alt Hacker News> Evidence from randomized clinical trials does not support the use of cannabis or cannabinoids for most conditions for which it is promoted, such as acute pain and insomnia.
I once slept in a hoodie with the hood under my back and woke up with horrible back pain, I could not sit still or focus on anything but the pain, 800mg of ibuprofen did nothing. I was about to go to the ER or urgent care when a doctor friend suggested trying cannabis, I took one small hit and was immediately pain free. I have never experienced such a dramatic medical effect in my life, one second I was writhing in pain and the next I was completely fine.
I’ve also seen videos of epileptics calming their seizures from cannabis. The autism community often speaks highly of it, how it makes them feel “normal” or more regulated. I’ve heard of stories of people getting off opioids by using cannabis. I think the people who get anxiety from it or no relief from insomnia are often taking far too much because there aren’t any good guidelines for self medicating and the guidelines they do get are from recreational users.
All I have are anecdotes, but given how obvious the effects were, I find it hard to believe there’s no medicinal value to cannabis.
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I fully accept there is pain relief value. What I wish were better studied is: what are the short, medium, long-term effects of using it at various dosages?
For example, it's pretty widely agreed that it (anecdotally) causes anxiety at higher doses - how high of a dose?
You do realize that your case has as much evidence that passage of time fixed your problem (or anything else that transpired) as it does for cannabis? And that is why people do randomized trials.
A substance can have pharmacological effects and still not be recommended for therapeutic use. As a hyperbolic example, suppose a substance relieved all pain for 1% of the population but caused death in everyone else. Even with a highly precise screening process this substance likely would not be administered in medicinal contexts.
Acute pain isn't discussed in detail in this paper, but here's a paper they cited:
> Conclusions: There is low-quality evidence indicating that cannabinoids may be a safe alternative for a small but significant reduction in subjective pain score when treating acute pain, with intramuscular administration resulting in a greater reduction relative to oral.
https://dx.doi.org/10.1089/can.2019.0079
For insomnia, this paper itself says:
> meta-analysis of 39 RCTs, 38 of which evaluated oral cannabinoids and 1 administered inhaled cannabis, that included 5100 adult participants with chronic pain reported that cannabis and cannabinoid use, compared with placebo, resulted in a small improvement in sleep quality [...]
It goes on to criticize those studies, but we again see low-quality evidence in favor.
In the context of evidence-based medicine, "does not support" can mean the RCTs establish with reasonable confidence that the treatment doesn't work. It can also mean the RCTs show an effect in the good direction but with insufficient statistical power, so that an identical study with more participants would probably--but not certainly--reach our significance threshold. The failure to distinguish between those two quite different situations seems willful and unfortunate here.