August 20, 2002
By Peggy Peck
Special to DG News
SAN DIEGO, CA
Multiple sclerosis patients responding to a mail survey report that 45 percent use marijuana for relief of muscle spasm or pain associated with multiple sclerosis (MS).
Speaking here on August 18th during the 10th World Congress on Pain, Dr. M. Sam Chong, consulting neurologist at King's College Hospital, in London, England, said the "use rate is actually higher than we expected, especially since 18 percent of the patients said they used cannabis in the last month." About half of the patients "started using marijuana only after MS was diagnosed", Dr. Chong said in an interview.
A total of 74 percent of respondents said marijuana either eliminated or controlled leg spasms that make walking difficult or impossible while 54 percent said they used marijuana mainly for pain relief.
The 15-page survey was mailed to 300 MS patients who are included in an MS patient database used by the neurology department and outpatient clinics. Among the 258 respondents, those who reported more severe symptoms were more likely to use marijuana than patients who had mild or moderate symptoms, Dr. Chong said. "And as symptom severity increased, use also increased" he added.
Those who were smokers smoked the marijuana, while those who were non-smokers baked it in a cake which they kept refrigerated, eating a piece when needed. Generally, "patients reported using marijuana just before bed. So they used and then went to sleep", he said.
Dr. Chong and his colleagues have not correlated the survey responses with a clinical assessment of symptoms, nor have they conducted any studies to determine serum concentrations of cannabis.
Dr. Sandra Chaplan, a clinical professor of anesthesiology at the University of California, in San Diego, California, United States, and a member of the organising committee for the pain meeting, noted that researchers have identified marijuana receptors in the brain, a finding that suggests the drug may have a role in pain relief.
Moreover, she said that only recently have "we come to recognize that intractable pain is a symptom of MS, so it makes sense that cannabis should be investigated for MS symptoms." She added that the program committee "has recognized the emerging role of cannabis and we consider this to be one of the themes at this meeting." For example, Tuesday's program includes a plenary session on cannabinoids.
But Dr. Chaplan said that "smoking" is not a medically acceptable mode of delivery. "We need to find a delivery system -- preferably a pill -- that will deliver the analgesic effects with little or no cognitive effects."
Dr. Chong agreed that "neurologists are not likely to start prescribing
marijuana, but among MS patients marijuana use is increasing because it
is commonly recommended by members of patient support groups".
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