Drug Czar criticizes randomized placebo-controlled scientific experiment as flawed methodology

From Scientific American today we learn of a study published in the journal Neurology that marijuana helped HIV patients reduce chronic foot pain.

A quick aside here, before commenting on the Drug Czar’s knee-jerk uninformed reaction to this…

HIV-Associated sensory neuropathy is a serious condition affecting almost one third of HIV/AIDS patients. According to Medscape Today, it is characterized by complaints of bizarre burning feelings, lancinating pains, and an increased perception of pain including “pain from stimuli which are not normally painful or noxious”.

I’m neither a doctor nor an HIV or AIDS patient, and frankly I had to look up the meaning of “lancinating”, but I think we can all agree it sounds terrible. This is real suffering, and thank goodness there are scientists pouring their efforts into helping those afflicted.

Now the scientific method demands that to properly study a particular drug’s effect on something, you must take a random sample of people, include a placebo, and measure to see whether there is a statistically significant difference between the drug and the placebo. If there is, you know you’re on to something.

Much of modern medicine is actually based on epidemiology,which studies patterns in populations of people after the fact, and tries to derive causes based on the patients’ histories. That’s all very well, and many times it’s the only available method for studying disease, but in the end, it doesn’t prove causation. It only gives us some good starting points for guesses.

The medical doctors and researchers in the study, however, randomly assigned half of the group to smoke cannabis (at 3.5% THC Content), and half to smoke the same cigarettes with the THC content extracted. Just over half of the cannabis group reported significant pain reduction, as opposed to less than a quarter of the placebo group.

So, can we get the office of the Drug Czar to weigh in on this for us?

David Murray, the White House Office of National Drug Control Policy's chief scientist, said, "Unfortunately, this particular study is not terribly convincing," citing what he saw as methodological problems.

"Unfortunately, it will lead many people into a false hope that street marijuana is somehow going to be the thing I can use that will make me feel better and won't jeopardize my health. Now that is a fraud and a dangerous one," he told Reuters.

So a randomized placebo-controlled experiment is flawed…says the folks who are still trying to sell you on the logical fallacy known as the “Gateway Theory”.

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Todd - March 17, 2007 2:13 AM

If only treatments for HIV were held to the same degree of placebo-controlled randomization as the cannabis study cited here.

I suppose the irony is lost on people, especially HIV/AIDS researchers though.

Placebo controls ? What's that ?

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