Pubdate: Tue, 05 Dec 2006
Source: Canadian Medical Association Journal (Canada)
Copyright: 2006 Canadian Medical Association
Contact:  http://www.cmaj.ca/
Details: http://www.mapinc.org/media/754
Author: Pauline Comeau, Ottawa
Bookmark: http://www.mapinc.org/mmjcn.htm (Marijuana - Medicinal - Canada)
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)

CUT TO MARIJUANA RESEARCH SENDS STRONG MESSAGE

The federal government's decision to cancel the Medical Marijuana 
Research Program (MMRP) sends a strong message that clinical research 
into the risks and benefits of herbal cannabis -- the kind 
distributed by Ottawa under Supreme Court order -- is not a priority.

The discontinuation also signals Canada is no longer interested in 
being a leader in cannabinoid research despite its unique position as 
the only country with a federally controlled marijuana grow-op to 
supply registered users.

The federal government has "suddenly taken away the research, or the 
possibility to do additional research, to inform not only the 
physicians but patients about safety and efficacy," says Dr. Mark 
Ware, the sole researcher to receive MMRP funding.

The research cuts also mean policy-makers won't have adequate safety 
and efficacy data, he adds. "They're making laws and regulations 
around a drug which there is limited data on ... which I think is a 
very awkward situation to be in," says Ware, from McGill's University 
Health Centre.

Ware received $262 000 for a 1-year pilot efficacy study launched in 
2001 on smoked cannabis for chronic neuropathic pain in 32 subjects. 
The study didn't begin until 2003, a delay that Ware says was caused 
largely by licensing requirements and other obstacles related to 
working with a controlled substance. Results will be published in a few months.

The second grant, worth $1.8 million, was awarded in 2003 for a 
Cannabis for the Management of Pain: Assessment of Safety Study 
(COMPASS), which involved comparing 350 medicinal marijuana users to 
a number of non-users suffering chronic pain. It began in January 
2005 and is ongoing. Physician reluctance to participate without 
safety data was part of the delay, says Ware.

The federal government announced in late September that it would not 
spend the $4 million remaining in the 5-year MMRP, which was launched 
in 2001 with a $7.5-million budget.

Marijuana researchers can seek funding from the Canadian Institutes 
for Health Research, but their success rate has historically been 
low, says Ware.

"The medical research community can decide what its own priorities 
are," says Erik Waddell, spokesman for Health Minister Tony Clement, 
repeating the message made by the minister of finance when the cut 
was announced. And MMRP was eliminated, Waddell says, after an 
evaluation showed that the monies allocated "weren't producing any 
results that were beneficial to Canadian taxpayers." Waddell 
repeatedly noted that only one researcher (Ware) was funded and no 
results produced.

Waddell also agreed with Health Canada officials who, when asked 
about the federal government's role in this field, stated: 
"...clinical research regarding the use of marijuana for therapeutic 
purposes and the development of marijuana-based products is best 
undertaken and funded by the pharmaceutical industry."

But, as Umar Syed, vice-president, scientific and strategic affairs 
for Cannasat Therapeutics explains, there is little incentive for the 
pharmaceutical industry to study the naturally occurring cannabinoids 
found in smoked marijuana, like that produced by the government at an 
underground mine in Flin Flon, Man. and distributed to patients with 
physician approval, because they cannot patent it. Instead, the 
industry seeks cannabinoid-like molecules that can be protected 
against competition, or, like Cannasat, focuses on new delivery 
systems -- patches or inhalers -- for naturally occurring 
cannabinoids that avoid the hyper-psychoactive effects associated 
with oral sprays or pills. (Cannasat is at least 4 years away from 
having such a product.)

Marijuana seeds and plants produced by Prairie Plant Systems 
(Cannasat is a PPS shareholder) have been distributed since 2003. A 
week after the MMRP cut, the government allocated $2.2 million to 
extend PPS's contract for 1 year. Waddell says there are no plans to 
close the grow-op.

As of September, 1492 people were authorized, with the support of 917 
physicians, to possess PPS marijuana for medical purposes. That 
approvals come with limited peer reviewed data is reinforced by 
Health Canada's Information for health care professionals (revised) 
- -- marihuana (marijuana, cannabis), which states: "While there are 
many anecdotal reports of the therapeutic value of smoked marihuana, 
scientific studies supporting the safety and efficacy of marihuana 
for therapeutic claims are inconclusive."

Despite this, Waddell insists that: "We believe that even with the 
cut to the medical marijuana research program there is sufficient 
evidence and support out there to continue the program of 
distributing medical marijuana."

The Canadian AIDS Society (CAS) disagrees, saying the lack of 
understanding of risk and benefits, dose requirements or 
counterindications with prescription drugs leaves physicians and 
patients in a quandary.

They are calling for the re-establishment of a Stakeholder Advisory 
Committee on active new substances that was disbanded last year and 
originally recommended MMRP be established.

While there is no plan to close the grow-op, CAS and others argue 
that without more data, doctors will remain reluctant to participate. 
Patients, in turn, won't get legal access, and the grow-op could be 
indirectly choked.

"We feel it is an important public health issue that needs to be 
addressed and the government should be involved in facilitating the 
research so that Canadians can make a more informed decision about 
their health care," says CAS executive-director Monique Doolittle-Romas.

Waddell said there are no plans to re-establish an advisory 
committee, but that if doctors feel strongly more research is needed, 
"then they should speak to Health Canada; we'd certainly listen to 
what they have to say." 
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MAP posted-by: Richard Lake