MS PATIENTS REPORT SOME RELIEF FROM MARIJUANA PILL, STUDY SHOWS

The Results Were Mixed, Though, Because Doctors' Tests Couldn't Detect
Improvement.

LONDON

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 if there
had been a major effect, it 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.

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.

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."