overcited, why ?

Why does this rather innocent looking statement require 10 sources? SandyGeorgia (Talk) 08:15, 3 December 2013 (UTC)

In Canada, marijuana vending machines are planned to be used in centres that cultivate the drug.

Borgelt 2013

This edit took two statements sourced to Borgelt 2013-- one sentence which discussed the benefits, one which discussed safety concerns, that is balanced-- and eliminated the second portion about safety.

1. Cannabis has been used to reduce nausea and vomiting in chemotherapy and people with AIDS, and to treat pain and muscle spasticity. PMID 23386598

2. According to a 2013 review, "Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations." PMID 23386598

So, we have safety concerns from our most recent review eliminated, while benefits identified in that same review are retained. What we have left in the article is only that the FDA doesn't consider that safety has been established, which is confusing, since the same can be said from reliable MEDRS-compliant secondary sources. SandyGeorgia (Talk) 09:18, 3 December 2013 (UTC)

The edit summary said: "Please don't cherry pick abstracts". But was that happening? Alexbrn 09:19, 3 December 2013 (UTC)
Unhelpful. Please stick to the facts; they usually speak for themselves. SandyGeorgia (Talk) 09:21, 3 December 2013 (UTC)
I meant it as a factual question, about the abstract of PMID 23386598 - this link doesn't work for me? Alexbrn 09:30, 3 December 2013 (UTC)
Oops, I found and fixed the error (when I numbered 1 and 2 above, the two got attached-- now fixed). Kinda funny since I just lectured you above about getting your sources straight the first time :) Sorry! Now you can see the article for yourself. Not only do we still have content to remove in here, we still have much content to add-- which is why I always find it strange when people fixate on the lead before working on the article. Whether it's in the lead or elsewhere, we have left out balance from this source. SandyGeorgia (Talk) 09:44, 3 December 2013 (UTC)
Right, so I think the the concern in the edit summary was that the content ("Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations.") was just a mirror of the abstract ("Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations"). And indeed this does look problematic to me, not because of cherry picking, but because of plagiarism. Alexbrn 09:55, 3 December 2013 (UTC)
It was one sentence, fully enclosed in quote marks. Are you familiar with plagiarism? Cherry picking refers to taking only one side of an argument from a particular source. Removing the safety issues while leaving the benefits is, yes, cherry picking. One sentence fully encased in quote marks and attributed to its source is not plagiarism. Or too close paraphrasing. Or copyvio. It's attributing a direct quote. SandyGeorgia (Talk) 10:06, 3 December 2013 (UTC)
Sorry, yes - you're completely right (I missed the quotes/attribution ... must be getting text-blindness). As for cherry-picking, this was the reason for the removal of the content, but it appears to have no basis since the original content wasn't partial. Alexbrn 10:12, 3 December 2013 (UTC)
No problem; since we've never worked together before, you probably didn't know that I launched this. SandyGeorgia (Talk) 10:27, 3 December 2013 (UTC)
There is no clear causal link between cannabis and schizophrenia and adding this to the lead section of medical cannabis is not only undue weight, it is completely off-topic. Were the study participants medical cannabis patients? Viriditas (talk) 10:17, 3 December 2013 (UTC)
I've mentioned that I usually leave work on the lead for last, after the article is written. I don't care at this point what text goes in the lead, but we can't leave out of the article entirely something all recent high-quality journal secondary reviews say, nor is something covered by multiple reviews undue or off-topic. One of the specific reasons we use recent reviews is because they help us assign due weight. Borgelt 2013 is not a study; it's a review. Misplaced Pages:Misplaced Pages Signpost/2008-06-30/Dispatches helps better understand how to apply WP:MEDRS. SandyGeorgia (Talk) 10:32, 3 December 2013 (UTC)
And yet, the exact opposite is the case. The source was being given undue weight (There is no clear causal link between cannabis and schizophrenia and "there is minimal information available about drug interactions and contraindications with cannabis-derived pharmaceuticals and medical cannabis"). Because the source was being misused, I removed it. Viriditas (talk) 10:42, 3 December 2013 (UTC)
I note that Borgelt 2013 was a source located by and added by Petra (to the lead), not me. In addition to the now four secondary review sources listed below that discuss schizophrenia, here are exact excerpts from Borgelt (our most recent review, PMID 23386598):
  • Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations.
  • The Canadian product insert for nabiximols states the following contraindications: ... history of schizophrenia or any other psychotic disorder;
  • Frequent use of cannabis, especially in adolescence, is associated with the development of schizophrenia, a chronic neurodevelopmental disorder. During adolescence, when schizophrenia typically presents, profound changes occur in the brain, often through synaptic pruning, a process that endocannabinoids help regulate. Using cannabis interferes with adolescent neurodevelopment, and imaging studies associate marijuana use with adverse development of the hippocampus and the cerebellum. Epidemiologic data associate heavy adolescent use of marijuana with both an earlier onset of schizophrenia and a 2-fold increased risk of developing schizophrenia.76 To be clear, the use of cannabis in adolescence does not cause schizophrenia but increases the risk of its onset, suggesting interplay between marijuana use and genetic predisposition for schizophrenia. For people who develop schizophrenia, ongoing use of marijuana is associated with more severe psychosis and impaired performance on tests of attention and impulsivity. Marijuana is a psychoactive substance whose psychiatric complications are known to increase with early onset and regular use.
