Medical Marijuana Approved By Sweden

Medicinal cannabis would now be available as a prescription in Sweden after Sativex, a cannabis-based mouth spray, was approved by the Medical Products Agency for the treatment of multiple sclerosis (MS).

“This is great news for those who can’t get any relief from the most common drugs,” Jan Hillert, an MS researcher at Karolinska Institute and said the institute is planning to closely monitor prescriptions for Sativex to ensure against abuse.

The cannabis-based mouth spray does not result in a “high” as the cannabinoids included — a near 1:1 mix of tetrahydrocannabinol (THC) and cannabidiol (CBD) — are not administered in large enough doses, according to both the agency and Sativex manufacturer GW Pharmaceuticals, which grows medicinal cannabis and prepares the extract in Britain.

Sativex spray is used sublingually (under the tongue), has been shown by a series of medical studies to be successful for alleviating multiple sclerosis (MS) symptoms.
“Evidence generated from clinical trials shows that Sativex® has a positive impact on spasticity in multiple sclerosis, while alleviating associated symptoms including pain, bladder or sleep disturbance,” GW Pharmaceuticals said in a press release. “By relieving the symptoms of MS, Sativex® can improve patients’ quality of life and allow them greater independence in performing their daily activities.”

The cannabis spray is already available as a prescription medication in the United Kingdom, Germany, Spain, Denmark, Canada and New Zealand, according to GW.

Arthritis Pain Relieved By Cannabis Extracts

According to clinical trial data published in an issue of the journal Rheumatology, the use of cannabis extracts has the potential of suppressing pain and improving quality of sleep in patients suffering from rheumatoid arthritis. The study was titled, “Preliminary assessment of the efficacy, tolerability, and safety of a cannabis-based medicine in the treatment of pain caused by rheumatoid arthritis.”

In a randomized, double-blind, parallel group study, fifty-eight patients participated and thirty-one of them self-administered Sativex, a whole plant medicinal cannabis extract containing precise doses of the cannabinoids THC and cannabidiol (CBD), for five weeks while others received a placebo.

Patients using Sativex experienced statistically significant improvements in pain on movement, pain at rest, quality of sleep, inflammation, and intensity of pain compared to the placebo group, the study found.

This study is the first clinical trial for assessing the effects of either cannabis or cannabis extracts on patients with rheumatoid arthritis.

Survey data published in the International Journal of Clinical Practice in March 2005 reported that approximately one out of six medicinal marijuana patients in the UK use cannabis to alleviate symptoms of arthritis.

Previous clinical data on Sativex had revealed cannabis extracts to reduce neuropathic pain, spasticity, pain-related sleep disturbances, and urinary dysfunction in Multiple Sclerosis patients unresponsive to standard treatment.

NCI Recognizes Cancer-Killing Properties Of Cannabinoids

Cancer-fighting properties of marijuana’s active components have been acknowledged by the website of the National Cancer Institute (NCI), a component of the United States National Institutes of Health (NIH). The body, however, stopped short of recognizing that cannabis may be recommended by oncologists as an anti-proliferative treatment therapy.

Last week, the agency added a new section to its website to address the issue of marijuana and cancer. The section, entitled ‘Cannabis and Cannabinoids (PDQ),’ provides “an overview of the use of cannabis and its components as a treatment for people with cancer-related symptoms caused by the disease itself or its treatment.”

The website noted that preclinical trials have demonstrated that the active components of marijuana can selectively target and inhibit cancer cell growth. “Cannabinoids may cause antitumor effects by various mechanisms, including induction of cell death, inhibition of cell growth, and inhibition of tumor angiogenesis and metastasis,” the site reads. “Cannabinoids appear to kill tumor cells but do not affect their non-transformed counterparts and may even protect them from cell death.”

The site further states: “The potential benefits of medicinal Cannabis for people living with cancer include antiemetic effects, appetite stimulation, pain relief, and improved sleep.”

Prescription Pain Drug Deaths Could Be Reduced With Cannabis

According to a peer-reviewed paper published online this week in the Harm Reduction Journal, physicians who prescribe opioid drugs to patients with neuropathy (nerve pain) ought to consider recommending cannabis as an alternative therapy.

“There is sufficient evidence of safety and efficacy for the use of (cannabis/cannabinoids) in the treatment of nerve pain relative to opioids,” the commentary states. “In states where medicinal cannabis is legal, physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids. … Prescribing cannabis in place of opioids for neuropathic pain may reduce the morbidity and mortality rates associated with prescription pain medications and may be an effective harm reduction strategy.”

The author notes that between the years 1999 and 2006, “approximately 65,000 people died from opioid analgesic overdose.” By contrast, he writes “[N]o one has ever died from an overdose of cannabis.”

In clinical trials, inhaled cannabis has consistently been demonstrated to minimize neuropathic pain of diverse causes in subjects unresponsive to standard pain therapies.

Prescribing cannabis for harm reduction

CMA Wants To Legalize And Regulate Marijuana

The California Medical Association (CMA) that includes 35,000 doctors has adopted an official policy that recommends the legalization and regulation of cannabis. The CMA adopted the new stance at its annual meeting recently in Anaheim.

The board of trustees of the largest physician group in California adopted the policy unanimously at its meeting in Sacramento, according to a statement on the CMA website.
California is one of the sixteen states where medical marijuana is legal, making it possible for doctors to recommend the drug to their patients.

Dr. James Hay, the president-elect of CMA, said that present-day laws put doctors in an uncomfortable position. “California decriminalized its medical use, yet if a physician recommends it to a patient we are violating federal law.” Hay said.

According to a statement put out by CMA, marijuana is a Schedule 1 drug that means that study and research of the drug is limited. “Think it ought to be regulated, better controlled, no control over what’s in marijuana. If we don’t know what’s in it, we can’t do any kind of scientific evaluation,” Hay said.

Dr. Donald Lyman, the Sacramento physician who wrote new policy of the group, attributed the shift to growing frustration over California’s medical marijuana law, which permits cannabis use with a doctor’s recommendation.

“It’s an uncomfortable position for doctors,” he said. “It is an open question whether cannabis is useful or not. That question can only be answered once it is legalized and more research is done. Then, and only then, can we know what it is useful for.”
The California Police Chiefs Association opposes the new policy of the CMA. “Drug use is a health issue and for too long we have let law enforcement and federal bureaucrats decide policy. CMA is saying let’s treat medical marijuana as a health issue,” Bill Piper, the director of national affairs for the Drug Policy Alliance said.

Dr. Igor Grant, head of the Center for Medicinal Cannabis at UC San Diego, defended therapeutic use of the drug. “There’s good evidence that it has medicinal value,” he said. “Can you say it’s 100% bulletproof? No. But the research we’ve done at the center shows it’s helpful with certain types of pain.”

California Medical Association