Trial for patients with chronic pain is first of its kind in North America
http://www.ottawacitizen.com/city/010815/647468.html
Wednesday 15 August 2001
A doctor at the Ottawa Hospital's
Rehabilitation Centre is running the first North American trial of a cannabis-based
drug, offering patients with chronic pain an under-the-tongue spray of
marijuana pain relief.
Up to 10 volunteers suffering from
multiple sclerosis and spinal cord injuries will begin taking the drug
next week, inhaling the spray through a cell-phone sized device so it's
absorbed quickly into the system without the harmful side effects of smoke.
"This is trying to provide what patients
are asking for," Dr. Dan DeForge said yesterday. "They tell us that inhaling
makes a big difference in terms of side effects and speed of relief, and
we're trying to avoid the carcinogenic effects of smoking."
Developed by the British company
GW Pharmaceuticals, the drug and inhaling device are also being tested
in the United Kingdom.
"We have had very encouraging results
from our UK trials," company spokesman Mark Rogerson said yesterday.
Dr. Willy Notcutt, who has led one
of the UK trials, told British newspapers that more than 75 per cent of
people with chronic pain have been shown to benefit from using the drug
-- a mix of tetrahydrocannabinol (THC) and cannabidiol (CBD), the two main
active ingredients in marijuana.
"That's actually very good results
for people with long-standing pain," he said. "If you are dealing with
people with chronic pain and you find something that benefits 30 per cent
of patients, then you are doing well."
The Ottawa trial will be double-blind,
with neither the doctor or patient knowing whether they are receiving the
drug or a placebo.
It will measure perception of pain
relief while also using objective measurements to see, for example, if
muscle spasms really have lessened, or if the patients just don't care
anymore, Dr. DeForge said.
If the trials support use of the
drug, it could eliminate problems associated with smoking homegrown marijuana
for medicinal relief, including concerns about drug purity and the toxicity
of smoke.
"We know that smoked cannabis, depending
on how much is used, has a profile similar to smoking cigarettes as far
as carcinogens and everything that's in the smoke," Dr. DeForge said.
While cannabis drugs can be taken
orally, and have been available in that form for more than a decade, Dr.
DeForge said patients complain they aren't absorbed quickly and have to
be taken in high doses that trigger side effects like nausea.
Another option, he said, can only
help patients.
"I try to be objective and say this
is another pharmaceutical compound that will help some of my patients and
I need to know which ones and which kind of side effects will develop,"
he said. "But it is exciting. It's always exciting to have another bullet
in your gun."
Dr. DeForge cautioned that the drug
is in the early stages of development, with current "phase two" trials
designed to catalogue doses and side effects. After the second phase is
complete, perhaps as early as Christmas, trials will progress to the "phase
three" stage designed to determine which compounds work best with larger
study groups.
Health Canada would not comment on
the study yesterday.
Mr. Rogerson would not speculate
on when the product would be available, if trials prove the drug works.
"We're taking it one step at a time," he said.
New marijuana regulations took effect
in Canada July 30, expanding the number of Canadians who may legally use
marijuana for medicinal purposes. Under the new regulations, patients with
terminal illnesses, chronic conditions or chronic pain can grow their own
marijuana or designate someone to grow it for them.
The illnesses range from AIDS to
multiple sclerosis to severe arthritis.
Bev Wake
The Ottawa Citizen