We have at least four secondary reviews now. We don't need to add an exact quote from one of them to the lead, but we do need to add something. Could we please get busy coming up with text? SandyGeorgia (Talk) 17:54, 3 December 2013 (UTC)
Nope. that material about schizophrenia did not come from the review of medical cannabis cited by the authors (Wang et al. 2008.) It's a bait and switch cited to a study that has nothing to do with medical cannabis use. It's extremely sneaky because this material is placed between a review of medical cannabis studies, making it look like that medical cannabis use is associated with schizophrenia. It's not, and the paper doesn't show that. Clearly, the abstract is misleading and the paper sensationalizes claims that have no bearing in fact. It's one thing to talk about adverse events from medical cannabis use in a controlled study. That kind of data is relevant to this article and should be encouraged. It's quite another to stick in off-topic adverse events from non-medical cannabis studies in the same paper and talk about "implications". Very sneaky and underhanded. Viriditas (talk) 04:45, 4 December 2013 (UTC)
Ah yes, ye-olde-cannabis-causes-schizophrenia-canard. That one has been making the rounds for about thirty years and gets trotted out every time a new medical cannabis law is passed. The idea that cannabis increases the risk of developing schizophrenia has no sufficient evidentiary basis nor any causal link and is based on an associative hypothesis. The self-medication hypothesis (schizophrenics use cannabis to help them cope) has not been ruled out, nor have many other competing hypotheses. The Royal College of Psychiatrists has previously said: "In some instances cannabis use may lead to a longer-lasting toxic psychosis involving delusions and hallucinations that can be misdiagnosed as schizophrenic illness...This is transient and clears up within a few days on termination of drug use; but the habitual user risks developing a more persistent psychosis, and potentially serious consequences (such as action under the Mental Health Acts and complications resulting from the administration of powerful neuroleptic drugs) may follow if an erroneous diagnosis of schizophrenia is made. It is also well established that cannabis can exacerbate the symptoms of those already suffering from schizophrenic illness and may worsen the course of the illness; but there is little evidence that cannabis use can precipitate schizophrenia or other mental illness in those not already predisposed to it." I believe this statement still sums up the consensus on the matter today. Furthermore, the incidence of schizophrenia has continued to drop while at the same time, cannabis use has increased. On the other hand, the Institute of Medicine of the United States National Academies says that cannabis is "moderately well suited for particular conditions, such as chemotherapy-induced nausea and vomiting and AIDS wasting." The bottom line is that we know cannabis helps certain medical conditions, but we do not have a handle on the adverse effects. We know that schizophrenics self-medicate with cannabis, many of whom happen to show the first symptoms (without cannabis) as young adults. The evidence is conflicting. But government agencies keep funding anti-drug studies and are determined to find one that shows a relationship between cannabis and mental illness, and every year someone trots out the old "cannabis causes schizophrenia" claim. But there remains no clear causal link between cannabis and schizophrenia. Viriditas (talk) 10:14, 3 December 2013 (UTC)
Have you got a source for the view of the Royal College of Psychiatrists? Alexbrn 10:20, 3 December 2013 (UTC)
Yes, I do, but it hardly matters. Why don't you show me the evidence that cannabis causes schizophrenia? Any causal links? No? And what does this have to do with medical cannabis? Nothing? I see. Viriditas (talk) 10:25, 3 December 2013 (UTC)
I does matter. Is it a recent view, for example? And in RS? The 2013 article whose abstract we are discussing is specifically concerned with medical cannabis. Alexbrn 10:28, 3 December 2013 (UTC)
It is the established view on the subject. What matters is WP:MEDRS#Choosing_sources. Why are you discussing an abstract? Did you not read the study or did you get confused by the use of the term "medical cannabis"? It says, "There is minimal information available about drug interactions and contraindications with cannabis-derived pharmaceuticals and medical cannabis." (204) Have you read it? It says nothing about people who use medical cannabis and any association with schizophrenia. This is why you should follow MEDRS and not rely on abstracts. Viriditas (talk) 10:37, 3 December 2013 (UTC)
Viriditas, I appreciate reading your personal views and opinions on the matter, but for the purposes of this talk page and article content on Misplaced Pages, we must follow our medical sourcing guidelines over opinion. You have removed text cited to a secondary review and that can be cited to several other reviews. In talk page discussions, we need to stick to what sources say and avoid personal opinions. I hope it won't be necessary to re-tag the article when we have so many high-quality sources from which to work. You've provided no sources; there are scores of secondary reviews that discuss the same things in the text you removed. SandyGeorgia (Talk) 10:36, 3 December 2013 (UTC)
Sandy, I'm afraid you are mistaken. I've offered no "personal views and opinions", I've simply reviewed the unreliable sources under discussion. The text that was removed has nothing to do with this subject, and per WP:MEDRS#Choosing_sources we don't use or rely on abstracts. Perhaps you would like to review the source yourself and let me know which part is relevant here? Viriditas (talk) 10:40, 3 December 2013 (UTC)

