Pubdate: Tue, 21 Jun 2005
Source: Edmonton Journal (CN AB)
Copyright: 2005 The Edmonton Journal
Author: Pamela Fayerman, CanWest News Service
Bookmark: (Cannabis - Medicinal - Canada)
Bookmark: (Chronic Pain)
Bookmark: (Sativex)


VANCOUVER - Evelyn Bruce has tried smoking marijuana and she's also had it 
in synthetic, liquid form, but now the 60-year-old Fraser Valley woman is 
happy to have a new option to reduce the pain plaguing the multiple 
sclerosis sufferer: a peppermint-flavoured mouth spray containing 
pulverized marijuana.

What she likes about it most is that it won't make her high.

Canada is the first country in the world to approve the product called 
Sativex and on Monday pharmacies here and across Canada began dispensing 
what is being touted by manufacturers as the "first marijuana-based 
pharmaceutical offered for sale anywhere in the world."

Bruce, who worked in the social services field until she went on long-term 
disability, said she expects her doctors will prescribe the new product to her.

"The liquid form marijuana drug [Cesamet] gave me unpleasant hallucinations 
as side effects and made me feel stupid. And I don't want to smoke 
marijuana because that just drives up my blood pressure, so the doctors at 
the University of B.C. multiple sclerosis clinic have told me that with 
Sativex, I shouldn't have those problems," said Bruce, who has been living 
with MS for nearly 30 years.

Chronic neuropathic pain (nerve pain) affects about 50 per cent of people 
with MS and it can occur either spontaneously or as a result of touch, 
temperature or movement.

The spray, which costs $124.95 per vial (51 sprays per vial) numbs the pain 
but not the brain.

Marketed in Canada by Bayer HealthCare, it was pioneered and is 
manufactured in England by GW Pharmaceuticals, which had the mandate to 
develop a non-smoked cannabis-based prescription medicine. The spray is 
made from a purified plant species called Cannabis sativa L. The product 
has been described by the maker as "a bit like a breath freshener and 
tasting like a rather bitter Guinness."

"With Sativex, you don't need to get high to manage your symptoms," GW 
spokesman Mark Rogerson said in a previous Ottawa Citizen interview before 
the drug was approved by Health Canada. Bayer will eventually apply for 
Pharmacare coverage but in the meantime, those who use Sativex will have to 
pay slightly more than what they might for marijuana distributed by 
compassion clubs, where pot is offered for about $8 a gram.

Like their patients, doctors welcome another tool in the anti-pain arsenal, 
especially one that won't wreak havoc on the mind or the lungs, as smoking 
medicinal marijuana might.

"Canada has a fairly liberal attitude towards cannabis for medicinal 
purposes and we are fortunate to have the chance to prescribe these drugs 
for patients with pain," said Dr. Virginia Devonshire, a neurologist at the 
UBC clinic, which handles up to 5,000 patients.

Made of a whole plant extract containing tetrahydrocannabinol (THC) and 
cannabidiol (CBD) as the main ingredients, Sativex is sprayed under the 
tongue or on the inside of the cheeks about five times a day. It works by 
stimulating the cannabinoid receptors in the central nervous system to 
suppress pain.

Two months ago, Health Canada expedited the approval for Sativex with the 
condition that its safety profile be monitored for benefits and risks. The 
side effects in clinical trials included nausea, fatigue and dizziness, all 
of which could be reduced by adjusting the doses. MS is the most common 
neurological disease in young adults, affecting about 50,000 Canadians.
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