CANNABIS FROM THE CHEMIST

STEVE BRADSHAW: Marihuana, cannabis, grass - they used to say it just
drove you crazy. Now it's being grown legally in secret in the South
of England and tested in trials filmed exclusively by Panorama.

Prof GRINSPOON: Cannabis will eventually be seen as the wonder drug of
the 21st Century.

BRADSHAW: All year the row over cannabis has been growing hotter than
ever.

Baroness GREENFIELD: You might literally be blowing your
mind.

BRADSHAW: Now we have the first results from the trials.

DR NOTCUTT: We've seen their pain scores go down to
zero.

BRADSHAW: Results that have already influenced the government's policy
on recreational cannabis and could soon mean medicinal cannabis from
the chemist.

Beirut 1982

[News broadcast] The French Foreign Legion Paratroopers have been
reconnoitring some of the physicians.......

BRADSHAW: Meet patient 002. Alex Ure used to fight with the French
Foreign Legion, he had to leave because of a severe spinal condition
made worse by parachute jumps.

ALEX: The pain got so bad once or twice, I actually ready to commit
suicide. I wanted rid of it, I just couldn't take no more.

BRADSHAW: And morphine? That's supposed to work, isn't
it?

ALEX: The morphine did work but in a higher dosage, and that was when
you were like a zombie, you just sat there.

March 2000 : Police Foundation recommends softer line on
cannabis

BRADSHAW: Last year, as pressure to liberalise cannabis laws began to
grow, Alex was enlisted in a pilot study into medicinal cannabis in
East Anglia. The 23 patients suffered from pain caused by nerve
damage for which other drugs can prove ineffective. They were given
cannabis extract sprayed under tongue, safer than smoking it. Alex
says the cannabis eased the pain so much he was even able to have sex
again.

ALEX: For five years the old willie would never work. It was because
of the stress of the back.. I've no idea what it was, but since I've
been on the trials, my middle wicket has decided it actually works,
and of course when it did work I got Wendy with me and - bang! A new
baby!

BRADSHAW: Daughter Kayley Eleanor was born last February. Being on a
medical trial, Alex was supposed to make sure he didn't get his
partner pregnant. But if he broke the rules, nobody's too worried
now.

ALEX: Three to four years ago if I had a baby to actually hold and
bend down and play with a child I couldn't do it before. I can do
anything with the child now. With the help of this cannabis, that's
my future, that's what I've got to look forward to.

Dr WILLY NOTCUTT James Paget Hospital, Great Yarmouth I think
undoubtedly cannabis does take the credit for Alex and Wendy's baby.
Quite how this is I'm not sure. I think essentially it's because his
pain has been sufficiently controlled to enable him to engage in sex
again. I think there are huge possibilities for cannabis in pain and
maybe many other conditions as well.

BRADSHAW: But could Alex's results have been a freak? Much bigger
trials were needed. The first major commercial cannabis trials in the
world. They were centred on Oxford and on multiple sclerosis, or MS,
which affects over 80,000 people in Britain. Through the year we
followed three severely affected MS patients all hoping not for a cure
but for some relief from their disabling symptoms.

Jan 2001 Police: Belgium decriminalises cannabis for personal use

BRADSHAW: Sandra lives in Banbury, she's a mother of two. She's had
MS for almost 25 years. Her big hope was that the cannabis extract
would relieve the tremor in her hand.

SANDRA: I used to really enjoy my meals, but now it's just a case of
shovelling it in.

BRADSHAW: A risky brain operation called a thalamotomy helped a bit
but only with one hand.

SANDRA: The other hand doesn't work at all. The other hand is as my
right hand was before I had the thalamotomy. (demonstrates
uncontrollable shaking left hand) That's as good as it gets.

BRADSHAW: Have you ever tried cannabis before?

SANDRA: No. Well... yes (laughs) that's not true. My brother got
some for me and it was just a block of resin and I baked it in a cake
and I found it did help with pain at night so I'd always have a
chocolate crispy cake at night before I went to bed.

BRADSHAW: Over in Whitney Tyrone's morning routine is just beginning.
Tyrone is in worse shape than Sandra. It takes two carers and a winch
just to get him up, and it takes them over an hour. He's tried the
odd joint before and found it did help a little, but he's promised to
stop while he's waiting to take the cannabis extract on the trial. He
makes do with tobacco to help him relax.

