EXPERTS QUESTION MEDICINAL USE OF POT

Smoking Pot to Ease MS Symptoms May Impair Mental Acuity, Study Suggests

TORONTO - Some people with multiple sclerosis have turned to street
marijuana in a bid to ease pain and other symptoms of the disabling
neurological disorder, but new research suggests smoking pot may
further harm already vulnerable cognitive abilities.

The study compared mental skills and emotional status of MS patients
who smoked cannabis for symptom relief against others with the
disease who did not use the illicit street drug.

"We found that the individuals who smoked cannabis performed more
poorly on the tests that measured the speed of thinking, speed of
cognition, speed of information processing," said co-investigator Dr.
Anthony Feinstein.

"So they were not as quick when it came to their thinking."

Feinstein, a neuropsychiatrist at Sunnybrook Health Sciences Centre
in Toronto, said study subjects who partook of the weed were about 50
per cent slower on average in cognitive tests than non-marijuana users.

"We also found that the group that smoked cannabis had a higher
lifetime prevalence of psychiatric disorders in general," he said,
referring to depression, anxiety and other mood alterations.

"Now we don't know whether it was the cannabis that led to this
disorder or the disorder was there before they smoked cannabis, so we
couldn't really attribute the direction of that relationship. It was
just an association."

Multiple sclerosis affects an estimated 55,000 to 75,000 Canadians,
the majority of them female. Depending on its severity, MS can cause
vision disturbances, pain, co-ordination problems, muscle stiffness
and spasticity, and partial or complete paralysis. The disorder can
also impair mood and cognitive abilities.

Feinstein said the researchers undertook the study of cannabis, which
is even prescribed by some MS physicians under Canada's Medical
Marijuana Access Regulations, to determine its effects on patients.

To conduct the study, published online Wednesday in the journal
Neurology, they enrolled 140 people with MS, 10 of whom had smoked
marijuana within the previous month and were defined as current users.

The pot smokers were each matched by age, sex, length of time they
had MS, and level of physical and neurological disability with four
other MS patients who did not use the drug.

Subjects had a mean age of about 35 and almost three-quarters were female.

The researchers then evaluated the participants for emotional
problems such as depression, anxiety and other psychiatric disorders.
They also tested the participants' thinking skills and memory.

While pot users scored more poorly compared to non-users, Feinstein
conceded the researchers don't know for sure that it was the cannabis
and not the natural progression of MS behind the toking patients'
reduced mental acuity.

"I don't think you can have any definitive result on the basis of 10
subjects. It's just an interesting observation," he acknowledged.
"Having said that... there were no differences between the cannabis
smokers and the non-cannabis smokers when it came to the MS disease
and there were no demographic differences."

"But the one difference came when we tested them cognitively. So
that's where the suggestion comes from, that smoked cannabis might be
bad for your cognition."

Feinstein said that while the researchers are not going to make any
"absolute statements" based on the findings from 10 patients, the
study makes it clear a larger study is needed to see if their
findings can be replicated.

Dr. Virginia Devonshire, director of the University of British
Columbia MS clinic, called the study interesting, but agreed there
were too few participants to draw a strong conclusion on the possible
negative effects of marijuana.

"People who have cognitive impairment who are starting to notice
those cognitive differences also tend to report more anxiety, more
depression," she said from Vancouver. "Are they perhaps more likely
to become cannabis users because of that?"

"So you don't know in the beginning are you looking at different
levels of cognitive impairment before people started smoking cannabis?"

Still, she said prescription drugs -- pills and an oral spray -- that
contain the active cannabinoid found in marijuana are known to cause
drowsiness and to dull mental agility.

"And I think what this study highlights for the patients who are sort
of using cannabis on their own is that it's not that simple," said
Devonshire, who advises her patients that marijuana is like any other
drug or medication: "You have to know that the benefits are going to
outweigh the side-effects."

Aprile Royal, a spokeswoman for the MS Society of Canada, said that
despite the study's small size, its findings are significant in that
they deal with an issue of concern to the organization that advocates
for patients -- an area she said needs much more research.