"On the links of cannabis to cancer & genotoxicity by two of its best researchers, Reece & Hulse"
The research of Reece and Hulse is a lot more controversial than your praise implies. From reading their work and researching more about their reputations, they're anti-cannabis jihadists. To read them, one would get the impression that cannabis is some sort of mega-thalidomide that's been loosed on the world; they've stated conclusions to the effect that cannabinoids are one of the principal environmental carcinogens. Just because they publish a lot of work does not mean that their research is authoritative. They rely on bundling studies selected for their negative conclusions about cannabis effects, and then subject the aggregate to the sort of regression analytical methods that can torture the data into saying almost anything, particularly when confounders are ignored. This most recent published compilation by them is pretty much of a rehash of earlier published research, as can be verified by perusing earlier issues posted right here on your Substack.
I don't think that cannabis is harmless, particularly high-potency THC products; You've linked studies on negative effects that I find persuasive. But it's nowhere near the public health catastrophe that Reece and Hulse are speculating that it is, and it's dismaying that their alarmism is granted credence anywhere, much less on this site.
It needs to be consider that along with responsible research, the recent explosion in post-legalization era cannabis research appears to included a well-funded effort directed at making cannabis wrong in order to thwart legalization of this non-patentable natural substance. The pharmaceutical industry would prefer to have all cannabinoids corraled under their control as synthetic patented product lines, to dispense or withhold at the behest of their influence and authority.
Anti-cannabis jihadists is a good word for them. I see how negative they are in their messaging.
But, while this isn't my field & maybe I'm getting bamboozled, it seems like their public health data is solid on the moderate links to some cancers & birth defects. At least, I've never seen any other researcher push back on the results themselves.
I suspect the link to testicular cancer is the strongest because I see something like that about once a month - and for the other cancers & birth defects where you see less human data, what we know about from preclinical research certainly makes it appear that the mechanisms exist for this to happen.
So yes, while I certainly don't think that cannabis is the public health catastrophe that they make it out to be - and I still "head to the basement" most nights - but from what I've seen from watching the data flow the last 5 years, I suspect that they're about right
Lex, I appreciate the honesty of this site, publishing every medical study you can find, positive and negative. It's an excellent clearinghouse for information. I've definitely changed my mind about the harm profile of cannabis in some respects. The massive increase in availability of the strongest products--and the increase in THC content in those products--indicates to me that the industry needs to check itself--or else it will be put in check forcibly, likely by over-reaction, possibly even re-criminalization. Strong cannabis and extracts are too easily overused, and chronic abuse is when the most serious problems result.
It also has to be said that cannabis is being studied now to an extent that it never was in the era before commercial legalization in US states. Some of that research appears to me to elevate the goal of making cannabis wrong and dangerous over he ethical approach of principled impartiality. The funders of the more spurious studies have expectations, it seems. I find this most notably true in the studies related to driving; if the same rigor was applied to caffeine as is found in some of the studies, coffee DUI would be held to be a rampant epidemic. Millions of people with prescriptions for benzos and opioids--often regular users--are allowed to drive without a priori assumptions about impairment, per se. I'm dismayed by attempts to suddenly turn cannabis into a serious driving impairment hazard in the aftermath of state legalization. I'm skeptical of BAC levels being considered as anything other than support evidence in DUI cases, for that matter. They should be held as supplemental to camera evidence of impaired vehicle handling, at most. I'm not saying that to excuse my own conduct, either; I'm essentially a nondrinker at this point in my life.
The medical studies related to physical problems like COPD and cancers appear to be more objective, but they're also mostly correlative in an era where we're finding an increasing number of confounding factors. Xenoestrogens, petrochemical pollutants, invisible air pollution from aerosols, herbicides like glysophate...these are all significant problems that are only now emerging to the scrutiny of researchers. We're now being told that many of us are carrying around a plastics load the weight of two credit cards, about half of it in our brains. As it's an accumulating exposure, given my age all I can do is be thankful that most plastics appear to be inert within body tissue, although the same can't necessarily be said for the breakdown products. I didn't order any of that. I advise people against using high-strength cannabis in large amounts, especially as a regular practice. Especially in early youth. But it's become a subject of inordinate attention, to the point of being scapegoated for a wide array of problems in advance of reliable evidence.
