Kevin Sabet is co-founder of Smart Approaches to Marijuana, an anti-marijuana lobbying group that provides one-sided information in their quest to keep marijuana unavailable.  However, the method he uses  to make his case is unscientific manipulation of evidence, spread in a morally bankrupt way to further his own talking points.  He cherry-picks data and ignores actual scientific evidence in order to confuse and try (desperately) to prove that marijuana is so dangerous that adults cannot use it safely.

I plan to use this page to point out all the ways in which Kevin Sabet gets it so wrong, and you may decide if this behavior is just sheer ignorance or a purposeful attempt to delude people into his erroneous way of thinking.

Sunday, September 10, 2017

Kevin, you need the refresher

Here is a perfect example of cherry-picking data to try to prove a point.  Here is Kevin, citing an observational study for PTSD.  First, the study has its limitations, such as only including veterans (96.7% of whom were male).  The researchers also excluded anyone with alcohol use of more than 2 drinks per sitting or any other drug use in the past 30 days.  These criteria excluded nearly three quarters of potential participants, showing that these exclusions lead to a cohort that do not match a real world population and allows limited extrapolation of findings to a general population.  As is the case with most observational studies of marijuana, it is difficult to control for the exposure dose, as it relies on patient self report of use.  The study did find an association between marijuana use and alcohol use.  Given that alcohol is clearly associated with violent behavior, it would be nearly impossible to attribute any increases to marijuana itself without a controlling for this additional alcohol use. The researchers acknowledge this themselves in the paper, saying, "Our finding that those who started using marijuana in the months after completing treatment had higher overall rates of violent behavior could be partially explained by the fact that starters also had higher rates of of alcohol use at follow-up (which is associated with violence.)"  But that sort of nuance is always beyond Kevin.

However, this is only one of a few, fairly low-quality studies on the subject.  When taken as a whole, the evidence shows some possible trend to worsening symptoms, but due to other confounders and study limitations, conclusions cannot yet be drawn.  Here is how the National Academy of Sciences reported the entirety of evidence on the subject in their 2017 report "The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research":

"Of the relevant studies reviewed, cannabis use appears to be associated with more severe symptoms, but limited sample sizes were an issue in certain studies; that issue, combined with the lack of adjustment for baseline symptom severity and other drug use and the examination of specialized patient populations, limits the strength of the conclusions that can be drawn. Overall, there is limited evidence for an association between cannabis use and increased PTSD symptom severity. The direction of the association is difficult to address, however. It has been argued that PTSD is a risk factor for cannabis use, and cannabis-using patients with PTSD often cite symptom-coping motives for cannabis use, which suggests that more severe PTSD may be driving patients to increase cannabis use in an effort to self-medicate. In contrast, one study () found overall improvements in several symptom domains after 4 months of abstinence from cannabis, suggesting that cannabis use may be causally related to more severe PTSD symptoms." 

Yet another more recent review from The Annals of Internal Medicine from September 2017 by O'Neil, et. al, also concluded that from all available evidence "Evidence is insufficient to draw conclusions about the benefits and harms of plant-based cannabis preparations in patients with PTSD."

Still, here is Kevin Sabet, citing one study and making blanket claims about the findings, all while snarkily implying that anyone who may not share his myopic view needs his teaching. He will accept any data that supports his own views and summarily dismiss anything counter to his narrative.

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