Pubdate: Fri, 26 Sep 2014
Source: Chronicle Herald (CN NS)
Copyright: 2014 The Halifax Herald Limited
Contact:  http://www.herald.ns.ca/
Details: http://www.mapinc.org/media/180
Author: Clare Mellor

EXPERIMENTING WITH MEDICAL POT

More Data Needed to Determine Effectiveness, Pain-Treatment Specialist Says

At least a dozen physicians raised their hands at a pain conference 
in Halifax on Friday when asked if they have prescribed medical 
marijuana for their patients.

More physicians in Canada are becoming familiar with medical 
marijuana but more education and research is needed, said Mark Ware, 
a renowned pain specialist at McGill University in Montreal.

"We need more data, yes, but we also need better mechanisms to get 
that data, that we do have, out to the hands of people that need to know it."

Ware, an associate professor in family medicine and anesthesia at 
McGill, spoke Friday at the Atlantic Pain Conference. In its seventh 
year, the conference dispenses the latest scientific information on 
pain management to health-care professionals.

Small short-term studies have provided clinical data showing smoked 
or inhaled cannabis can reduce pain and improve sleep and quality of 
life in patients with neuropathic pain, said Ware, also director of 
clinical research at the Alan Edwards Pain Management Unit at McGill 
University Health Centre.

But larger long-term clinical studies are needed to look at efficacy 
and side-effects, he said.

"The issue is who is going to do those trials? Who is going to take 
herbal cannabis and put it through that kind of process? There aren't 
the patents that are associated with it. There isn't the investment 
opportunity that a drug company has with a novel compound."

As the medical marijuana industry grows, he hopes those companies 
producing marijuana will reinvest a portion of earnings into research 
and education.

"Some of that revenue stream should be reinvested into doing the 
kinds of studies that we know we need to help inform the process," 
said Ware, a member of the non-profit Canadian Consortium for the 
Investigation of Cannabinoids. That group is made up of physicians 
and scientists pushing for research and education in the field.

"We (need) to monitor and track the process carefully. If we lose 
track of it and we are not knowing who is doing what, what are the 
doses, we won't learn anything. We'll be having the same discussions 
five years from now."

Cannabinoids, chemicals from marijuana, have been officially approved 
in Canada for treatment of nausea associated with chemotherapy, 
appetite stimulation for people with HIV/AIDS, neuropathic pain, 
spasticity associated with multiple sclerosis, and advanced cancer 
pain, Ware said.

"On the herbal cannabis side, there is no approved indication. It is 
not a drug that has been through the same (testing) process ... There 
is some data but it's a mass of small studies that we have to filter 
through to pick out whether we are satisfied that is sufficient to go 
ahead and use the drug in those conditions."

He has been researching and studying cannabis for 15 years. He has 
about 15 patients using medical marijuana under the new federal program.

"I've had patients in various levels using the prescription options 
and the herbal routes for about 15 years now ... I've seen some 
remarkable improvements, but I echo my colleagues, and I feel that it 
is fine to see some benefits in the clinical practice (but) we need 
to validate that through clinical trials."

Karen Smith of Halifax, who has suffered from chronic pain for over 
30 years, said she hopes medical marijuana will become more available 
to patients with chronic pain in the next few years.

"I think in the next couple of years, the pharmaceutical companies 
may be getting a run for their money," she said. "I think it might be 
the way to go for many."
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MAP posted-by: Jay Bergstrom