TYRONE: It will just help my legs to flop down in a
minute.

BRADSHAW: Tyrone was diagnosed with MS 20 years ago. He stayed active
much longer than doctors expected but he's now almost completely lost
the use of his limbs. One symptom is an involuntary tightening of the
muscles.

TYRONE: There's no pain with it, it's just really annoying because you
can't do anything about it. I'm hanging to this chair with my bum at
the moment without being... I'm so close to the edge of it.

BRADSHAW: I mean it does look absolutely exhausting.

TYRONE: Oh it is. I feel as though I've been ten rounds with Mike
Tyson.

BRADSHAW: Tyrone doesn't expect a cure, he's just hoping to get back a
little dignity.

TYRONE: I would like to be able to sleep, I would like to be able to
sit, feed myself properly and be able to hold a pen and sign my name.

BRADSHAW: The St Mary's Girls school at Wantage, model for the famous
fictional girls school "St Trinians". In the morning the chaplain
takes the service. It's been a while since his wife Jo has been able
to join him. Jo has the most debilitating MS of any patient we met.
She also needs carers and winches to get up in the morning. Jo was an
active young woman in good health until the mid 80s. Now at 58 she's
almost totally paralysed.

JO: I can move this arm a little and I can move my head and
neck.

BRADSHAW: And that's it?

JO: Yes, but I can move.. I've got a lot of movement in my head,
fortunately, but apparently that's very often the last thing to go
anyway.

Feb 2001 : Report underlines mental health risks from smoking
cannabis

BRADSHAW: Once she's up, Jo continues to work as a reading tutor and
plays an active part in the school's daily life.

But you're normally okay at night, sleeping at night?

JO: Oh yes, wonderfully.

BRADSHAW: Dreams?

JO: Yes, wonderful, I chop logs and I ride bicycles and run marathons
and things. There's no wheelchair in my dreams. It's all me -
usually working quite hard.

BRADSHAW: And then you wake up.

JO: Yes, but I don't mind because I enjoyed it while I had it. I've
tried pretty well all the alternative therapies and none of them
really helped me.

BRADSHAW: Had you ever thought of taking cannabis?

JO: I've thought of it, I've never done it because I've got too much
to lose really. My husband's job I think would be in jeopardy and we
live in a tied house and I can just imagine the fun the local papers
would have with school chaplain found hanging around pub wanting
cannabis and so on, and it just isn't worth it really.

BRADSHAW: This is the effect Jo's generation used to think cannabis
had on young women. In the 30s cannabis was demonised by propaganda
films, films that showed young women losing their minds as well as
their morals, though the effects we were supposed to fear are just the
ones many people like. But times change. Fifteen thousand cannabis
plants are now being grown quite legally at a secret location in the
home counties. Eight feet high with, carefully studied but never
smoked, psychoactive seed heads. The company behind the trials is
breeding from strains familiar to connoisseurs. The aim - to find an
extract that can help patients without getting them high.

How many conditions could cannabis based medicines
treat?

Dr PHILIP ROBSON Medical Director, Clinical Trials Multiple sclerosis,
spinal cord injury, inflammatory conditions like rheumatoid arthritis,
irritable bowel syndrome, Crohn's disease, osteomyelitis, there's a
number of painful conditions which aren't really well helped by
morphine and other strong analgesics, cancer pain perhaps is an
example of that. And then you've got the symptoms related to HIV
AIDS, perhaps more speculative things cannabis may be useful in
certain mental conditions, mental illnesses. On and on it goes.

BRADSHAW: Early results from the historic British trials are being
watched keenly across the world, not least at the prestigious Harvard
Medical School in the USA, base of one of the world's leading
proponents of medicinal cannabis.

Prof LESTER GRINSPOON M.D. Harvard Medical School I believe that
cannabis, because it is so versatile as a medicine, will eventually be
used by millions of people around the planet. In fact, like
penicillin was considered the wonder drug of the 40s, because it was
versatile, it was non-toxic, it was inexpensive. I think that
cannabis is very likely eventually to be seen as a wonder drug of the
opening of the 21st Century.

BRADSHAW: But in another famous university town in Oxford, centre of
the new trials, those claims are strongly questioned by Britain's best
known brain scientist.

