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Marijuana Relieves Chronic Pain, Research Shows


2 Star

Marijuana Relieves Chronic Pain, Research Shows

Our Review Summary

The story did point out some good details that were missed by Reuters Health, but, overall, it managed to say less with more words. Unlike the Reuters Health story, for example, this story failed to note that the study covered a very selective subpopulation of pain sufferers, meaning the findings, even if ultimately validated, do not apply to most readers with chronic pain.


Why This Matters

Because stories like this are often reduced to little more than one sentence in a news feed on a web page or 140 characters in a tweet, it is crucial to set the right tone up high. This story fails to present a balanced and measured assessment of the importance of the study from the over-reaching headline to some of the more boosterish sections in the text.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory
There is no discussion of costs in the story. Couldn’t sample costs have been obtained by calling a medical marijuana outlet in California?

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory
Both stories did one very important thing when writing about a study this small. They presented the evidence in absolute terms rather than relative terms, which tend to mask the small scale of a study. People on placebo had a pain level of 6.1 and people on the highest dose of marijuana had pain of 5.4. Both of those numbers are still on the high side, given that zero is pain free. The Reuters story demonstrates that the 0.7 difference in pain quality did not affect the quality of life for these patients, but this story implies and repeats the significance of the 0.7 difference, going so far as to let the author of the study state, "We’ve shown again that cannabis is analgesic." A careful reader of the actual research article would question this.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory
Neither story actually quantified the harms, but they both noted there were side effects. This story received an unsatisfactory rating for missing the salient detail that the only dose of marijuana that made any difference in pain relief was the dose that also caused the most side effects. Also, the study reports on 21 patients. One subject withdrew because of INCREASED pain on the lower dosage cannabinol. If the trial were expanded, one could expect that you could have about a 5% chance of getting worse with this drug. Another fact worth noting.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory
This story waits too long to explain that this is only a study of 21 people over a very short period, unlike the Reuters Health story, which put the scope of the study in the lead. It could have done a better job discussing the limitations of the study. It does note one crucial detail that the Reuters Health story missed. “The participants were allowed to continue on their routine pain medications.” It doesn’t use that information to evaluate the quality of the evidence, though. Well then how do they know what truly caused the pain relief or whether the marijuana interacted differently with each person’s specific meds? The reporter did a good job of describing how the study was conducted, but failed to mention the great strengths of randomized crossover design and double blinding. The story should have noted the evidence that the blinding of the subjects was unsuccessful, as Reuters Health pointed out.

Does the story commit disease-mongering?

Not Satisfactory
Some quantification of how many people may suffer from chronic pain would have been good context. One of the important aspects of the research is how limited it is. It applies to a small subpopulation of adults with pain: those with neuropathic pain of at least three months duration who had sustained a physical injury due to surgery or trauma. The researchers had to consider about 5 chronic pain patients to get each subject. (The study is not broadly generalizable). Neuropathic pain is a special kind of pain. By not emphasizing this, the story may be read as applying to anyone with chronic pain. (The subheadline – "Three puffs a day helped people with nerve pain, study finds" – is not specific enough as all pain involves nerves.)

Does the story use independent sources and identify conflicts of interest?

The story quotes one outside expert, Dr. Henry McQuay, who also was quoted by Reuters Health. He provides some much needed context, given the boosterish quotes from the lead author. He describes current research on marijuana as “a trickle of evidence that cannabis may help some patients who are struggling at present.” But, unlike the Reuters Health story, this reporter also details McQuays conflicts, letting readers decide whether to take his words with a grain of salt, given that he serves on an advisory board for Pfizer, which makes painkillers. Why not also explain who funded the study? There is one small caveat with McQuay. He wrote an editorial accompanying the study. It would have been nice if WebMD had gone to the lengths Reuters Health did in finding an expert beyond just the two who appear side by side in the journal together.

Does the story compare the new approach with existing alternatives?

Not Satisfactory
This story alludes to “other remedies” and “existing treatments” but, unlike the Reuters Health story, does not get into the specifics.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory
Neither story explains that marijuana is illegal in most states and in Canada, where the study took place. This may seem obvious, but it goes right to the heart of how useful this information is. The story could have listed the states with medical marijuana laws or talked about other countries that have legalized marijuana. Given the lack of quality/dosage standardization for this illegal product, those readers who try to use the drug in a therapeutic way cannot reliably buy or administer the dosages studied. Thus, availability is an issue on another level as well.

Does the story establish the true novelty of the approach?

This story does a better job than the Reuters Health story in establishing how this study is attempting to bring some scientific rigor to what has been discussed anecdotally. As the study’s lead author says, “About 10% to 15% of patients attending a chronic pain clinic use cannabis as part of their pain strategy.” The news release says this is “the first trial to be conducted where patients have been allowed to smoke cannabis at home and to monitor their responses, daily". That should have been made clear in the story.

Total Score: 3 of 10 Satisfactory


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