January 18, 2003 05:02
THE first cannabis-based medicines to treat patients with chronic pain could hit the market by the end of this year, an East Anglian doctor has predicted.
Dr William Notcutt, a consultant anaesthetist at James Paget Hospital in Gorleston, conducted Britain's first clinical trial of the, still illegal, drug as a medicine more than two years ago.
The groundbreaking research, which he says has "transformed" the lives of some of his patients, could result in a self-administered prescription treatment, which is sprayed under the tongue.
Research and development group GW Pharmaceuticals is hoping to gain a license for the world's first cannabis medicine and launch the product before this year is out.
Dr Notcutt said trials had initially been conducted on patients suffering from multiple sclerosis (MS) and spinal injuries – but he believes the treatment has even greater prospects.
"Its use is potentially much wider than that," he said. "We believe it could be helpful with rheumatoid arthritis, possibly in certain types of cancer and certain types of brain tumours.
"There are lots of things coming out of the research and, in five or 10 years' time, there could be an explosion of uses, far beyond the world of pain."
The clinician began trials in May 2000, grateful to GW Pharmaceuticals for supplying suitable samples of cannabis to research for medical use. It had grown special plants for that purpose.
"I had been involved in trying to get cannabis studied as a medicine for many years," said Dr Notcutt.
"The critical thing was pharmaceutical grade products. It is not possible to study smoked cannabis, or cannabis found in a field or supplied by Customs and Excise.
"That is where GW came in. They were able to supply reliably consistent, high quality and properly analysed cannabis so we knew exactly what we were using."
He began to piece together research on using cannabis to help people with long-standing pain. Results proved promising, with some patients reporting a dramatic improvement.
"It seems to help some people a lot, some not at all. But even if it helps just 50% of patients, it is worth doing," said Dr Notcutt.
"The incidences of side effects seemed no worse than conventional medicine for treating long standing pain, maybe even less. There were definite benefits from the treatment.
"Some patients have come to me and said this was the best treatment they had ever had. Two patients said they had their best night's sleep for 10 years. It helped them cope a little better."
The spray-under-the-tongue technique works like an inhaler for asthma, mimicking the process when cannabis is smoked and gas gets under the lungs. The treatment is absorbed into the body.
"Cannabis is not easy to inhale," said Dr Notcutt. "People often eat, bake it or make a tea out of it. The critical thing is getting right dose so people can get on with their everyday life.
"There is no point being immobilised by chronic pain, and then being immobilised by treatment with cannabis."
Dr Notcutt said he believed the medicine could be useful for people who suffer from chronic pain and have jobs "where you need your brain in gear 100%".
There are 36 people currently receiving the treatment in the trials at James Paget, but the doctor said he expected it would take some time to introduce the new treatment to the UK market.
"It is not just a matter of signing a piece of paper. People have got to be told how to use it, and doctors have got to be told how to prescribe it.
"It's not like any drug where it comes in and you just prescribe it. We have got to get people on board and learn how to use it."
Dr Notcutt sees the clinical trials as a medical step forward, rather than a move to relaxing drug laws –the Home Office granted a licence for GW Pharmaceuticals to use the drug for research purposes.
"I think there is going to be a wide potential of benefits, but I don't know how big this thing is going to be," he said.
"I can't really rate the importance of the treatment at the moment. I think it would have to be done in retrospect, perhaps in 10 years' time," he said.
"I think it's important, but I'm biased. I think the broad possibilities of cannabis are important. Lots of people have seen benefits from the treatment – it has improved their quality of life.
"But I'm going to be involved in this for a long time yet. There is
a lot more work to do. It is going to take some time, but there is light
at the end of the tunnel."
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