More MS news articles for Aug 2001

Area doctor tests marijuana spray

Trial for patients with chronic pain is first of its kind in North America

Wednesday 15 August 2001
Bev Wake
The Ottawa Citizen

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.