The article (PMID 23386598) says:

The purpose of this article is to describe the pharmacology, therapeutic benefits and risks, and various dosage formulations that have been studied with medical cannabis. Specifically, medical cannabis for pain and muscle spasms, the most common uses of medical cannabis, will be evaluated using an in-depth evidence-based approach

. Alexbrn 11:07, 3 December 2013 (UTC)

Nope. You've been the victim of a bait and switch. It doesn't review medical cannabis and schizophrenia, and I have to say that the study authors were very sneaky because a casual glance at the abstract and study make it seem like they did, so I completely understand your confusion. The relevant material begins on p. 203, in a section called "Safety Concerns", subtitled "Adverse Effects, Drug Interactions, and Contraindications". It correctly starts off examining actual studies of medical cannabis users, which is referenced to Wang et al. 2008. Wang's data listing adverse effects can be found here. However, there's nothing here about schizophrenia. The authors continue until p. 204, where the bait and switch occurs. At the bottom of the page, in a subsection titled "Psychiatric Implications", they begin looking at the "Frequent use of cannabis, especially in adolescence" which they say "is associated with the development of schizophrenia" which they hedge by later following it with "the use of cannabis in adolescence does not cause schizophrenia but increases the risk of its onset, suggesting interplay between marijuana use and genetic predisposition for schizophrenia." Meanwhile, nothing here is based on any study with medical cannabis. But you're right, it sure makes it look like it is to outsiders. Very sneaky. Viriditas (talk) 04:36, 4 December 2013 (UTC)

Here is what a 2008 Cochrane review (considered by many the gold standard, YMMV, I have a Misplaced Pages subscription) says (note that the source Viriditas removed is five years newer, 2013 Borgelt):

For people with schizophrenia: At present, the data is too limited to support, or refute, the use of cannabis/cannabinoid compounds for people suffering with schizophrenia. For clinicians: There is insufficient trial-based evidence to support or refute the use of cannabis based interventions. Clearly the clinician cannot be sure that treating patients with cannabis/cannabinoid compounds is desirable practice.

