MS PATIENTS IN MARIJUANA TRIALS

Studies attempt to determine drug's therapeutic value

Anecdotal evidence has long suggested cannabis provides relief for a
variety of multiple sclerosis symptoms, such as pain and muscle spasms.

LONDON - "I have never smoked a cigarette, never mind a joint, so I had no
idea whether I'd go all woozy or not," says Lavinia Parish, with a twinkle
in her eye.

Lavinia, 51, suffers from multiple sclerosis and is currently taking part
in a Cannabis in Multiple Sclerosis trial in the U.K, where patients are
given the drug in capsule form.

Three weeks into the 15-week study, however, Lavinia, says she has not
noticed any effects. "I keep waiting for something to happen," she says. "I
may be on the placebo or it may be that cannabis just doesn't affect me.
I'll have to wait and see."

In Canada, MS will be one of the conditions deemed suitable for medicinal
marijuana use when the rules change on July 30 to protect certain patients
with chronic or terminal illnesses against being prosecuted for using
cannabis. There is anecdotal evidence that marijuana can help with nausea,
poor appetite and pain. Studies such as the one Lavinia is participating in
should prove whether marijuana really does have any therapeutic value.

MS is a disease of the nervous system that affects about 50,000 Canadians.
Lavinia's story is typical, reflecting the sheer unpredictability of the
disorder.

"The first sign I had of MS was in the early Seventies," she says. "I was
playing tennis and I couldn't decide whether the ball was going into the
net or not. At the same time, my left arm was a bit numb, and when I placed
my hand in water, I didn't seem to be registering whether it was hot or cold."

Despite these early indications, she had no idea there was anything
seriously wrong. She mentioned her symptoms to her doctor, who sent her to
a specialist. Lavinia can't remember what diagnosis -- if any -- was made.
But she's glad she wasn't told earlier that she had the disease. "I would
have spent the next 20 years worrying. But as it was, I was fine; I had
four sons and was running my own restaurant and keeping busy."

In 1992, Lavinia was walking through long grass near her home when she
realized something was wrong. "I suddenly became aware that I was having to
concentrate on moving my left leg."

Over the following months, her symptoms worsened. She grew clumsier and
started dropping things. Then, in 1993, one of Lavinia's insurance policies
matured. She decided to spend her windfall on health insurance, but when
the insurance company consulted her medical notes, they discovered the
problems Lavinia had suffered in the Seventies.

She was refused insurance, and the firm contacted her doctor who referred
her to a specialist. Tests confirmed she had MS.

Although the root causes of MS are unclear, the condition is a result of
damage to a substance called myelin, which forms a protective sheath around
nerve fibres in the brain and spinal cord. When myelin is destroyed,
electrical impulses to muscle and sensory organs are slow, distorted or
fail to arrive. Lavinia's right leg started to cause her difficulties. The
muscles began to tighten and walking became difficult. After using a stick
for a while, she resigned herself to using a wheelchair five years ago.

"My legs are dead, but my condition seems to be staying the same," she
says. "There have been moments of tremendous depression, especially when
I'd just got divorced -- but you just have to battle on."

"I can't get myself in and out of the car, so I have to have someone there
at both ends of the journey," she says. "That's where I hope this cannabis
trial will eventually be able to help me. If the drug were to stop my legs
being so stiff, I might be able to get in and out of the car on my own."

Anecdotal evidence has long suggested cannabis provides relief for a
variety of MS symptoms. Earlier this year, a trial carried out by GW
Pharmaceuticals on 70 British patients revealed that an extract of cannabis
sprayed under the tongue significantly reduced pain, muscle spasms and
bladder problems among sufferers of MS, cancer and arthritis.

Dr. John Zajicek, one of the specialists carrying out the new cannabis
trials, says the study will not rely on patient feedback alone -- a
physiotherapist will assess the effect of the treatments on the muscles.

"Some studies rely on patients filling out questionnaires on how they feel,
which may be biased because of side effects," says Zajicek, who is based at
Plymouth University and Derriford Hospital, also in Plymouth.

"Patients may feel euphoric because they are receiving a cannabis high,
which may make them inclined to say the drug is having a positive effect,
even if it's not actually helping."

The results of the trial are expected to be available by the end of 2002 or
the beginning of 2003.

For more details of the cannabis trials see www.cannabis-trial.plymouth.ac.uk