Sure. I can address that.
This is not really true and it's not been validated in studies. The studies that have been done on smoked cannabis were very small, and they compared smoked cannabis to placebo.
In the only trial we could find that compared smoked cannabis to an oral cannabinoid, called dronabinol, the dronabinol was actually superior. It caused longer pain relief than the smoked cannabis. That was the only study that we could find. There are reasons for that. The metabolism of oral cannabinoids make it last longer than smoked cannabis.
In any event, I don't believe this is at all an established fact, that smoked cannabis is more effective than oral cannabis. I think many patients and individuals who smoke cannabis confuse its psychoactive effects—its pleasant psychoactive effects of euphoria and relief of anxiety—with pain relief.
The fact is that if you are prescribing a medication for pain relief, what you absolutely do not want is to make the patient cognitively impaired and experiencing the mood-altering effects of a drug every day, all day, for years on end. Smoked cannabis is so far from any other prescription medication in terms of proof of effectiveness or safety that Health Canada would never even come close to approving it as a medication, if it weren't for this essentially political process of the new medical marijuana regulations.
Furthermore, there is no medication in the world that is delivered by a smoked delivery system, where you actually burn a plant product. That's a very primitive way of delivering a medication. It gives an uncontrolled, very high rise in THC levels and a sharp decline, and it contains numerous harmful products that are carcinogenic and cause heart disease and stroke and other problems.
I know that people say that it's so much better and it contains magic ingredients that haven't yet been identified. I think that there is a strong possibility that patients and other individuals who say that are confusing its psychoactive effects with its actual therapeutic benefit.