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IACM-Bulletin of 28 November 1999

Science: Survey on the medical use of cannabis products in the German speech area

An anonymous standardized survey of the medical use of cannabis and cannabis products of patients in Germany, Austria and Switzerland was conducted by the Association for Cannabis as Medicine (Cologne) in co-operation with the EURopean Institute for Oncological and Immunological Research (Berlin). Between April 1998 and April 1999 170 subjects participated in this survey; questionnaires of 128 patients could be included into the evaluation.

68 percent of these participants were males, 32 percent females, with a total mean age of 37.5 (+/- 9.6) years. The most frequently mentioned indications for medicinal cannabis use were depression (12.0 percent), multiple sclerosis (10.8 percent), HIV-infection (9.0 percent), migraine (6.6), asthma (6.0), back pain (5.4), hepatitis C (4.8), sleeping disorders (4.8), epilepsy (3.6), spasticity (3.6), headache (3.6), alcoholism (3.0), glaucoma (3.0), nausea (3.0), disk prolapse (2.4), and spinal cord injury (2.4). Multiple responses were possible.

The majority of patients used natural cannabis products such as marihuana, hashish and an alcoholic tincture; in just five cases dronabinol (Marinol) was taken by prescription. About half of the 128 participants of the survey (52.4 percent) had used cannabis as a recreational drug before the onset of their illness. To date 14.3 percent took cannabis orally, 49.2 percent by inhalation and in 36.5 percent of cases both application modes were used.

72.2 percent of the patients stated the symptoms of their illness to have much improved after cannabis ingestion, 23.4 percent stated to have slightly improved, 4.8 percent experienced no change and 1.6 percent described that their symptoms got worse. Being asked for the satisfaction with their therapeutic use of cannabis 60.8 percent stated to be very satisfied, 24.0 percent satisfied, 11.2 percent partly satisfied and 4.0 percent were not satisfied. 70.8 percent experienced no side effects, 26.4 percent described moderate and 3.3 percent strong side effects. 84.1 percent of patients have not felt any need for dose escalation during the last three months, 11.0 percent had to increase their cannabis dose moderately and 4.8 percent strongly in order to maintain the therapeutic effects.

Thus, this survey demonstrates a successful use of cannabis products for the treatment of a multitude of various illnesses and symptoms. This use was usually accompanied only by slight and in general acceptable side effects. Because the patient group responding to this survey is presumably highly selected, no conclusions can be drawn about the quantity of wanted and unwanted effects of the medicinal use of the hemp plant for particular indications.

(Source: Schnelle M, Grotenhermen F, Reif M, Gorter RW: Results of a standardized survey on the medical use of cannabis products in the German speech area [published in German]. In: Grotenhermen F, Saller R (eds): Cannabis und Cannabinoide in der Medizin [Cannabis and Cannabinoids in Medicine]. Research in Complementary Medicine 6, Supplement 3, 1999.)

Science: Phase I trial with cannabis for medical use

A British drug company said on 16 November it hoped to have a cannabis-based medicine ready to be prescribed by doctors within three or four years. GW Pharmaceuticals said it was making progress in clinical studies with cannabis-based medicines.

Volunteers had been taking cannabis under clinical conditions in order to determine the best dose and toleration of treatment. The pilot Phase I study involved just six healthy individuals and was intended to pave the way for larger patient trials. They had taken cannabis either from an inhaler or via liquid under the tongue.

Dr Geoffrey Guy, the company's chairman, said: "All the subjects came through very well, and we were very pleased with the study. Now we have a much better idea of what our starting point should be." Heart rate, temperature and respiration were monitored and blood samples taken for analysis. In addition each volunteer went through a battery of cognitive and psychometric tests. Dr Guy said: "We have been able to define and follow through the psychoactive effects. None of the effects is disturbing, or would be classed in a clinical trial as serious." He said patients did not need to "get high" to gain a therapeutic benefit.

If approved by the regulatory authorities, the second phase trials would commence next year. They will involve up to two or three hundred patients with multiple sclerosis, spinal cord injury, and phantom limb pain, said Dr Guy. By the end of the final Phase III trials a total of around 2,000 patients will have taken part. The main studies should be completed in 2002.

"Subject to the necessary regulatory approvals, we hope to have a cannabis-based medicine available for prescription by doctors within three to four years," Guy said. GW Pharmaceuticals is licensed by the British Home Office (Interior Ministry) to grow, possess and supply cannabis for medical research. Dr Guy personally potted GW Pharmaceuticals' 20,000th cannabis plant on August 24 this year. The plants are housed in a highly secure and environmentally controlled glasshouse at a secret location.

(Sources: Reuters of 16 November 1999, PA News of 16 November 1999)

News in brief

Spain:
Under the title "El cáńamo ante el nuevo milenio" (Hemp before the new millennium) the second meeting "La Bella Flor" was celebrated at the Faculty of Law of the University of Málaga from 29 to 31 October, arranged by ARSECA (Asociación Ramón Santos de Estudios del Cannabis de Andalucía). On Friday afternoon possible medical applications of the hemp plant were discussed with lectures by Dr. Ricardo Navarrete Varo and Dr. Manuel Guzmán, professor of biochemistry and molecular biology at the Complutense University of Madrid.
(Source: Personal communication by Ricardo Navarrete Varo of ARSECA)

USA:
Two advocates of the medicinal use of marijuana pleaded guilty on 19 November to growing more than 6,000 plants and selling the drug, saying their only hope was to ask for a judge's mercy after they were precluded from raising medical issues in their defence. Peter McWilliams and Todd McCormick, intended to tell jurors about the state law passed by voters in 1996 allowing marijuana use for medical purposes, its purported benefits and their own health. Mr. McWilliams has AIDS, and Mr. McCormick has fused vertebrae from childhood cancer treatments.
(Source: New York Times of 24 November 1999)

Canada:
A banner has been created to help the defence team of Renee Boje, an American woman fighting extradition to the USA to face drug-conspiracy charges in a legal battle in Canada. She has claimed refugee status. Boje, 30, was arrested in 1997 outside the Bel Air mansion of Todd McCormick, where police said she was seen watering and moving some of the 4,000 pot plants being cultivated there. Banner site: www.safesafe.com/reneeboje

Europe:
Around 40 million people in EURope have tried cannabis at some time in their lives but heroin is still the main problem drug, a report on narcotics abuse in the EURopean Union said on 22 November. Between three and five million people in the bloc have tried heroin, the Lisbon-based EURopean Monitoring Centre for Drugs and Drug Addiction (EMCDDA) said in its annual report which was launched in Berlin. There are between one and 1.5 million "problem" drug users in the EU out of a population of some 375 million, it said. In countries with high levels of regular cannabis use, such as Germany, Britain or the Netherlands, the number of users had stabilised or even fallen.
(Source: Reuters of 22 November 1999)

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