Baroness GREENFIELD CBE Prof of Pharmacology, Oxford University The
very term 'wonder drug' is very frightening. I think it's important
to realise that we are dealing with a drug that does affect the
chemistry of the brain. Now at the moment there's lots of
experiments, both INT the test tube and in laboratories as well as
clinically to try and find out just how dangerous this drug is and
what it's doing to the brain.

BRADSHAW: At the Oxford clinic, Sandra, with a new haircut, has come
for her first dose of cannabis extract.

March 2001 : Met Police propose softer line on cannabis

BRADSHAW: Over the next two months she'll be given four different
formulas to take home. One formula will contain just scented water as
a placebo. Placebos are used on trials so doctors can make sure it's
the medicine working, not the patient's imagination.

May 2001 : US Supreme Court blocks medical use of cannabis

Tyrone's start date has been delayed. Patients have to be carefully
screened for conditions like schizophrenia, heart problems or high
blood pressure which might put them at risk from cannabis. Tyrone's
only problem, his blood pressure was too high until today.

TYRONE: I've actually been told today that my blood pressure is fine
and I'm just waiting for the hospital to ring me and make an
appointment.

BRADSHAW: And what happens then?

TYRONE: I go up there and hopefully I shall then be able to go on the
trial.

BRADSHAW: July, the debate is heating up and it's Jo's first day in
the clinic.

JO: Well they've accepted me on the trial and this is day one, and I'm
not really sure myself. I know I'm going to be here a long time which
is why Roger is going fishing.

July 2001 : 'Decriminalise cannabis' says Mo Mowlam

BRADSHAW: The chaplain's wife, ready to risk her first high, is about
to take her first dose of cannabis extract.

ROGER: I mean I appreciate that it's not going to be some sort of
final miracle cure, she's not going to go home, she's going to be able
to make the beds and walk around. But, if there was just a little bit
less pain, a little bit less anxiety, a little bit more fluid movement
then that would be absolutely tremendous.

smoke cannabis and they don't get into great difficulties. But as a
psychiatrist, what I see are the people who do get into difficulties,
people who've smoked heavily for a number of years begin to become
more paranoid, more anxious, more suspicious. Then they begin to get
deluded and hallucinated, and they really present to us with a picture
that looks just like paranoid schizophrenia. So we have lots and lots
of patients, my clinics, my unit, the units in this hospital are full
of people who have gone psychotic following taking large amounts of
cannabis. Now if they then stop taking the cannabis, then they pretty
well recover and they do really well. If they continue taking the
drug then they do very badly and end up as a chronic psychotic person.

BRADSHAW: Do you have any concerns about what might happen long-term
to the people in these trials?

Baroness GREENFIELD CBE Prof of Pharmacology Oxford University My
concerns are not so much for the patients because if they are having
help and its working, that's marvellous and I hope no on would stop
that happening. My concerns are how those data are interpreted. If
people think this is giving them the green light to just go and get
high indiscriminately, I am very concerned, and I hope that enough
floor space is given if you like forum space is given to actually
ventilate the scientific arguments for and against so that we can
really draw a clear distinction between a medicine and a drug of abuse.

BRADSHAW: Mid summer, Sandra is close to the end of her trial. She's
now allowed to take the spray she thought worked best, and there do
seem to be clear benefits.

BRADSHAW: You had trouble picking up the lighter on the table before.
Is that something you could manage now?

SANDRA: Well, it most probably is.

BRADSHAW: And you can hold it still.

SANDRA: Yes.

BRADSHAW: That's fantastic. You simply couldn't do that before, could
you.

SANDRA: No.

BRADSHAW: And you can take it back?

SANDRA: Yes.

BRADSHAW: And put it down.

SANDRA: Yes.

BRADSHAW: And that really is new.

SANDRA: That's marvellous. That makes me feel so normal.

BRADSHAW: That afternoon, time to decode her results. Under the rules
doctor and patient are in the dark about which formula she's taken
when.

Dr ROBSON: Sandra, hello.

SANDRA: Hello. How are you?

Dr ROBSON: We meet at last.

SANDRA: Yes, at last.

Dr ROBSON: So, how's it been going?

SANDRA: Well I feel so much better than I have done for months and
months and months.

BRADSHAW: Three of the four formula she's taken contain various
combinations of the active chemicals in cannabis including THC which
causes the high. The other contained the placebo, just scented water.

Dr ROBSON: So three and four you thought was the treatment that was
best for you.

