POT PATCH MAY RELIEVE PAIN

Medical Marijuana Better 'Worn' Than Smoked: Doctors

The country's top pain specialists predict doctors will some day prescribe
marijuana to control chronic pain.

But physicians won't allow patients to smoke it. Instead, pain sufferers
would wear it or inhale it.

Doctors foresee a day when they will prescribe the active ingredients of
marijuana, or a marijuana-like chemical, in a spray to be inhaled, or as a
rub or patch to be absorbed through the skin.

"Because of the concern with smoking, alternatives... are required before
long-term use of cannabinoids (marijuana drug derivatives) can be
recommended," said Winnipeg anesthetist and pain control expert Dr. Ian
Sutton. Pot smoke is as dangerous as cigarettes, he said. "Most physicians
won't get involved with smoking, and with campaigns against smoking, why
would you advocate it?" Sutton said.

As an aerosol or a patch, marijuana is just as good as smoking pot, without
the health risks, say doctors, who yesterday urged the federal government
to loosen controls to allow long-term studies of medical marijuana.

Only two limited studies do have the green light -- one in Montreal and
another in Halifax. The topic was a highlight of the second of a three-day
Canadian Pain Society Conference that has drawn 350 specialists from
Canada, the United States, Australia, Sri Lanka and Nigeria. Last summer,
Ottawa amended federal drug laws to allow a limited number of patients
suffering from conditions such as multiple sclerosis, HIV, cancer and
Crohn's disease to obtain a special exemption to smoke marijuana to relieve
their conditions.

Chronic pain patients who smoke marijuana for medicinal purposes reacted
with derision to the cautious position the doctors are taking.

Patients say smoking works and there's no reason to complicate an effective
drug because of politics.

Andy Caisse, 33, one of 255 Canadians with federal clearance to smoke
marijuana, says he's tried marijuana in other forms, but only smoking
controls his multiple sclerosis. Dave Tetreault, 33, who suffers from
Crohn's disease, a painful inflammatory bowel disease, agreed.

Both men belong to the Manitoba Compassion Club, which advocates the
medical use of marijuana, and both claim to smoke four to five joints a day.

Tetreault smokes illegally -- he has no document from his doctor allowing
him to smoke marijuana -- and he believes doctors are being fussy by
opposing the legalization of a street drug.

"The comparison between cigarette smoke and marijuana, that's just an
excuse. If their hearts were really in it, there would be none of these
delaying tactics," Tetreault said. The future of marijuana in pain control
is more of a political issue than a medical debate, doctors admit.

The Canadian Medical Association and the Canadian Medical Protective
Association are both on record as being opposed to prescription marijuana
on the grounds that federal legislation, as it is currently written, leaves
individual doctors legally responsible for patients' abuse of the drug.
"The whole issue of the CMPA, they look after malpractice (insurance) and
they're saying, if we don't know about this drug, don't prescribe it. If
something happens, you're going to get into trouble," said another
specialist, Dr. John Clark, a pain management specialist at Dalhousie
University in Halifax.

"The whole issue is very political," Clark said.