Spray alternative to pot on the market in Canada

June 22, 2005

Wendy Koch, USA Today

Canadians now have access to a legal spray alternative to medical marijuana. 

Beginning this week, multiple sclerosis patients with constant tingling pain can get a doctor's prescription for a new drug, Sativex, derived from the marijuana plant.

The under-the-tongue spray, approved only in Canada, is one of several emerging alternatives to smoking pot for medical relief. The new pharmaceuticals, some of which may not enter the U.S. market for years, may alter the public debate about medical marijuana.

'People ... who don't want to break the law' will use the spray, says Dr. Lester Grinspoon, professor emeritus at Harvard University and an advocate for legalizing pot use. 'They're elevating the debate on medical marijuana.'

But Grinspoon expects many new users will find they prefer smoking marijuana. 'There is no holding back medical marijuana. It's going to happen,' he says.

Tom Riley, spokesman for the White House's Office of National Drug Control Policy, agrees there's change ahead. But he says the new drugs will lessen the controversy over medical marijuana.

Riley says the Bush administration, which has opposed medical pot use, would welcome alternatives that are scientifically proved to be safe and effective. Several Republicans, led by Rep. Mark Souder of Indiana, cited the availability of Marinol — a pill with the active pot ingredient THC — in arguing against a bill to protect medical pot users from federal prosecution.

The U.S. House broadly defeated that bill last week. Its rejection followed a Supreme Court ruling earlier this month that allows federal prosecution even if smokers are following state laws. Currently, 10 states allow medical pot use.

'This is a burgeoning field,' says Dr. Andrew Mattison, co-director of the Center for Medicinal Cannabis Research at the University of California-San Diego. 'There's probably going to be great potential with the Sativex compound.'

Sativex is a whole plant extract that contains THC (tetrahydrocannabinol) and CBD (cannabidiol) as main ingredients. The user gets quick relief but does not get high. About 20,000 MS patients in Canada with chronic nerve pain could find relief with the spray.

Mark Rogerson, spokesman for Sativex maker GW Pharmaceuticals, says the British firm is taking the first step toward U.S. regulatory approval. But he says the U.S. market, while 'very big and attractive' is also 'very difficult.'

Solvay Pharmaceuticals, maker of Marinol, is also seeking U.S. regulatory approval for a spray version of its drug. It is conducting trials with the U.S. Food and Drug Administration's oversight but expects the approval to take years. Its spray would give users relief within minutes. The pills take about two hours to reach peak effect.

Marinol is the only legal pot alternative in the USA. Approved in 1985, it is used to treat anorexia in AIDS patients and nausea and vomiting in chemotherapy patients. It contains only THC, one of about 400 compounds in the marijuana plant.

'We estimate 25,000 prescriptions are written for Marinol every month in the United States,' says Kevin Rose, Solvay's director for specialized markets.

Grinspoon says many users who've tried Marinol don't like it as much as marijuana, complaining that they have a hard time swallowing the pill or that it takes too long to work.

The alternatives have the advantage of being smokeless, but they're costly. A vial of Sativex costs $124.95 in Canada, which provides 51 sprays, enough for 10 days for the average user. That amounts to about $375 monthly. Currently, insurers are not covering it. Marinol, which has been on the market 20 years, also costs hundreds of dollars monthly. Many insurers cover it.

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