----- Original Message -----
Sent: Friday, November 07, 2003 5:43
PM
Subject: [Sndbox] Pot Pill Helps MS
AP) A marijuana pill appeared to
relieve some of the symptoms of multiple sclerosis in the first scientifically
rigorous study of the strongly debated drug.
The research, published
this week in The Lancet medical journal, found that even though improvements
could not be detected by doctors' tests, a greater proportion of patients
taking the drug reported reduced pain and muscle stiffness than those taking
fake capsules.
Experts said the mixed results make them tricky to
interpret. Some said they were encouraged any improvement was noted, while
others said any major effect would have shown up in the doctors' tests.
One study leader, Dr. John Zajicek of the University of Plymouth in
England, said the research raises questions about what's more important: a
doctor's measurements or the patient's perspective.
"I think if
there's a conflict, it's what the patient feels which is important, so I think
it's quite encouraging," said Roger Pertwee, a professor of neuropharmacology
at University of Aberdeen, who was not connected with the study.
Multiple sclerosis, a common nervous system disease, causes a range of
chronic symptoms, including muscle stiffness and spasms, pain, tremor,
fatigue, depression and bladder problems.
It is difficult to study
because the disease is unpredictable and its symptoms hard to measure.
Orthodox treatments often provide inadequate relief, so many MS
sufferers experiment with alternatives, including cannabis and its major
active components � cannabinoids.
There have been anecdotal reports of
the success of cannabis � the Latin word for marijuana � in treating MS
symptoms, particularly muscle stiffness. However, there has been little
scientific evidence.
The study was set up to test the theory that
cannabis and cannabinoids reduce muscle stiffness and may help alleviate other
MS-related symptoms.
It involved 630 multiple sclerosis patients from
around Britain. One-third received a capsule containing whole cannabis oil;
another third took one containing a synthetic version of a cannabinoid known
as tetrahydrocannabinol, or THC. The rest got a fake capsule. Results were
reported after 15 weeks of treatment.
"The stiffness as you move the
limb on the bed and measure it carefully does not pick up a difference," said
one researcher, Dr. Alan Thompson. "But when you look at the impact that
(muscle stiffness) has on everyday life � on what the patient feels � then
there is a difference."
Fifty-seven percent of the patients taking the
whole cannabis extract said their pain had eased, compared with 50 percent on
THC and 37 percent on dummy capsules.
For muscle stiffness, 61 percent
on cannabis extract and 60 percent on THC reported an improvement, compared
with 46 percent on fake treatment.
Patients reported improved sleep
and fewer or less intense muscle spasms. Those who could walk showed improved
walking ability.
However, when an objective test of muscle stiffness
was used, no difference was detected.
One explanation for the mixed
results could be the muscle test, called the Ashworth scale, is not sensitive
enough to detect changes that are meaningful to patients.
"It is very
far removed from everyday life. Moving someone's leg up and down when they are
lying flat on a table doesn't necessarily translate very well into what
happens when they get up and try to walk around or do the housework or
whatever," Thompson said.
In addition, the way the drug was given
could have been a factor, Pertwee said.
"Oral capsules in vegetable
oil ... are notoriously problematic in terms of absorption," said Pertwee, an
expert in the pharmacology of cannabis. "What tends to happen is the
cannabinoids are so fat soluble that they just sit in the vegetable oil and
it's difficult to persuade the drug to go into the (blood)."
Pertwee
said smoking is not considered a therapeutic option because marijuana smoke
causes cancer and other forms of cannabis extract are possible, such as a
mouth spray.
In addition, a high percentage of those on fake pills �
46 percent � reported improvements and about 77 percent of those on cannabis
and 50 percent of those on dummy medication guessed what they were on because
of the easily recognized side effects of marijuana, such as dry mouth and a
lightheaded high.
"It makes their perception suspect in that there
could have been, in effect, an enhanced placebo effect," said Dr. Andrew
Goodman, director of the MS center at the University of Rochester in New York
and deputy medical officer of the U.S. National MS Society, who was not
involved in the study. "You know you're getting it, so therefore it feels like
it works even better, perhaps. That's why the results are tricky to
interpret."
However, Pertwee said the unusually high placebo effect
may reflect natural cannabinoid activity in the body. Research indicates the
body makes its own cannabinoids and levels are elevated in MS. It could be the
body tries to self-medicate in response to the disease, he said.
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