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A fundamental aspect of modern medicine is the requirement of evidence, derived from well-designed and well-conducted research, to support the use or application of any medicinal substance or other form of therapy as an effective and safe means by which to treat an illness or condition.

Evidence-based medicine (EBM) is now the foremost standard involved in determining how recommendable a medicinal substance can be. Involving rigours such as meta-analysis, systematic reviews and randomised control trials, it is a more demanding standard than any prior empirical standard.

But confronted with the issue of cannabis, EBM comes under greater scrutiny, and requires careful thought. While these rigors serve to provide the most acceptable risk to benefit profile as possible, there are clear arguments to suggest that in some areas it is overly prohibitive.

Here we discuss the tenets of EBM, and how they might potentially better accommodate the unique properties, in addition to the alternative points of evidence, as presented by cannabis as a medicinal substance.

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