Tuesday, December 06, 2005


As I read the Advanced Nutrients hydroponic plant food website I see a very honest series of articles talking about the medical effects of cannabis.

When I say honest I mean that instead of a one-sided approach that either lies in favor of cannabis or lies to make a case against it, the articles contain a refreshing sense of candor and balance that shows me a lot of credibility and an intelligent approach to this very controversial and confusing topic.

Other than news from the United States about cannabis, which is usually all bad because the United States government and its social-medical establishment is very much against cannabis, there is interesting news about cannabis from around the world.

From Australia comes a study that says that four out of five people who were studied who were suffering from severe schizophrenia were pot smokers when they were young.

Some people would read this study and conclude that cannabis is a causal factor in development of schizophrenia. Other studies, conducted in the UK, Australia, Denmark, Sweden and Holland, also could indicate mild evidence of a causal link between cannabis and mental disorders.

A causal link means that the use of cannabis partially or wholly causes a disease or condition, not just that somebody who uses cannabis also happens to suffer from a disease or condition.

Perhaps the most famous “causal link” that has ever been asserted is the “gateway theory” which asserts that cannabis causes people to want to use other illegal drugs. The drug warriors would often say, “Almost everybody we’ve met who uses heroin tells us that the first illegal drug they ever used is cannabis. Therefore, there’s a link between cannabis and heroin use.”

Cannabis advocates have offered a humorous rebuttal to this assertion, stating that people who use heroin drank milk when they were young, but that doesn’t prove that milk causes heroin use!

It is the same situation with the alleged causal relationship between pot and mental illness. Somebody smokes pot when they are young and has schizophrenia later, so somebody proposes that the pot caused the schizophrenia. There is no real way to prove it. Statistics do lie, and it may well be that people smoke pot because they have mental problems anyway, rather than that the people were totally mentally healthy and then smoked pot and suddenly they went bonkers!

Nevertheless, if we are to be honest about cannabis, we must acknowledge research that indicates that when young people with mental illness risk factors use cannabis, it can destabilize them and lead to mental illness.

A Danish study in the British Journal of Psychiatry found that almost half of patients treated for a cannabis-related mental disorder go on to develop a schizophrenic illness. People who had used cannabis developed schizophrenia earlier than those with the illness who had not smoked marijuana.

Unlike drug warriors who will spin the study to back up the reefer madness/causal effect hypothesis, the Danish researchers emphasized that the study did not show that cannabis caused psychosis, because factors such as heredity, other drug use and socio-economic status had not been taken into account, and these factors are known to influence whether a person develops mental problems. However, an American study using sophisticated imaging techniques found abnormalities in the brains of adolescents with schizophrenia that are similar to those found in adolescents who use cannabis on a daily basis, but those who do not use cannabis daily had no such abnormalities.

"These findings suggest that, in addition to interfering with normal brain development, heavy marijuana use in adolescents may also lead to an earlier onset of schizophrenia in individuals who are genetically predisposed to the disorder," says Dr Sanjiv Kumra, assistant professor of psychiatry at the Albert Einstein College of Medicine, New York, who worked on the study.

According to Robin Murray, professor of psychiatry at the Institute of Psychiatry in London, one person in four has the genes that make them susceptible to developing cannabis-induced psychosis.

The cause and effect relationship in how cannabis benefits people is a bit easier to explore and predict than whether it causes mental illness. For example, when GW Pharmaceuticals in England gave organic cannabis extracts to hundreds of multiple sclerosis (MS) patients, and most of those patients reported beneficial effects; when those effects were also observed and proven by clinical observation and study, then it is possible to legitimately say that cannabis is causing specific effects. In this case, the effects are beneficial.

Last month, the UK Government announced that GW’s Sativex, an oral extract spray derived from cannabis that is licensed in Canada but not yet in the UK, could be prescribed on a "named patient" basis for pain relief in patients with MS.

GW announces that it has been informed by the Home Office that the Drugs Minister, Paul Goggins, has confirmed that Sativex® oromucosal spray, its cannabis-based medicine, may be imported from Canada to satisfy its prescription to individual patients in the UK as an unlicensed medicine. This development is in response to enquiries from a number of UK doctors and individual patients who have been in contact with the Home Office to request access to Sativex.

In accordance with the Medicines Act, a medicine which has yet to be licensed in the UK may be prescribed and supplied in response to an unsolicited request to fulfill the special needs of an individual patient under a physician’s direct personal responsibility. The basis on which Sativex may be imported, therefore, is the clinical judgment of doctors in relation to specific nominated patients.

This development follows the approval of Sativex by Health Canada in April 2005. The medicine has been available on prescription in Canada since late June, 2005.

More recently, the Medicines and Healthcare products Regulatory Agency (MHRA) has issued to GW a Wholesale Dealer’s (Importation from non-EU countries) License, and has not objected to the importation of Sativex under the regulations for importation of medicines unlicensed in the UK.

