CANNABIS TRIAL LAUNCHED IN PATIENTS WITH MS

The world's biggest clinical trial of the cannabis plant got under
way this week at Derriford Hospital, Plymouth; the trial is looking
at the control of pain and tremors in multiple sclerosis. Twenty
patients were given their first doses of capsules containing cannabis
oil, tetra hydro cannabinol, or placebo. After three months, if all
goes to plan, the trial will be slowly extended across the country,
eventually taking in 660 participants in 40 centres.

The cannabis in multiple sclerosis (CAMS) study is sponsored by the
Medical Research Council and approved by the government, which has
arranged for the drug to be imported from Switzerland. A parallel
study will examine the effect of the drug on lower urinary tract
symptoms.

Patients will undergo up to five weeks of titration, followed by two
months at a steady dose. "We're looking for a dose that can help
relieve symptoms with minimal side effects," said research registrar
Dr Patrick Fox. "We find that few patients want to be stoned or high
when they have to take the drug all the time."

Patients who benefit from the treatment can opt to continue for a
further nine months. They may legally take their medication home
because each has been granted a licence by the Home Office to possess
schedule 1 drugs. Participants have been advised not to drive during
the study period.

Cannabis has been a schedule 1 drug since 1971, when the World Health
Organization pronounced it medically useless. Two years ago a House
of Lords select committee argued that more research was necessary in
view of widespread anecdotal reports of the drug's efficacy in
controlling pain and tremor, particularly in multiple sclerosis.

The government has announced its willingness to amend drug laws if
the benefits of cannabis can be shown. This would mean giving
cannabis a legal status similar to morphine.

The CAMS study is the fourth cannabis trial to begin in Britain in
recent months. Three smaller phase II trials have been under way
since the autumn--in Guernsey, Oxford, and Norfolk. The drug used in
these trials is a sublingual spray, taken from plants grown by G W
Pharmaceuticals in Kent. The researchers expect to extend these
trials to 2000 patients over the next two years.

Professor William Notcutt, who heads the trial at the James Paget
Hospital, Gorleston, Norfolk, has enrolled not only people with
multiple sclerosis but also patients with various chronic pain
syndromes, such as neuralgia and lower back pain. "We're looking at
overall quality of life as well as pain relief," he said. "If a
patient says they feel better since starting the drug, I'm not going
to panic that some of that might be drug induced euphoria and cut
their dose on moral grounds."