MARIJUANA AND THE MUNCHIES

A New 'Cannabinoid Blocker' Could Help Rehabilitate the Weed

History hasn't been kind to cannabis, a researcher at Dalhousie
University lamented last year. The drug is one of the most used
worldwide, but misconceptions about its therapeutic potential and
safety continue. More research is on the way, but marijuana's true
rehabilitation could come from, of all things, a new diet drug that
works by deactivating the same therapeutic neural network in our
bodies that marijuana activates.

Whether or not you've ever tried marijuana, whether or not you've
inhaled, you have your own cannabis infrastructure, a grid of nerve
receptors that changes your experience of pain, sleep and appetite. We
all make our own natural cannabinoids, marijuana-like chemical
compounds. "If you're hungry," says Dr. Mark Ware, a professor at
McGill University's pain centre, "they're probably active in you right
now."

But what if you're hungry too often, as are 95 per cent of Canada's
2.25 million Type 2 diabetics whose excess weight aggravates their
disease and costs the economy one of every seven health care dollars
it spends? Looking for an anti-munchies drug, researchers found the
synthetic compound rimonabant, a cannabinoid blocker. (It switches off
the same neural network that our own cannabinoids and marijuana turn
on.) So long as you stay on it, the drug reduces appetite, blood
sugar, waist size and weight (by about five per cent), while it raises
HDL ("good") cholesterol. Rimonabant was approved in Europe last year.
Negotiations with the Food and Drug Administration in the U.S. are
underway. It could be available in Canada next year.

In a dearth of effective weight-loss drugs, will there be a run on it?
"It's not a bikini drug," says Dr. Josee Dubuc-Lissoir of
Sanofi-Aventis, the French manufacturer. She says an education
campaign will limit prescribing it to fighting diabetes and
cardiovascular disease. Rimonabant will likely be as popular here as
it's been in Europe, and it may well help policy-makers understand
that the body's cannabinoid network holds marvellous therapeutic
secrets that could still be better understood -- including the way
marijuana helps the sick and dying.

For critically ill Americans, that can't happen soon enough. In March,
a U.S. court ruled that even the dying -- for whom cannabis restores
sleep and appetite and reduces pain -- can be prosecuted under
American laws. Is the situation any better in Canada? To some extent,
says Ware and Halifax's Dr. Mary Lynch, the pair of Canadian
researchers known worldwide for studying cannabis and its manufactured
versions -- Sativex, Marinol (dronabinol), and Cesamet (nabilone) --
used in the treatment of chronic pain, cancer, AIDS and multiple
sclerosis. With researchers across the country, Ware and Lynch are
running a trial to test its safety and efficacy against standard
chronic pain medications.

It's the last Canadian study for now. Months after gaining office, the
Harper government declined to renew funding for the Medical Marijuana
Research Program the Liberals began seven years ago. Lynch isn't
surprised. "We live in a pain-denying world," she says.

Canada allows regulated access to the herb itself, but obtaining it is
an uphill climb, especially when you're sick or when you can't find
the required pain specialists to wade through the government's
mountain of paperwork on your behalf. In Eastern Canada especially,
legal access has become merely theoretical: the one Halifax pain
clinic that serves all of Atlantic Canada closed its doors to most new
referrals years ago.

Until recently, though, Canada led the world in research, and still
has the most prescribable cannabinoids. The U.S. has two drugs only,
as does most of Europe, including the Netherlands, which also has an
access program. Only Canada has approved Sativex, an oral spray, for
chronic pain relief.

Ware's cannabis patients don't get the munchies if they're
appropriately dosed, nor do they get "stoned." The sick respond
differently to drugs than do the healthy, he explains. "These are
extremely ill people who have failed conventional treatments. These
aren't the ones standing on Parliament Hill waving hemp flags."
They're rarely overweight, either -- though now they may be glad of
those who are.