Pubdate: Thu, 10 Oct 2002
Source: National Post (Canada)
Copyright: 2002 Southam Inc.
Contact:  http://www.nationalpost.com/
Details: http://www.mapinc.org/media/286
Author: Tom Arnold, National Post
Bookmark: http://www.mapinc.org/mmjcn.htm (Cannabis - Medicinal - Canada)

OTTAWA PROBES MARIJUANA'S EFFECT ON PAIN

First Clinical Trial to Follow 32 Patients over Eight Weeks

The federal government is putting up $840,000 for Canada's first clinical 
study into whether marijuana use can help ease pain.

The Community Research Initiative of Toronto and St. Michael's Hospital in 
Toronto are to begin evaluating the therapeutic effects of smoked cannabis 
in HIV/AIDS.

In the clinical trial, 32 patients will be closely examined over eight 
weeks to test the safety of short-term exposure to different strengths of 
cannabis, and how cannabis interacts with HIV medications. The analysis 
will also include the effect of smoked marijuana on nausea, pain, mood and 
neuro-cognitive function.

The results of the study will help determine the design of a larger, 
multi-centre, clinical trial across the country. It is also important 
because Anne McLellan, the federal Health Minister, has said she will not 
proceed with medicinal legalization without clinical trials looking at the 
plant's effectiveness.

"There is so little good concrete scientific data about the potential 
benefits or effects of smoked cannabis in a number of illnesses, including 
HIV and AIDS," said Kevin Gough, an infectious diseases specialist who will 
act as the study's principal investigator.

"HIV itself, the disease, and the medications we use to treat it, produce a 
number of side effects, including loss of appetite, nausea, and pain. Other 
diseases like cancer and multiple sclerosis can also lead to similar 
symptoms that might benefit from smoked cannabis, but the studies aren't there.

"This is the first trial in Canada to be looking at cannabis in any medical 
context," added Dr. Gough, who is also medical director of HIV services at 
St. Michael's Hospital in Toronto.

For those suffering from HIV or AIDS, loss of appetite and weight loss can 
be life threatening, said Derek Thaczuk, former chairman of the board of 
directors of the Community Research Initiative of Toronto, an organization 
dedicated to research on HIV and AIDS.

"There is plenty of anecdotal evidence to suggest that smoking marijuana 
increases people's appetite and therefore helps them gain weight," he said. 
"What we're doing with this study is subjecting it to some scientific 
rigour and trying to get quantitative answers to the question of 'Can 
smoked cannabis help with this condition and if so, how much?' "

The marijuana has been imported from the U.S. government's National 
Institutes of Drug Abuse. The organization grows its own marijuana on a 
farm in Mississippi. The Canadian research team purchased 500 grams for the 
research project.

Mr. Thaczuk, who chairs the Toronto research initiative's scientific 
committee, said work on the study has been carried out for two years with 
Health Canada, and the scientific and HIV/AIDS communities.

The study is based on a method known as a placebo-controlled crossover 
design. This means all participants will receive marijuana containing four 
different strengths of tetrahydrocannabinol (THC) at different times, 
including a placebo. Each patient will smoke the various forms of the drug 
for a week, monitoring their usage, pain level and weight. They will remain 
marijuana-free for the next week, but still self-monitoring.

Although they will be smoking medicinal pot in their own homes whenever 
they choose, they will undergo a battery of tests as an in-patient at a 
clinic once a week.

THC is the component of cannabis known to cause the "high" people 
experience. THC is also believed responsible for the drug's potential 
medical benefits, such as appetite stimulation.

The study is expected to be completed within one year.

The federal government has funded another study, one in which researchers 
at McGill University will research the therapeutic effects of marijuana on 
neurological pain. The $235,000 project is to get underway this fall.

In August, Ms. McLellan prompted applause when she told doctors at a 
meeting of the Canadian Medical Association in New Brunswick that she was 
uncomfortable with people smoking pot to relieve pain and that the 
government would not look at distributing medicinal marijuana before it 
does clinical drug trials.

Ms. McLellan's comments appeared to contradict her predecessor Allan Rock, 
who had suggested he was looking at easing up on legal access to the drug 
as medicine. However, she insisted she was not backing away from the 
government's plan to distribute marijuana for medicinal purposes.

Like any other drug, she said, the safety, efficacy and long-term effects 
of marijuana must be studied before approval. Canadian doctors have led a 
powerful lobby against prescribing pot as medicine, arguing it has not been 
tested for safety or efficacy.
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MAP posted-by: Terry Liittschwager