Stephen Ziegler, PhD, JD: The Risks and Benefits of Cannabis Treatment in Rheumatic Disease

Stephen Ziegler, PhD, JD, discusses his Congress of Clinical Rheumatology West presentation, “No Prescription Required? The Growth of Humor Therapy, Psilocybin, and Cannabis as Alternative and Complementary Treatments for Pain and Palliative Care.” Ziegler is a professor emeritus from Purdue University in Fort Wayne, Indiana.

Discussing the effectiveness of cannabis presents a challenge because most studies available are observational as opposed to randomized controlled trials (RCTs). This limitation is primarily due to the substances being categorized as Schedule I drugs. Unfortunately, according to Ziegler, the Drug Enforcement Administration (DEA) argues there isn't enough research to reclassify them from Schedule I because they are in Schedule I, creating a catch-22 situation.

When it comes to these treatments, there are inherent risks and potential benefits, as with any medical intervention. One significant risk is that Schedule I substances violate federal law, which can have legal consequences. Additionally, due to the lack of research caused by their Schedule I status, providers face challenges in making informed recommendations. Issues including proper dosing and treatment protocols become ambiguous, and inconsistent state policies further complicate matters.

Practitioners are often risk-averse and prioritize managing the risks and benefits of treatments. With limited clear information and policy inconsistencies, implementing these treatments becomes challenging. Ziegler argues removing psilocybin and cannabis from Schedule I of the Controlled Substances Act (CSA) is essential to enable more research and establish clear guidelines for their use.

Regarding the value of conference coverage, he believes conferences have proven highly beneficial for several reasons. They present cutting-edge research, raise pertinent issues, and foster discussions among colleagues.

“As a former professor, I found conferences to be a rich source of research topics and ideas,” he stated. “They play a valuable role in advancing knowledge and fostering collaboration.”

This transcript was edited for clarity.