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Newshawk: Alan Randell
Pubdate: Thu, 13 Jul 2000
Source: Independent, The (UK)
Copyright: 2000 Independent Newspapers (UK) Ltd.
Contact: letters@independent.co.uk
Address: 1 Canada Square, Canary Wharf, London E14 5DL

Author: Justina Haesaerts


Nearly 30 Years After Cannabis Was Banned, A Proposed Change In The Law Looks Set To
Clear It For Medicinal Use. But Just How Useful Is The Drug - And How Safe?

Historical rumour has it that Queen Victoria was a keen proponent of cannabis, apparently
using it for the relief of period pains. Sir John Russell Reynolds, for many years her personal
physician, wrote extensively on the benefits of taking cannabis, and in Victorian times the
herb was widely used to treat a variety of ailments and conditions, including muscle spasms,
menstrual cramps and rheumatism.

Now, 150 years later, the situation is very different. Cannabis is illegal. Not only is it
outlawed in Britain as a class-B drug; the herb, which is referred to in the oldest surviving text
on medical drugs - the 5,000-year-old Chinese Shen-Nung Pen-tsao - is banned for all medical

But the phoenix is rising from the ashes. After a dormancy of almost 30 years since the total
ban in 1971, a private member's Bill for the legalisation of cannabis for medical purposes is
currently going through Parliament; its second reading is scheduled for later this month and
has the signed support of 100 MPs. Should the Bill go through, cannabis may become
immediately available as a treatment for illnesses such as multiple sclerosis. Research in the
UK is abuzz with testing for its therapeutic gains. For conditions from asthma to migraines,
cannabis could be the treatment of tomorrow.

Lester Grinspoon is associate professor of psychiatry at Harvard Medical School, in the
United States. He is co-author of the book Cannabis the Forbidden Medicine and is one of
many medical professionals across the world who believe that there is sufficient proof that
cannabis is legitimate for medicinal purposes.

Dr Grinspoon explained: "It has been well known for thousand of years that cannabis has
medical uses. It is far safer than most medicines prescribed by doctors daily and often works
for patients who cannot tolerate the side-effects of other drugs. In many cases no other drug
will do the job as safely or as well."

The list of illnesses that cannabis has been used to treat, from both historical and
contemporary evidence, is impressive. Dr Grinspoon continued: "Clinical experience suggests
that it is helpful for patients with severe nausea and vomiting, arthritis, glaucoma, muscle
spasms, pre-menstrual syndrome, seizure disorders, the Aids weight-loss syndrome, asthma,
fibromyalgia, Tourette's syndrome and depression, to name a few."

Doctors have known of the medicinal benefits of cannabis for decades. Two drugs based on
its active ingredient - tetrahydrocannabinol, or THC - have been used in Britain for over 30
years to treat nausea in cancer patients who are undergoing chemotherapy, although their use
has declined as newer drugs have taken their place.

Interest in other medicinal uses of cannabis is growing. There are at least 60 psychoactive
substances among the 400 chemicals contained in the drug. The aim of research is to extract
the active constituents of cannabis - in the same way that morphine was extracted from opium
- to establish which are of benefit.

A 1997 report by the British Medical Association's board of science, "Therapeutic Uses of
Cannabis", concluded that there was evidence that the drug could help muscle spasm in
patients with multiple sclerosis. There was also limited evidence of benefits in epilepsy,
glaucoma, asthma, high blood pressure and the weight-loss associated with Aids.

The BMA stressed it was not advocating use of the whole cannabis plant, which could be as
damaging as tobacco, if not more so, but wanted research to determine which of the plant's
400 chemical constituents might bring medical benefits. However, in the meantime, it called
on the courts to show compassion to people using the drug for medicinal reasons.

As you read this, there are about 40,000 cannabis plants being cultivated at a secret location in
the south of England for precisely that purpose. GW Pharmaceuticals was set up in
December 1997, after discussions with UK government officials, by Geoffrey Guy, who has
18 years' experience in pharmaceutical development, with the sole purpose of conducting
medical research on cannabis.

Because of the illegality of using cannabis for medical purposes, any research has to be
conducted with the Home Office's permission. To conduct in-depth research, the company
has been granted two licences: a cultivation licence, which allows it to grow cannabis in a
highly secure glasshouse facility, and a licence for possession and supply for medical research,
which - as the name suggests - allows the company to dispense cannabis preparations for the
purpose of research.

But after 5,000 years of historical accounts and reams of anecdotal evidence - why all this
additional investigation? Why should we not just light up a spliff at the first inkling of a

The BMA's findings cite that smoking a cannabis cigarette - containing only herbal cannabis -
leads to three times more tar inhalation than from smoking a tobacco cigarette. Chronic
smoking of cannabis can increase the risk of smoking-related illnesses - such as cardiovascular
disease, bronchitis and emphysema - threefold. Other potential dangers of long-term use
include the suppression of ovulation in women, a decreased sperm count in men, sedation and

Research into the administration of cannabis via alternative, safer methods is already under
way. GW Pharmaceuticals has developed a number of delivery methods, including
sub-lingual sprays and drops and aerosols and vaporisers for inhalation. The benefits of such
methods are that they avoid smoking and allow the cannabinoids to be absorbed straight into
the bloodstream.

By the time the herb has been fully developed for medicinal use, it is likely that its
psychotropic effects will have been eliminated. In other words, if you are going to be using it
as a medicine in the future, you are not going to be getting high.

Dr Guy believes that the psychoactive effect is an unwanted effect. He said: "There is a false
assumption that multiple sclerosis sufferers, for example, who use cannabis get high and don't
care about the pain. That is not what happens.

"People who are taking part in our trials are ordinary people who want relief from the pain
and other symptoms such as spasm. They just want to get on with their lives. They want to
go to the supermarket and do simple things, and you can't do that if you are suffering from
unwanted psychoactive side-effects."

Roger Pertwee, of Aberdeen University, who has dedicated years of scientific study to
cannabis, seconds his view. He explained: "I've seen anecdotal claims that you don't need to
get high to feel better. Usually people are not seeking to get high; they are just using it to treat
their symptoms. I would imagine that for some people getting high is a real nuisance. It
might be fun on the odd occasion, but every day it would get rather boring."

The sub-lingual and inhalation methods developed by GW Pharmaceuticals will ensure a
sufficiently low dosage to eliminate the psychotropic effects but still provide quick, effective
pain relief.

Earlier this month, another breakthrough for administering cannabis was achieved by a team
of scientists at Imperial College, University of London. They showed that cannabinoids act
on the spinal cord as well as the brain. The finding paves the way for the development of
new cannabinoid-based drugs that target the spinal cord to fight pain but bypass the brain and
so, again, do not cause the high.

So what happens next? GW Pharmaceuticals estimates that a cannabis-based medicine will be
available in 2003. Dr Guy predicts that it will be treated in the same way as morphine.
"Morphine, which is used as a painkiller for cancer, is a dangerous substance. But under the
right conditions, nobody would suggest that we couldn't prescribe morphine. What we are
keen to do is to see if cannabis should occupy the same shelf in the pharmacist's cupboard as
morphine does."

So, if and when a cannabis-based medicine becomes available, it is unlikely to bear much
similarity to what Queen Victoria would have put in her pipe.
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