FIRST LARGE STUDY OF POT FOR MS FINDS BENEFIT

The first large clinical trial looking at whether marijuana actually has a
medicinal effect for people with multiple sclerosis has found that there is
probably a clinical benefit from taking the drug.

The British trial was designed to see if doses of cannabinoids, the active
compounds in cannabis, reduce spasticity in people who have MS. While it
made no discernible difference on that front, people who received the drug
had less pain, slept better and had better mobility than people who
received a placebo.

"It's fair to say that in the study, we did not see an effect on that pure
muscle stiffness," said Dr. Alan Thompson of the U.K. MS research group,
which conducted the trial.

"But when we went on to look at . . . the impact of that stiffness on
people and on their lives and on their mobility, we did see a fairly
consistent pattern suggesting there was some benefit in those taking the
cannabis preparations."

The study, which will be published Saturday in the British medical journal
The Lancet, is expected to be keenly scrutinized by both sides in the
heated debate over whether marijuana belongs in the medicine cabinet.

Anecdotal evidence suggests the drug is helpful for managing the symptoms
of a range of ailments but those opposed to its use argue there is precious
little scientific proof to back up the claims.

"The eyes of the world are on this study because each country has been
wondering what they should do about this," Thompson, from the National
Hospital for Neurology and Neurosurgery, said in an interview from London.

"What we now have is data that people can look at. And they have to decide
on the basis of the data how they wish to proceed."

A Canadian MS researcher praised the study, saying she hopes it leads to
legal changes.

"Aside from the research and moving ahead that way, I hope that this study
will also stimulate some better, more rational laws regarding cannabis for
medical purposes," said Dr. Luanne Metz, a neurologist and a professor of
clinical neurosciences at the University of Calgary.

Currently MS patients can get a waiver allowing them to possess and grow
marijuana ? so long as they get a doctor to attest to the fact they have MS
and specify the dose they should use. Because so little research has been
done on cannabis and because the strength of marijuana from plants can vary
greatly, that puts doctors in an ethical bind.

"How do you do that? And how do you prescribe smoked cannabis when you know
that it puts three to four times the tar in the lungs as a cigarette does?"
asked Metz, who co-wrote a commentary on the study for the journal with
research associate Stacey Page.

"It puts physicians in a bad spot and patients in an impossible spot."

The research team followed 611 people with multiple sclerosis from across
Britain. Participants were randomly assigned to receive oral cannabis
extract, a synthetic version of a cannabinoid known as tetrahydrocannabinol
or THC or a placebo.

Neither patients nor their doctors were told who was receiving which
treatment, though the authors conceded that many of the people getting
cannabis guessed they were on the drug.

The researchers tested muscle stiffness using an accepted tool known as the
Ashworth scale. A physician attempted to move the limbs of a reclining
patient, assessing on a scale of zero to four how hard it was to do so.

They found no real difference between the groups, but conceded the scale
might be too insensitive to register "small but clinically significant
effects on spasticity."

Metz agreed.

"I think it's a lousy way to measure it. I've used the scale and I'm
unimpressed that it has much sensitivity to it," she said.

Benefits were noted in other tests, including a timed 10-metre walk and
self-assessments filled in by the patients. There was a significant placebo
effect noted in the findings, but in all measures other than spasticity
those receiving cannabis or THC scored significantly higher than those on
placebo.

Still, it was not a clear home run. Thompson himself called the findings "a
mixed picture"; the study suggests more research is necessary.

"One always hopes for clarity," Thompson admitted. "The trouble with
science, I think it's fair to say, is that it often gives you grey rather
than black and white. And you don't get clarity. And we are forced to make
judgments based on the evidence . . . as to how we intend to proceed."