Ms Grainne Power:

I want to reiterate at a high level what Dr. Nolan said. The IASP review was the culmination of the work of multidisciplinary associations representing healthcare professionals and scientists from many countries. In March 2021, it published a meta-analysis and systematic review on the evidence around the use of cannabinoids under the topic of pain. I would respectfully suggest to members, if they have an hour, to Google it. It is very nicely constructed and broken down into the safety, the efficacy, the preclinical and clinical data, the animal studies and whether they can or cannot be translated into human or clinical impact, and also the societal and policy implications related to the use of these compounds for pain management. It is an extensive piece of work by global leaders and one of the work streams was, in fact, led by Professor David Finn of NUI Galway, who may be known to some of the committee members.

In summary, the major findings are on preclinical and clinical safety. As Dr. Nolan said, it identifies a range of important research gaps and the lack of high-quality clinical evidence for safety or efficacy means that this particular association does not endorse general use. This association recognises the pressing need for studies to fill the research gap.

As I said at the recent private session, none of us is questioning those for whom cannabinoids have provided relief from the lived experience of pain.

It is about the quality of evidence rather than the legitimacy of people's claims. There is lots in there. There was a recent publication in the British Medical Journal countering some of those claims but there are definite differences in methodologies and the methodologies used by IASP were robust. The HPRA is a single entity and we have done a quick review of the evidence in a general way, so I would not want to pre-judge the outcome of a whole-of-health system expert review that might happen, as Mr. O'Connor outlined earlier.