Which to me is the same bottom line to our readers-- there are safety concerns which have prevented the use of medical cannabis. You (Viriditas) say there is no risk and have removed all mention of any safety concerns (including the other three in the sentence, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations); Cochrane 2008 says because the risk of schizophrenia is unknown so it is still unsafe; Borgelt 2013 says it is unsafe because there is a risk. Wherever our text falls on that continuum, we have sources that say that there are safety concerns wrt schizophrenia, yet we've removed all mention, including the rest of the sentence. We've left out something mentioned in secondary reviews, and we've done that so far based only on editor opinion with no sources offered. SandyGeorgia (Talk) 11:38, 3 December 2013 (UTC)

By the way, now I know how that text came to be added to the lead. See discussion above: Petra added one sentence from that source to the lead (why the lead), which is unbalanced, and the second source added by Petra is directly contradicted by the first, Borgelt 2013, but the text from the first was left out) so I expanded with the direct quote. And questioned why it was added to the lead. Can we not work on the lead last? SandyGeorgia (Talk) 12:04, 3 December 2013 (UTC)

There is a fair bit of evidence that cannibals use is associated with the risk of psychosis. . There is disagreement if it is causal but there is still a concern Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:29, 3 December 2013 (UTC)

There is no such causal evidence only associations which have never borne fruit. Correlation does not imply causation. Some cannabis users are schizophrenic. Some schizophrenics are cannabis users. What does that tell us about the risks of cannabis? What about causation? Multiple alternative hypotheses have not been ruled out, and this claim has not been proven in /actual/ studies of people who take medical cannabis, such as Russo et al. 2002. Russo et al. observed "no consistent or attributable neuropsychological or neurological deterioration" in a study of medical cannabis users. In addition to many other tests, they employed "MRI scans, neuropsychological tests, P300 testing, history and neurological clinical examination." The study that is cited in the article does not cite use by medical cannabis, it cites recreational cannabis users who may have been misdiagnosed, who may already have mental illness, or who are suffering from other disorders. The idea that cannabis causes psychosis is not supported by good evidence and the study in question does not concern patients who use it. These sources are being misused to claim that medical cannabis users are at a greater risk of mental illness, when actual studies of medical cannabis users have found no such association. The fact remains, the numbers of schizophrenia cases have gone down while cannabis use has increased. We would expect to see more cases of schizophrenia as cannabis use becomes more prevalent. That has not happened. Where are the rising cases of schizophrenia caused by medical canabis? Surely, we should see it by now. In 2011, depending on how you count the numbers, there were anywhere from 1-2+ million medical cannabis users in the United States. Surely we should be seeing a huge uptick in mental illness if this claim of causation had merit. Are we? No, we are not. At least 70% of kids have used cannabis, but for all this time schizophrenia only affects 1%. The numbers have not increased. If you want to talk about a risk to patients, then cite reviews of medical cannabis studies. Russo et al. 2002 did the research and found no such risk or result. Citing cases that study cannabis use in adolescents who are of the age of onset for mental illness, and who may have not been screened properly or misdiagnosed, and who are not (in the majority of cases) likely candidates for medical cananbis use (i.e. adults) is playing hard and loose with the facts. Let's look at the known risks in relation to the facts: in just the years from 1999-2009, 300,000 Americans died from legal prescription drugs. And, according to the CDC, "more deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined." So, legal prescription drugs, legal tobacco, and legal alcohol are the big killers. Any idea how many people died from using medical cannabis last year? More to the point, how many people who had a prescription for medical cannabis were admitted to hospitals for adverse effects? If you don't know the answers to these questions, then tell me how you can possibly claim that medical cannabis can lead to mental illness? Please don't cite me irrelevant, associative studies of recreational drug use by teenagers or CYA, mandatory disclaimer legalese on the back of pharmaceutical boxes. Show me the evidence. Viriditas (talk) 03:30, 4 December 2013 (UTC)
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