Learn more about Sativex, a cannabis-based spray for MS sufferers

April 20, 2005

Karen Kleiss, Edmonton Journal

(This story was originally published on Monday, March 28, 2005.)

Sherri Jones is a woman of faith; a fresh-faced, fortysomething stay-at-home mom who grows pot in her basement and every night before bed takes a long, slow hit from her bong.

She lives in fear that her children will be taunted because their mom smokes weed, that her guests will catch a whiff of the buds flowering in the basement or that hooligans will break in and steal her medicine.

Mostly, though, she fears the judgement of those who don't understand that cannabis is the only drug that helps her control the pain and spastic limbs brought on by multiple sclerosis, a disease she has been living with for seven years.

For those reasons the local woman doesn't want her real name used in this article, so Sherri Jones is a pseudonym.

'I am not a strung-out druggie,' Jones says defiantly. 'I am a normal stay-at-home mom and I am totally against drugs.

'If I didn't have MS, or it didn't help MS, then I wouldn't smoke it. Period.'

Her fears could soon be a thing of the past: pharmaceutical companies' multimillion-dollar push to bring a new crop of marijuana-based drugs to market is giving hope to those who want the medical benefits of marijuana without the stigma.

If GW Pharmaceuticals of England gets approval from Health Canada -- perhaps as soon as this summer -- Jones could get a doctor's prescription for Sativex, a pot-based drug she can spray under her tongue.

If approved, Sativex will only be prescribed to treat the pain and spasticity that comes with MS, but developers hope it will eventually be used to treat symptoms of cancer, arthritis and even irritable bowel syndrome. No buds, no bong, no smoke and no secrecy.

Jones feels like a criminal even though she is one of the more than 700 Canadians who has the government's permission to use the drug. She keeps her special status secret from everyone -- even her own mother.

'People will judge,' she says. 'This is such a hush-hush thing. You don't want anyone to know.'

Not all Canadians who use pot for medical purposes feel the way Jones does. At least 8,000 belong to compassion clubs across the country and use marijuana that is illegally grown and distributed. They argue the drug is safe, effective and should not be illegal. They say the Canadian government's Medical Marihuana Access Regulations are bumbling and byzantine and the quality of the government's marijuana is intolerably poor. Compassion clubs fill the void with organic, high-potency pot.

But companies like GW Pharmaceuticals and its Toronto-based competitor Cannasat are betting millions of dollars that many of those users would choose a spray, pill or patch from their neighbourhood pharmacist over a brownie, joint or tincture from their local compassion club.

Their doctors almost certainly will. The Canadian Medical Association has strongly opposed the government's medical marijuana regulations, saying science doesn't know enough about the drug to prescribe it safely. The Canadian Medical Protective Association, which insures doctors, warns physicians not to sign patients' marijuana exemption forms.

Dr. Michael Yeung is a doctor at the Calgary Multiple Sclerosis Clinic which provides services to 5,000 MS patients in Alberta, a province with one of the highest rates of MS in the world. Neither he nor any other doctor there will prescribe pot. Smoking is dangerous, they say, and too little is known about the drug.

'We don't know the long-term side effects, we can't judge dosage ... We don't even know what the active ingredient is,' he says.

And, Yeung says, it is difficult to prescribe. 'What am I supposed say, take one toke?'

GW Pharmaceuticals says it has that problem solved.

'By standardizing delivery by means of a spray, we are ensuring that it is safe and that it is consistent,' GW spokesman Mark Rogerson says.

'The dose you take tomorrow ... will be exactly the same as the dose you took today, you will know where it comes from. With Sativex you don't need to get high to manage your symptoms.'

Getting high is one of the key reasons MS sufferers stop using pot, according to a 2003 study published in the Canadian Journal of Neurological Studies.

'The side effect of being high was unacceptable,' one respondent told researchers. The patient stopped using the drug even though it helped with walking and stiffness. Another said: 'I have to take care of myself and being stoned and forgetting stuff can't be part of my life.'

Most MS patients will never try marijuana. The study's authors say even though nearly all know marijuana could relieve the extreme fatigue, chronic pain and muscle spasticity that comes with MS, they won't try it because it is illegal.

Sativex will be legal, and the big pharmaceutical companies say that means more patients will use it and get the medical benefits of marijuana. What could be wrong with that?

Some observers say it could mean the end of patient choice; the organic, high-potency bud offered by compassion clubs may be forced underground by the sanctioned pharmaceutical spray.

'Most of these clubs exist simply because the police let them exist,' Osgoode Hall Law School professor Alan Young says. A lawyer who has played a seminal role in the Canadian pro-pot movement, Young recently joined Cannasat in its quest to develop a marijuana-based pharmaceutical.

'Law enforcement knows it is a public relations nightmare to target what might be a medical operation, so they leave (the compassion clubs) be.

'But in 10 years, if there is a vibrant market in cannabinoid products, Health Canada and the Department of Justice may take the view that these clubs don't serve a constructive purpose anymore. ... Then maybe you will see a change in law enforcement policy.'

Pro-pot activists have for decades put their liberty on the line to get cannabis into the hands of the people who need it, says Reille Capler of the B.C. Compassion Club Society. If pharmaceuticals can help achieve that aim, they will support it.

'There is a niche for them to fill because of the stigma and the legal status,' Capler says. 'But we're on an uneven playing field.'

She and her colleagues worry about the drug companies' drive for profit, the ultimate accountability to shareholders -- not to patients -- and an apparent mission to secure a monopoly on pot-based medicines.

'(Pharmaceuticals) can't replace the products and services of a compassion club, and can't replace the benefits of the variety of strains we offer,' Capler says. Some patients prefer smoking organic weed and pharmaceuticals will be a one-size-fits-all dose that may not work for all patients.

Then there is the cost: compassion clubs offer pot to patients for roughly $8 per gram, and most patients use between one and two grams per day. The cost is not covered by health care plans and Capler says the club gives the drug free to needy patients.

The drug companies want to make money.

'There are a lot of people who will have a long discussion about what a medicine is,' GW Pharmaceuticals' founder Dr. Geoffrey Guy told The Walrus magazine last year. 'But I am a pharmaceutical physician, and my definition of a pharmaceutical is a 'worthwhile medicine that makes money.''

Nobody can say how lucrative the market for marijuana-based drugs might be, but some believe pot will be a multi-purpose drug that treats millions of people for everything from cancer to aids to arthritis.

Millions of people who, like Sherri Jones, just want to live a healthy, pain-free life without feeling like a criminal or fearing the judgement of her peers.

'People put this stigma on us,' she says. 'They say these pot growers are gangsters, Mafia, potheads and drug lords. That's what they see.

'If that spray works, I'm sure as heck getting rid of this stuff.'

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