Marijuana’s health benefits are widely touted but poorly understood. This release does little to add to the evidence. The health claim made in the headline has little to do with what was evaluated in the published study. There is no true quantification of the benefits of marijuana as a therapy for preserving cognitive function in AIDS patients, no context about the risks associated with smoking marijuana, no comparison to alternatives, no mention of costs, and not much in the way of explaining the strength of the study in question. This is especially problematic when it comes to marijuana. Like chocolate, marijuana is something that is often heralded for its health benefits, often with questionable findings underpinning the claims.
As noted above, marijuana is widely used and many claims are indeed made about its benefits. It’s great that this study was undertaken if it adds to the body of knowledge. The objective of the study, however, was not to make clinical recommendations on marijuana benefits for HIV patients as suggested in the headline. According to the study, the objective was to measure the level of a biomarker indicating the presence of inflammation in HIV patients who used marijuana compared to those who did not.
Researchers still need to better understand the plant’s biology and physiology to determine which populations will in fact benefit from its use, and to determine the best modes of delivery, dosing schedules, etc.
There is nothing in this release about costs. And there’s really nothing about dosing, either. So a reader and an HIV patient would have no idea what a true marijuana therapy would cost to see any — assuming there are any — benefits.
The release notes that the study relies on self-reporting of marijuana use by the blood donors and then correlation with THC levels in the blood. We are at least a couple steps away from knowing how much THC is needed for an actual clinical outcome (which is not addressed in the study) and as a consequence would not be able to estimate cost.
The first sentence makes a bold claim about benefits: “A chemical found in marijuana, known as tetrahydrocannabinol, or THC, has been found to potentially slow the process in which mental decline can occur in up to 50 percent of HIV patients, says a new Michigan State University study.”
Based on the research, this statement about benefits is problematic. There is nothing in the study that showed the people who used marijuana had higher cognitive function than non-users. No cognitive function was measured. Instead, researchers were looking at biomarkers for inflammation that may–may–be linked with cognitive decline, but no one is sure yet. So even if marijuana users have less of these particular inflammatory biomarkers, they may still suffer mental decline for other reasons.
It’s also not clear what “up to” 50 percent of patients means. Does this mean that 50 out of 100 HIV patients saw their mental faculties preserved by marijuana? Or does it mean that 20 out of the 40 people mentioned in the study saw a benefit? It is unclear and misleading. That phrase “up to” always gives us pause. Be clear with your audience. Show them the math.
There is nothing in the release about the harms of ingesting or smoking marijuana. The release (nor the study) never mentions specifically how the HIV patients consumed their marijuana — whether through smoking, edibles, cannabis oil or other means, or any potential risks associated with any of the methods.
Anytime we inhale smoke into our lungs we are taking a risk. At a minimum, some of those risks should be mentioned. And, better yet, if the study did not adequately track patients to assess the negative effects of marijuana smoking or otherwise ingesting, that should be acknowledged.
It’s likely that the negative impact of marijuana was not mentioned because the study was in vitro (using blood samples). However, that underscores the fact that no true clinical correlation can reasonably be made from this study alone.
There is one tiny mention of the fact that the study was published in the journal AIDS so we are to presume it underwent peer review and some sort of editorial scrutiny. But there are no caveats about the study mentioned and not a very clear explanation of how it was conducted. For example, were the 40 patients equally divided between those who smoked marijuana and those who did not? Was any of this smoking done in the presence of the researchers? Was this all just based on self-reporting? If so, this is highly problematic, especially with a drug that is still illegal in many places by federal law.
It’s unfortunate because as a “hard science” paper, it seems pretty rigorously done and would stand on its own merit, but the release leaves out details which would make the purpose of the study more clear. The study was not designed to show clinical outcomes.
There is no disease mongering in the piece.
The funding sources of the study are not mentioned.
There is no mention of any alternatives in the release.
Given that marijuana is still illegal in most states and considered illegal by the federal government, it would be worth mentioning that patients hoping to receive a marijuana treatment would have to live in a state where it is legal for medicinal purposes.
The release does not establish the novelty of the findings.
We find the headline and the quotes in the story unjustifiable given the lack of supporting evidence. This is significant speculation on a study this small with a protocol that appears to be little more than surveys plus blood cell examination.
Systematic, Criteria-Driven
The inimitable @garyschwitzer has published an opinion piece on how health journalism contributes to public health outcomes - and why the industry works the way it does.
US-centric, but Australian journos will find this helpful.
#aushealth https://t.co/zBDaOOsMGx
In the latest installment of @JAMA_current's series on the public's eroding trust in health care, @garyschwitzer calls for improving the accuracy and quality of health journalism https://t.co/kgCNz0BTgq
Comments (1)
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Kip Hansen
December 13, 2017 at 5:42 pmFar too many of these marijuana studies are performed by groups active in the advocacy of marijuana legalization — and promote unfounded/unproven “benefits” for this specific purpose.
The study in question was performed by “MSU’s Institute for Integrative Toxicology, has studied the effects of marijuana on the immune system since 1990. ” — that’s 27 years of advocacy. The chemical they claim is responsible for the “anti-inflamatory” affect? THC — the psychoactive chemical responsible for the “high” achieved by pot smokers.
The study in question did not quantify marijuana use — only tested drawn blood for marijuana metabolites, so there is no possible dose response data. They also did not test for actual mental functioning, the only testing was for inflamatory biomarkers.
There may be some medical science in there somewhere — but it is lost in the MSU press release’s pro-pot advocacy.
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