In that regard, view is that medical studies need to be reviewed one at a time, for their methodology and their conclusions. There's an increasing trend in medical studies of all sorts to take opportunities to aggregate data from multiple studies and run regression analysis with the numbers. Medical studies are not economic statistics--and the problems of statistics abuse are bad enough in the case of studies of economic performance. The abuses of medical metastudies are often worse. The hyperbole found in the studies by Reece and Hulse are a prime example of that problem.* The methodology of the most sweeping condemnations of cannabis found in papers by Reese and Hulse is not intensive clincal biological study; instead, it's a form of epidemiological study that draws correlative conclusions from "geotemporospatial and casual inferential overview" of compiled data sets from a wide array of studies. Polite--but pointed- skepticism of the conclusions of one of their most prominent papers is found here: https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-022-00932-0
"While the authors use reputable datasets and a well-established epidemiological methodology, the authors’ conclusion of a causal association is limited due to biases inherent in ecological epidemiological studies. Though the researchers attempt to overcome these biases through validation and statistical manipulations, their approaches are insufficient to create conditions suitable for causal inferencing upon examination. There are also concerns in the practical and conceptual application of the studies’ dataset that further question the validity of the authors’ inferences. Further research exploring the potential benefits and harm of cannabinoids in the context of cancer must be performed before a distinct relationship can be defined..." The writer then goes on to unpack their research at length, as can be read by accessing the link above. It makes for thought-provoking reading, for those of us with an appreciation of dryly detailed critique.
Extra credit, for those with a taste for that sort of thing: have a look at this paper by Reese and Hulse https://journals.sagepub.com/doi/10.1177/2333794X19894798 which alleges that there's a high likelihood that cannabis use causes neural tube defects. That conclusion is based on a reading of statistical studies (eliding group survey statistics on self-reported cannabis use with documented medical outcomes) using the aforementioned "geotemporospatial and casual inferential" methodology and applying regression analysis to posit that cannabis is responsible for an increased incidence of spina bifida. Check the data sets used for comparison (the authors themselves offer the caveat that there are some gaps in the data they're using for evidence.)
Between the strange assemblage of data sets and the absence of any attention to the presence of possible confounding factors (overlaps with water supplies drawn from tar sands, rates of alcohol abuse, other problems unknown) that almost exclusively "geotemporospatial" semi-epidemiological study looks like Proofiness to me. If anything, the use of regression analysis only obfuscates its inherent problems. But--to this day--what credential medical researcher wants to "defend cannabis" against the allegations in a study making those charges, no matter the shoddiness of the methodology and its speculative conclusions? How much of a payoff would there be for anyone professionally, notwithstanding their defense of scientific rigor and principled integrity? Even a pro bono refutation could subject the professional offering it to insinuations of a suspected alliance with Big Cannabis, etc. (Incidentally, who paid for the study by Reece and Hulse?)
I don't like bad, biased, propagandistic scaremongering passed off as legitimate epidemiology. Bad research and bad researchers deserve to be taken down. I regret that I don't have the credentials to do it. But if my criticisms have the merit that I'm contending, some credentialed professional should be able to highlight the specific credibility problems present in at least some of the research by Reece and Hulse, along with the extravagant speculations of their conclusions, which they imply as authoritative and conclusive.
While I don't have the time right now, a while back I did enough keyword searches into Reece and Hulse to learn that they have been repeatedly criticized for their lack of objectivity and probity, both in regard to the subject of cannabis and their approach to addiction medicine (where Reece has a practice in Australia.) Reece in particular has been criticized, iirc; Hulse appears to be a junior associate (and unlike Reece, not a medical doctor.)
Interesting that the Reece-associated link below refers to the pernicious influence of the cannabis lobby in Australia; as the links to support groups (including in the US) show, the cannabis prohibition lobby is also well-funded, and many of the listed organizations have been in existence for years. https://drugfree.org.au/images/pdf-files/homepagepdf/DRReeceSupport2020_updated6May2020.pdf
Reece and his allies apparently put an extraordinary amount of energy into having his research studies disseminated as widely as possible. His research papers are widely circulated, even though many of them appear to be rehashes of the same research, slightly modified and submitted for publication as new papers.
While cannabis in currently in the hot seat for its possible role in exacerbating mental health problems, I don't find nearly as much attention paid to the mental health problems associated with being an officially ordained social pariah, including legal harassment, entanglement with the courts, mandated rehabilitation for uncomplicated simple possession--and, above all, the deleterious effects of incarceration on the body and mind of the incarcerated, and the indirect impacts on family members. (By the way, what percentage of the incarcerated population--or those subjected to enforced rehabilitation for drug abuse--are eventually put on a daily regimen of prescription drugs such as SSRIs or antipsychotics?)
[*By contrast, metastudies featuring research into the correlation between high-potency cannabis use in youth and increased incidence of developing acute psychotic incidents and other severe mental problems appears to be well-grounded, and deserving of more investigation.]
