The studies cited by this metastudy all suffer from the same issue: They aren't studying the cannabis plant at all and even if they are, it's not in the chemovars (chemical makeups) that real consumers are actually consuming - due to cannabis sourcing issues stemming from cannabis's continued illegality.

For randomized controlled trials, even in "legal" states, university scientists can't just walk into a dispensary and buy cannabis to then administer to test subjects.

That's Post-Prohibition for you.

As far as I can tell, most (EDITED FROM ALL) of the studies utilize isolates - and not necessarily in conjunction.

For instance, none of the 6 anxiety studies included in this metastudy used THC and CBD together.

The headline could read instead: No evidence cannabinoid isolates help anxiety, depression, or PTSD.

Cannabis advocates are the first to mention the entourage effect. Cannabis prohibitionists on the other hand, love nothing more than to cite incomplete science.

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Aurornis 2 days ago | parent | next [-]

Using quantified isolates is the correct way to do a controlled study. Dosing is important.

Claims that you need a special combination of exactly the right strains are just a way to move the goalposts forever. They could study 10 different strains in controlled trials and the same people would show up to dismiss this study because they weren't using some random strain that has some perfect combination of entourage effect.

Using actual plants and smoking would also introduce another major variable, with further claims that the strains they were giving patients were too weak or they were smoking it wrong.

EDIT: I don't have time to read every single citation included, but the claim above that they were all THC or CBD isolates does not appear correct. One randomly selected citation:

> The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: a randomized cross-over clinical trial

So the claim above that they didn't investigate smoked cannabis or "entourage effect" is false.

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tannedNerd 2 days ago | parent | next [-]

Way to completely misunderstand and try in an underhanded way to the dismiss entourage effect.

It’s not smoking 10 strains in a row it’s the fact that you need CBD THC and all the terpenes to get the effects. So the current growing trend of just getting the THC number higher tends to result in plants that don’t actually give people the full spectrum of effects, beneficial or not.

So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.

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Aurornis 2 days ago | parent [-]

> It’s not smoking 10 strains in a row

I never said it was. I was saying you could run 10 different studies on 10 different strains with 10 different "entourage effect" profiles and even if all of them were negative, they would be dismissed as not having precisely the right entourage effect.

If there are anti-depressant compounds in cannabis plants then they can be extracted and isolated, too.

> So the correct way to do this would be a full spectrum isolate, which again you coincidently forgot to mention I’m sure.

Of course, the correct formulation is something other than what was tested, right? And if they tested a full spectrum isolate with negative results, we should assume that it just wasn't the right blend of terpenes and therefore that study should be dismissed too? Repeat ad nauseum?

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plurinshael a day ago | parent [-]

Why would you not have to try each and every combination of features known to create a different effect on the outcome?

There are what, 500 different psycho-active chemicals in cannabis? And how many different kinds of neuro-chemicals can our brains create in synapses? And how do we even begin to organize the ways that that information is transmitted to the structure (topology) of the neural systems? And their firing action logic? And the behavior of the whole organism in question?

Seems like like multiple, multi-linear variable spaces composed within each other. None of which are understandable independently of the other. None of which are perfectly mapped or traverscible landscapes. Why wouldn’t you have to try each and every possible configuration of the system in order to understand how it works?

We are not even working with a strong philosophical foundation or definition of consciousness. We must explore every possibility, leave no stone unturned.

	▲	Aurornis a day ago \| parent [-]
		> There are what, 500 different psycho-active chemicals in cannabis? I think you're extrapolating from exaggerated factoids. There are only a small number of compounds in cannabis that exist at the intersection of: - Present in high enough quantities to matter - Not destroyed during smoking/vaping/processing - Bioavailable enough to enter the bloodstream - With the correct chemical structure to penetrate the blood-brain barrier - Potent enough to elicit effects at the concentrations achieved in human consumption There are not 500 compounds in cannabis that fit this criteria. The number is much smaller. If there was some combination that achieved dramatic antidepressant effects where typical cannabis failed, don't you think someone would have noticed by now? There's no reason to assume that some combination of 500 different variables exists to do something that we haven't observed yet. There are much more fruitful paths to research than endlessly researching every variation of cannabis for the sake of researching cannabis.

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bitxbitxbitcoin 2 days ago | parent | prev | next [-]

> Using quantified isolates is the correct way to do a controlled study. Dosing is important.

That's the correct way to do a controlled study on the isolate - not the plant that it comes from.

It's clear to me at least that the authors of the metastudy conflate the two and many shades between them for purposes of this study.

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lokar 2 days ago | parent | prev | next [-]

I think that's a bit of a straw man.

You could study one combination that is broadly representative and is much much closer than the isolate.

	▲	Aurornis 2 days ago \| parent [-]
		They included studies which looked at multiple different smoked cannabis varieties. The claim above about only looking at isolates was false.

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bitxbitxbitcoin 2 days ago | parent | prev [-]

That's a great example study to highlight what I really mean by entourage effect. I've edited my post to emphasize most not all - i only looked at the 6 anxiety studies as that's what I have the most experience with - as well as the included table which highlighted that the vast majority of studies included in this metastudy only looked at THC.

That particular study did look at High THC low CBD, mid THC mid CBD, and high CBD low THC. There's no information on the terpene profile of the smoked cannabis preparations, though, and that is a confounding variable in the entourage effect that potentially defeats the part of the entourage effect they did test. Additionally, a quick look at the cannabinoid %s in those smoked preparations rehighlights my point that these are not inclusive of all the chemical compositions that the cannabis plant could present itself in.

I still stand by my point and hope the clarifications bring the conversation back on track to the fact I was highlighting which is simply that this is a metastudy built off of studies that were conducted with restrictions on experimental design that few observers fully understand the research implications of.

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post-it 2 days ago | parent | prev | next [-]

Yeah, I noticed this too. Canadian universities have been studying cannabis use using actual cannabis, so I'm not sure why this metastudy considered anything else. "We need to publish something" perhaps.

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pipeline_peak 2 days ago | parent | prev [-]

>The headline could read instead: No evidence cannabinoid isolates help anxiety, depression, or PTSD.

There’s no evidence that what they tested with was pure THC isolates. If they’re using cannabis in plant form, even if it was bred for higher thc content, there is still cbd.

	▲	bitxbitxbitcoin 2 days ago \| parent [-]
		Those that are interested to click through should and see the studies cited by this metastudy and whether they used whole plant cannabis extracts, cannabis isolates, or even non cannabis derived isolates. tldr; "If they're using cannabis in plant form" is a very, very high bar for the current state of cannabis (really cannabinoid) research.