I did medical research as an undergraduate medical student at Heidelberg University, and I published five papers—both basic science or animal work and clinical investigations. I was a research fellow at Harvard Medical School in my postgraduate training, which was one of my three fellowships after an internal medicine residency at Harvard. I am extremely familiar with investigations of this nature, and I've been looking into the research evidence that supports the use of cannabis as a treatment.
There are extremely well-done, randomized, placebo-controlled trials, both in Canada and the United States, and in other countries, that support the use of cannabis and its safety and efficacy. One study by Donald Abrams, published in 2011, showed that the use of cannabis—in that particular study it was vaporized—in conjunction with prescription opioid pain medicines allowed a reduction in the dose of the narcotic pain medicines by 25%. In and of itself, that is an important way of decreasing the risk that patients are exposed to in the use of opiates, and the pain control was equally good.
There have been studies in Canada by Dr. Mark Ware, whom you may well know, who showed that inhaled cannabis—smoked, again—was efficacious for the treatment of neuropathic pain.
One of the problems, however, with being able to do these types of studies that we are all familiar with as physicians and scientists is institutional bias—particularly in the United States—against doing studies involving cannabis. There is a very clear disinterest in showing that cannabis may have any medical benefit, and that has limited our ability to carry out appropriate studies. Nonetheless, the study I cited by Dr. Abrams was done with permission by the National Institute on Drug Abuse in the U.S., and there are other studies that are equally demonstrative of benefit.
In terms of risk, other studies have shown poor evidence that using cannabis is linked to any sort of development of psychiatric or physical disease.