"On the links of cannabis to cancer & genotoxicity by two of its best researchers, Reece & Hulse"
The research of Reece and Hulse is a lot more controversial than your praise implies. From reading their work and researching more about their reputations, they're anti-cannabis jihadists. To read them, one would get the impression that cannabis is some sort of mega-thalidomide that's been loosed on the world; they've stated conclusions to the effect that cannabinoids are one of the principal environmental carcinogens. Just because they publish a lot of work does not mean that their research is authoritative. They rely on bundling studies selected for their negative conclusions about cannabis effects, and then subject the aggregate to the sort of regression analytical methods that can torture the data into saying almost anything, particularly when confounders are ignored. This most recent published compilation by them is pretty much of a rehash of earlier published research, as can be verified by perusing earlier issues posted right here on your Substack.
I don't think that cannabis is harmless, particularly high-potency THC products; You've linked studies on negative effects that I find persuasive. But it's nowhere near the public health catastrophe that Reece and Hulse are speculating that it is, and it's dismaying that their alarmism is granted credence anywhere, much less on this site.
It needs to be consider that along with responsible research, the recent explosion in post-legalization era cannabis research appears to included a well-funded effort directed at making cannabis wrong in order to thwart legalization of this non-patentable natural substance. The pharmaceutical industry would prefer to have all cannabinoids corraled under their control as synthetic patented product lines, to dispense or withhold at the behest of their influence and authority.
Anti-cannabis jihadists is a good word for them. I see how negative they are in their messaging.
But, while this isn't my field & maybe I'm getting bamboozled, it seems like their public health data is solid on the moderate links to some cancers & birth defects. At least, I've never seen any other researcher push back on the results themselves.
I suspect the link to testicular cancer is the strongest because I see something like that about once a month - and for the other cancers & birth defects where you see less human data, what we know about from preclinical research certainly makes it appear that the mechanisms exist for this to happen.
So yes, while I certainly don't think that cannabis is the public health catastrophe that they make it out to be - and I still "head to the basement" most nights - but from what I've seen from watching the data flow the last 5 years, I suspect that they're about right
Lex, I appreciate the honesty of this site, publishing every medical study you can find, positive and negative. It's an excellent clearinghouse for information. I've definitely changed my mind about the harm profile of cannabis in some respects. The massive increase in availability of the strongest products--and the increase in THC content in those products--indicates to me that the industry needs to check itself--or else it will be put in check forcibly, likely by over-reaction, possibly even re-criminalization. Strong cannabis and extracts are too easily overused, and chronic abuse is when the most serious problems result.
It also has to be said that cannabis is being studied now to an extent that it never was in the era before commercial legalization in US states. Some of that research appears to me to elevate the goal of making cannabis wrong and dangerous over he ethical approach of principled impartiality. The funders of the more spurious studies have expectations, it seems. I find this most notably true in the studies related to driving; if the same rigor was applied to caffeine as is found in some of the studies, coffee DUI would be held to be a rampant epidemic. Millions of people with prescriptions for benzos and opioids--often regular users--are allowed to drive without a priori assumptions about impairment, per se. I'm dismayed by attempts to suddenly turn cannabis into a serious driving impairment hazard in the aftermath of state legalization. I'm skeptical of BAC levels being considered as anything other than support evidence in DUI cases, for that matter. They should be held as supplemental to camera evidence of impaired vehicle handling, at most. I'm not saying that to excuse my own conduct, either; I'm essentially a nondrinker at this point in my life.
The medical studies related to physical problems like COPD and cancers appear to be more objective, but they're also mostly correlative in an era where we're finding an increasing number of confounding factors. Xenoestrogens, petrochemical pollutants, invisible air pollution from aerosols, herbicides like glysophate...these are all significant problems that are only now emerging to the scrutiny of researchers. We're now being told that many of us are carrying around a plastics load the weight of two credit cards, about half of it in our brains. As it's an accumulating exposure, given my age all I can do is be thankful that most plastics appear to be inert within body tissue, although the same can't necessarily be said for the breakdown products. I didn't order any of that. I advise people against using high-strength cannabis in large amounts, especially as a regular practice. Especially in early youth. But it's become a subject of inordinate attention, to the point of being scapegoated for a wide array of problems in advance of reliable evidence.
