With 23 US states and the District of Columbia already having legalized marijuana for medicinal use, Rick and I agree on PodMed this week that the horse is out of the barn with respect to its widespread utilization. Yet we discuss two studies in JAMA this week examining the trials that have attempted to scrutinize the purported benefits of marijuana and are forced to agree with the editorialist that better trials are needed. The primary study is a meta-analysis of all databases since inception to April 2015; rather dauntingly comprehensive, we agree! Studies included examined the benefits of medical marijuana for a variety of conditions ranging from side effects of chemotherapy to spasticity. Almost 6500 subjects comprised the study cohort. In short, the authors found moderate quality evidence that marijuana was beneficial for chronic pain and spasticity, but low quality evidence supporting its use in the remainder of conditions examined. Moreover, a significant risk of a range of side effects, ranging from dizziness to frank hallucination, was found. Sounds like a need for high quality studies to us.
Other topics this week, all from NEJM, include bridging anticoagulation for those with atrial fibrillation on blood thinners, an antibody to reverse the common anticoagulant dabigatran, and screening for cancer in those who present with unprovoked deep venous thrombosis. Until next week, y'all live well.
Other topics this week include