Sativex will remain a Schedule 1 controlled drug in the UK in line with stated government policy. This means that the prescribing of Sativex can only be permitted under Home Office license. The Home Office will therefore be developing a licensing regime to fit these circumstances. GW expects to discuss the implementation practicalities with the Home Office over the coming weeks.

Clearance for supply on an unlicensed basis does not affect GW’s plans to seek full regulatory approval from the MHRA for Sativex in the UK; the company has been trying to get full regulatoy approval for three years. GW is currently conducting many Phase III trials and is still planning to submit an application for Marketing Authorization to the MHRA during 2006. Only after such an approval is granted can the product be promoted in the UK. Many people are disappointed at the slowness of the MHRA, noting that Canada has already approved Sativex.

Sativex, which is the only medicine in the world derived directly from organically-grown cannabis plants, works by influencing the way pain messages are transmitted through the body.

"It's not that patients get high and stop caring about their pain," asserts Mark Rogerson, spokesman for GW Pharmaceuticals. "A person taking a normal dose will receive only a fraction of the tetrahydrocannabinol (THC) - the active ingredient in cannabis that causes a high - of a recreational user."

A recent study published in the journal Neurology showed that Sativex was significantly better than a placebo at reducing pain and sleep disturbances in MS patients.

Other new research shows that Sativex relieves pain and slows the progression of rheumatoid arthritis for patients who suffer from that disease.

Researchers from the Royal National Hospital for Rheumatic Diseases, in Bath, England, say significant pain-relieving effects were observed and disease activity was significantly suppressed following Sativex treatment.

They say that while the differences are small and variable across the population, they represent benefits of clinical relevance and show the need for more detailed investigation.

Of the 56 patients in the five-week randomized study, 31 were given Sativex daily by fixed delivery oromucosal spray and 27 received placebo.

Each spray of Sativex delivers Tetrahydrocannabinol (2.7mg) and cannabidiol (2.5mg). The balancing of THC and CBD are crucial to the success of Sativex, according to GW scientists, who say that one of their main goals is to achieve medical benefits without getting people stoned. If THC was used solo, or if a person smokes a joint of whole cannabis, they are likely to get dosed with “too much” THC, which causes cannabis “intoxication.”

GW’s goal is to create medicine that has medical effects but no psychological effects. It doesn’t want to be accused of “getting people high,” because the euphoric and mind-altering effects of cannabis are seen as negative side-effects by people who only want relief from diseases or disease symptoms. While many of us who enjoy cannabis for recreation and medical use might think that people who don’t want to get high are weird, we must be open-minded enough to realize that some people want to stay “sober.” They don’t want a drug affecting the way they think, feel and perceive. For them, GW’s cannabis extracts are an ideal way to get medical effects without getting high.

In the rheumatoid arthritis study, the patients were tested for how cannabis affected their movement ability, as well as their stiffness in the morning, and their ability to sleep. GW’s extracts produced statistically significant improvements in pain of movement, pain at rest, quality of sleep, and disease activity. Better yet, GW’s Sativex appears to be safer and more effective than the prescription drugs it competes with. This is the case with most situations wherein cannabis competes with pharmaceuticals.

The GW arthritis study found that most Sativex “side effects” were mild or moderate and the treatment group showed no serious adverse effects or withdrawals due to side effects. Three patients (11 percent) withdrew from the placebo group after experiencing adverse events such as mild dizziness, light-headedness, and dry mouth.

In light of the “evidence” that cannabis might influence the onset of mental illness, a GW spokesperson felt the need to offer his company’s view of whether Sativex could cause mental problems.

According to Mark Rogerson of GW Pharmaceuticals: "We have found no evidence that Sativex causes psychosis. Such side effects as there are - and no drug is without them - are generally mild, reversible and well tolerated. There may be a temporary intoxication-like reaction, and, for this reason, we have always excluded people with serious mental illness from our trials."

Rogerson also noted that there’s plenty of momentum for Sativex to be used worldwide. GW is set to supply Sativex to the Health department of the Catalonia Government in Spain. Sativex will be used to treat 600 patients suffering from multiple sclerosis and other conditions under a compassionate access program.

The contract will mark the first time that patients in Europe have had access to Sativex outside a clinical trial.

Dr Geoffrey Guy, executive chairman of GW, said: “This initiative represents a pragmatic and compassionate approach for seriously ill patients with little alternative therapy. At the same time, it will provide a useful additional source of revenue for GW as we continue to invest in developing Sativex to bring it to the UK and other international markets through regulatory approval processes.”

Guy has his money goals, and patients want relief. Some people want the freedom to grow their own medicine; others want to use cannabis derivatives without getting high. What all of us need to focus on is that cannabis contains many compounds that are miraculously helpful.

Cannabis is a gift from the God of Nature. Whole smoked cannabis, orally ingested cannabis extracts and foods, and topically applied cannabis ointments grown with quality plant foods have all helped hundreds of thousands of people.

Despite all the divisive rhetoric, the fact is that when cannabis is intelligently used, it’s fantastic medicine!


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