In that regard, view is that medical studies need to be reviewed one at a time, for their methodology and their conclusions. There's an increasing trend in medical studies of all sorts to take opportunities to aggregate data from multiple studies and run regression analysis with the numbers. Medical studies are not economic statistics--and the problems of statistics abuse are bad enough in the case of studies of economic performance. The abuses of medical metastudies are often worse. The hyperbole found in the studies by Reece and Hulse are a prime example of that problem.* The methodology of the most sweeping condemnations of cannabis found in papers by Reese and Hulse is not intensive clincal biological study; instead, it's a form of epidemiological study that draws correlative conclusions from "geotemporospatial and casual inferential overview" of compiled data sets from a wide array of studies. Polite--but pointed- skepticism of the conclusions of one of their most prominent papers is found here: https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-022-00932-0
"While the authors use reputable datasets and a well-established epidemiological methodology, the authors’ conclusion of a causal association is limited due to biases inherent in ecological epidemiological studies. Though the researchers attempt to overcome these biases through validation and statistical manipulations, their approaches are insufficient to create conditions suitable for causal inferencing upon examination. There are also concerns in the practical and conceptual application of the studies’ dataset that further question the validity of the authors’ inferences. Further research exploring the potential benefits and harm of cannabinoids in the context of cancer must be performed before a distinct relationship can be defined..." The writer then goes on to unpack their research at length, as can be read by accessing the link above. It makes for thought-provoking reading, for those of us with an appreciation of dryly detailed critique.
Extra credit, for those with a taste for that sort of thing: have a look at this paper by Reese and Hulse https://journals.sagepub.com/doi/10.1177/2333794X19894798 which alleges that there's a high likelihood that cannabis use causes neural tube defects. That conclusion is based on a reading of statistical studies (eliding group survey statistics on self-reported cannabis use with documented medical outcomes) using the aforementioned "geotemporospatial and casual inferential" methodology and applying regression analysis to posit that cannabis is responsible for an increased incidence of spina bifida. Check the data sets used for comparison (the authors themselves offer the caveat that there are some gaps in the data they're using for evidence.)
Between the strange assemblage of data sets and the absence of any attention to the presence of possible confounding factors (overlaps with water supplies drawn from tar sands, rates of alcohol abuse, other problems unknown) that almost exclusively "geotemporospatial" semi-epidemiological study looks like Proofiness to me. If anything, the use of regression analysis only obfuscates its inherent problems. But--to this day--what credential medical researcher wants to "defend cannabis" against the allegations in a study making those charges, no matter the shoddiness of the methodology and its speculative conclusions? How much of a payoff would there be for anyone professionally, notwithstanding their defense of scientific rigor and principled integrity? Even a pro bono refutation could subject the professional offering it to insinuations of a suspected alliance with Big Cannabis, etc. (Incidentally, who paid for the study by Reece and Hulse?)
I don't like bad, biased, propagandistic scaremongering passed off as legitimate epidemiology. Bad research and bad researchers deserve to be taken down. I regret that I don't have the credentials to do it. But if my criticisms have the merit that I'm contending, some credentialed professional should be able to highlight the specific credibility problems present in at least some of the research by Reece and Hulse, along with the extravagant speculations of their conclusions, which they imply as authoritative and conclusive.
While I don't have the time right now, a while back I did enough keyword searches into Reece and Hulse to learn that they have been repeatedly criticized for their lack of objectivity and probity, both in regard to the subject of cannabis and their approach to addiction medicine (where Reece has a practice in Australia.) Reece in particular has been criticized, iirc; Hulse appears to be a junior associate (and unlike Reece, not a medical doctor.)
Interesting that the Reece-associated link below refers to the pernicious influence of the cannabis lobby in Australia; as the links to support groups (including in the US) show, the cannabis prohibition lobby is also well-funded, and many of the listed organizations have been in existence for years. https://drugfree.org.au/images/pdf-files/homepagepdf/DRReeceSupport2020_updated6May2020.pdf
Reece and his allies apparently put an extraordinary amount of energy into having his research studies disseminated as widely as possible. His research papers are widely circulated, even though many of them appear to be rehashes of the same research, slightly modified and submitted for publication as new papers.
While cannabis in currently in the hot seat for its possible role in exacerbating mental health problems, I don't find nearly as much attention paid to the mental health problems associated with being an officially ordained social pariah, including legal harassment, entanglement with the courts, mandated rehabilitation for uncomplicated simple possession--and, above all, the deleterious effects of incarceration on the body and mind of the incarcerated, and the indirect impacts on family members. (By the way, what percentage of the incarcerated population--or those subjected to enforced rehabilitation for drug abuse--are eventually put on a daily regimen of prescription drugs such as SSRIs or antipsychotics?)
[*By contrast, metastudies featuring research into the correlation between high-potency cannabis use in youth and increased incidence of developing acute psychotic incidents and other severe mental problems appears to be well-grounded, and deserving of more investigation.]