SANDRA: I now think it is better for me than three or two or
one.

Dr ROBSON: Okay, well the period for what in fact the high THC
version, the period when you were taking a huge number of sprays turns
out to be placebo.

SANDRA: [to assistant] I kept telling you not to get stressed out
about it (laughing).

BRADSHAW: How typical is Sandra?

Dr PHILIP ROBSON Medical Director, Clinical Trials I think she's very
typical in a sense that all of the patients have been very severely
handicapped by the symptoms of their disorder, which is usually
multiple sclerosis, and it's been striking that most people have had a
positive response. I mean if you took that twenty patients that we've
initially seen, perhaps two or three would not have been helped
because they'd have been too sensitive to the effects of THC, in other
words getting intoxicated before they got effects. Another fourteen
would be given at least some significant clinical relief of at least
one symptom which had been previously intractable with standard
therapy, and then two or three patients would have experienced symptom
relief which really goes beyond that, in fact might reach the level
which would transform their lives. That's striking.

BRADSHAW: Just one problem, as often happens in medical trials, some
patients have been feeling better even when they were on the placebo.
It turns out that when Sandra started riding, she was not on cannabis
at all.

Now when you thought you were riding better because of the cannabis,
it turns out that it was the placebo.

SANDRA: Really?

BRADSHAW: Did you know that?

SANDRA: No.

BRADSHAW: That was during the placebo period. Does that surprise
you?

SANDRA: Well, it doesn't.. it does surprise me because I felt much
more able to do it. But I don't know whether it was me just telling
myself that you will do it.

BRADSHAW: I mean do you think, because you thought you were riding
better and it was the placebo, do you think it could all be in your
head imagining your better?

SANDRA: No. No. The illness isn't in my head.

BRADSHAW: Meanwhile Roger and Jo are away on holiday at a hotel at
Sandringham in Norfolk. Jo's two weeks into the trials. They were
both looking relaxed when I went to see them.

Hi, how are you doing? How are you?

JO: I'm fine thank you.

BRADSHAW: How are you feeling? How are you feeling?

JO: Wonderful, it's amazing. If it's the placebo, it's working. I'm
very much more relaxed. People say my face looks less strained. And
Roger, pick up my arm, look.

ROGER: You see, before that would all be stiff.

BRADSHAW: That was really stiff before.

JO: That would have been a sight.

ROGER: So can now actually move it which is lovely.

BRADSHAW: So it's not all in your head, it's in your arm as
well.

JO: Well if I could have done this with my mind I think I would have
done. And actually I had physiotherapy the day after they started me
and one of her little tricks is to lean my right back and make me lift
my legs and I can usually do six and she kind of calls it ten as I
struggle - and I did twenty-five.

BRADSHAW: Twenty-five...?

JO: On the following day after they actually started.

BRADSHAW: So you'd describe the effect as?

JO: Miraculous, really extraordinary. I mean I've never had any sort
of relief of this kind and as I told you, tried pretty well every
alternative therapy that there is.

BRADSHAW: When Jo says miraculous, that's not a word you would use..
either of you would use lightly.

ROGER: No, it isn't. I mean when you have somebody whose arms and
legs are stiff and difficult to move, then you discover that the
person can actually move their hands easily, and that they're much,
much lighter and their face is lit up and is much happier, then I
think you have to use a word like that.

BRADSHAW: Like?

ROGER: Miraculous. It is, it has made a remarkable difference to Jo
and that can be nothing but good.

BRADSHAW: At home in Whitney there's good news for Tyrone too. Some
of the old stiffness has gone. Today he's getting up with the help of
just one carer.

TYRONE: It's certainly easier to manoeuvre me. My legs just bend as I
get up, instead of having to have a cigarette to relax me in the
morning, I don't need that anymore.

BRADSHAW: You mean an ordinary cigarette.

TYRONE: An ordinary cigarette.

BRADSHAW: You don't even need that any longer.

TYRONE: No.

BRADSHAW: And you think it's because...?

TYRONE: Well it's because of the cannabis without a
doubt.

BRADSHAW: So what do you want to happen both of you now
is...?

TYRONE: For cannabis to be legalised.

BRADSHAW: Medicinally.

TYRONE: Not just... Well....

WIFE: How long have you got (laughs) I mean it's a big issue isn't it,
legalisation of cannabis.

