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18 March 2005

For pain relief, spray on some Mary Jane

by Feroza Master
The London Globe

HE WAS TOO young to be on his deathbed. The 35-year-old man had smoked three joints of cannabis a day for more than 10 years. He had lung cancer and he could not breathe on his own.

“By the time I got him, it was too late,” says Dr Onn Min Kon, a lung cancer specialist at the Chest and Allergy Clinic at St. Mary’s Hospital, London.

The man died within three months. Granted, 80 per cent of Dr Kon’s patients will die within a year of coming to him. But most of them are in their 50s or 60s and have smoked tobacco all their lives. However, Dr Kon is seeing five to six young people a year with lung disease caused by smoking marijuana.

“This should not be happening,” Dr Kon says. “I am seeing young people with lungs that look like they’ve smoked 40 years. There are big holes in them.”

Its destructive effect on the lungs is caused by the way cannabis is inhaled. Unlike cigarettes, a person has to inhale one-third more smoke than tobacco to get high. And to get the full effect of the drug, a person has to hold the smoke in their mouth four times longer than tobacco.

It’s that high and state of euphoria that gives MS and cancer patients pain relief. Patients with the degenerative nervous system disease MS struggle with involuntary and painful muscle spasms. The pain is sometimes too strong for narcotics to soothe. Like cancer sufferers, MS patients reach for marijuana.

But why do people with cancer and other diseases reach for a drug that is killing them?

With a special licence from the British Government, the drug company GW Pharmaceuticals has created a drug called a “cannabis derivative” called Sativex. It’s sprayed in the mouth and contains the active ingredient in marijuana – THC.

“This spray is better than smoking,” says GW Pharmaceutical spokesman Mark Rogerson. “Smoking kills you. As far as we’re concerned it’s not an acceptable delivery mechanism for a medicine. And you’re rolling it up with other substances such as tobacco and setting fire to it. So you’re destroying at lot of material in the process of burning it.”

The company has secret greenhouses hidden in the English countryside where they grow thousands of marijuana plants. They then extract the THC to create Sativex.

In a clinical trial run by GW Pharmaceuticals, the company examined 177 patients with severe cancer pain. These patients were in the advanced stages of cancer and strong narcotics such as morphine no longer helped. GW Pharmaceuticals says 40 per cent of patients using Sativex showed more than 30 per cent improvement in pain.

But UK regulators are sceptical. The Medicines and Healthcare products Regulatory Agency (MHRA) said they wanted more evidence about the benefits of the drug before it grants approval for it to be distributed in the country. The MHRA says there are no problems with the drug’s quality or safety. It is preventing approval solely over the issue about the drug’s efficacy. It says it’s uncertain as to how the drug helps decrease the severity of muscle spasms in MS patients. Now MHRA wants GW Pharmaceuticals to do another study. The company is seeking a hearing at the Medicines Commission, the senior advisory body to the MHRA.

If GW Pharmaceuticals wins the case this summer, Sativex will immediately be granted a product licence in the UK. In the meantime, the drug has already passed the first approval phase in Canada and could be on the market there within six months.

GW Pharmaceuticals don’t blame the MHRA for their scepticism. Previous trials of similar sprays have been disappointing. Dr John Zajicek of the UK MS Research Group is a co-author of a 2003 study that examined how patients with MS react to cannabis in the form of a liquid spray. While Zajicek’s spray contained a high amount of THC, there was only a small decrease in pain. Zajicek concluded that smoking the drug is the fastest way for THC to enter the bloodstream. GW Pharmaceuticals says Sativex is more effective than previous sprays because it has a different chemical composition.

Cannabis remains an illegal drug, although it was recently re-classified as a Class “C” drug. That means the maximum penalty for possession is two years in jail – quite a hefty sentence for someone smoking a drug for medicinal purposes.

Dr Kon would welcome a spray. He is pleased with GW Pharmaceuticals’ results, but remains sceptical.

“What I don’t want to see in 40 years time is a bunch of breathless 20 and 30 years, having not looked at this question properly. That’s the nightmare scenario: people think smoking pot is completely fine without knowing the side effects.”

ferozamaster@gmail.com

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