BRADSHAW: Summer in London, high on grass, the national cannabis
rally. The campaigners want an end to laws that last year meant over
80,000 cannabis prosecutions and cautions. The early medical trial
results have already helped persuade the government to ease controls
over recreational cannabis. Possession for personal use will no
longer be an arrestable offence.

If we find cannabis does work as a medicine, what effect will that
have on the whole debate?

Prof LESTER GRINSPOON M.D. Harvard Medical School It's going to have
an enormous effect because cannabis is such a versatile medicine.
Many people are going to be using it as a medicine, and they and the
people who take care of them and the people who observe them, who
surround them, are going to have to reconsider their notions of the
toxicity of this substance, and as they come to understand that it's a
relatively benign substance, this is going to bring about the
decriminalisation of cannabis.

BRADSHAW: That would mean cannabis or marihuana not just from the
chemist but like Amsterdam, cannabis from the coffee house. But the
government have ruled out going that far, and even under the more
relaxed laws, supplying cannabis could still get you five years.

How do you react when people say look, these trials are going to show
cannabis is safe, could benefit lots of people and therefore we should
decriminalise it?

Baroness GREENFIELD CBE Prof of Pharmacology, Oxford University I
think the dangers are that people might think they are taking a drug
that has been proved to be harmless. What you must bear in mind is
that there is more to your brain and your body than merely acute
death. It's not so much that you're going to die, it is more that if
you are changing the chemical landscape of your brain, as life does
generally, but if you're doing it in this very large scale way, then
perhaps - and I say perhaps - you are running the risk that you are
changing your configurations and the kind of mind that you might have.
You might literally be blowing your mind.

BRADSHAW: September and the results are starting to come in, including
from the pilot study into chronic pain in Great Yarmouth. Patient 002
is doing fine, and the other twenty-two patients with nerve damage
pain report relief too, if not always quite so dramatic.

ALEX: I can't really describe the pain no more because for the last
seven months I've had no pain. What can I say about pain? I'm not the
right person to talk to now. I'm free from pain.

Dr WILLY NOTCUTT James Paget Hospital, Great Yarmouth The results so
far have exceeded what I dared hope for. My previous experience with
other similar types of material had led me to believe we might get a
third better, and if we got a half.. 50% of our patients improved I'd
say great, we were there. But we're seeing 80% of our patients
getting good quality benefit from the cannabis. For some they have
got almost total relief of their pain.

BRADSHAW: Total relief?

Dr NOTCUTT: Total relief.

BRADSHAW: Complete pain relief from cannabis!

Dr NOTCUTT: We've seen their pain scores go down to zero.

BRADSHAW: It's the autumn term. Jo and Tyrone have had mixed results.
Both now know they're taking the real drug. But Tyrone has been
having trouble finding a dose that can help his paralysed back without
making him high or nauseous, and Jo's early hopes haven't yet been
fulfilled, but neither are ready to give up.

JO: I got onto a higher dose and had a period of feeling out of it and
rather sort of out of control, but now we've reduced the dose I'm
feeling very much more hopeful and better.

BRADSHAW: Still feel it's a miracle? Not quite.

JO: In terms of what other help I've been offered over the years, it
is, because I've had all kinds of things to try and help me. I can't
remember the names of all the drugs but the sort of muscle relaxants
that they give you have all had rather unpleasant side effects.
Whereas this, I think now we've got the dose nearer to what I should
have, it's helpful without being at all hindersome.

BRADSHAW: If you haven't found the right dose now, could it be that
there isn't one?

TYRONE: No. No, I really do think it's going to take a long time of
adding little sprays here and then taking a spray away there, but it
will come.

BRADSHAW: Sandra has had the best results of all and her best summer
for years. She knows she won't be cured but it has helped some of her
symptoms. Of course Sandra could just be feeling better because she's
on trial, but she's convinced it's the drug that's helped her.

So what has cannabis meant for you?

SANDRA: A whole new outlook on life because of having a good night's
sleep, pain free, and being able to feed myself breakfast, feed myself
lunch, feed myself dinner, it makes me feel normal which is all I'm
asking. Please, please, give me the cannabis and let me feel normal.

BRADSHAW: With the government optimistic that the trials will be
successful, we could see the drug in the chemist in just two years -
four thousand years after cannabis was first used as a medicine.