Medical marijuana: Help without the high

August 16, 2002

Jennifer Thomas, USA Today,

As the battle over medical marijuana intensifies, researchers are quietly trying to come up with a way to dodge the bullets. Their aim: Develop a form of the drug that will treat pain but not get you high. In laboratories and greenhouses around the world, they are are experimenting with pills, inhalers, patches and even suppositories that would deliver marijuana's pain-killing effects without the psychoactivity. Scientists hope the new products will quiet critics who believe the medical marijuana movement is nothing more than a bid to eliminate penalties for smoking pot for fun. Researchers also believe the products will be popular with doctors and patients. For sufferers of chronic diseases who use marijuana to treat pain, getting high is an undesirable side effect. 'Recreational users smoke pot to get high,' says Mark Rogerson, a spokesman for GW Pharmaceuticals Ltd. in England, which has a permit from the British government to grow marijuana plants for medical research. 'People who are ill smoke it so they can get on with their jobs, make supper for the kids, go to the supermarket. Feeling high and light-headed is not what they want,' he adds. Irvin Rosenfeld, who smokes 12 marijuana cigarettes a day to dull the pain of a crippling bone disorder, agrees. 'Smoking marijuana lets me do my job and live my life,' says the 48-year-old stockbroker from Fort Lauderdale, Fla. He has multiple congenital cartilaginous exostosis, a rare and painful genetic disease that causes tumors to grow at the ends of his bones. Advocates of medical marijuana contend it can ease the nausea triggered by chemotherapy, soothe the tremors and muscle spasms of multiple sclerosis, rekindle the appetites of people with AIDS who suffer severe weight loss and also is useful with glaucoma, migraines, arthritis and even depression symptoms. But bringing medical marijuana to your local pharmacy won't be easy. Getting U.S. Food and Drug Administration approval for many drugs is a long and expensive process, and marijuana poses some unique challenges, researchers say. First, because marijuana grows in nature, it can't be patented. Big drug companies are hesitant to spend millions of dollars on research and clinical trials on a product they can't own outright, says Sumner Burstein, a professor of biochemistry and molecular pharmacology at the University of Massachusetts in Worcester. Second, a drug manufacturer would need to come up with a way to administer marijuana other than through smoking it, because marijuana smoke is considered at least as toxic as cigarette smoke. Further complicating matters, marijuana is a highly complex plant that contains more than 400 chemicals. Although marijuana contains 60 chemicals called cannabinoids that could play a role in its painkilling effects, only one — tetrahydrocannabinol, or THC — is the compound that researchers believe is responsible for those painkilling effects. And THC is also the compound responsible for the psychoactive high that recreational marijuana users crave. Researchers are experimenting with different combinations and dosages that would deliver the painkilling effects without the mind-bending ones. After 10 years of research, Burstein says he has the answer. He has developed and patented a synthetic form of THC called CT-3 that he says works as well as marijuana for pain relief but is not psychoactive. 'There is a critical need for a drug that is potent but does not have the bad side effects,' Burstein says. 'We think we've found it.' Burstein was funding the research out of his own pocket until recently, when he licensed CT-3 to Atlantic Technology Ventures Inc., a small New York City company that is trying to get a major drug company interested in continuing the clinical trials. Completing the trials to get FDA approval would cost about $100 million, he estimates. There is already a synthetic form of THC called Marinol that has been available by prescription since the mid-1980s. But some patients complain that Marinol, a pill, takes too long to work because it has to be absorbed through the digestive system, a company spokeswoman says. Marijuana that is smoked delivers its effects almost instantly, and some patients say they can regulate the dosage of smoked marijuana more easily. Unimed Pharmaceuticals of Deerfield, Ill., the company that makes Marinol, is addressing those issues by working on an aerosol spray that would deliver quick pain-relief similar to smoked marijuana. England's GW Pharmaceuticals is taking yet another approach in the quest. The company was granted a license by the British government in 1998 to grow 40,000 cannabis plants in secret greenhouses for research. Although plants in the wild can be chemically different from one other, the plants grown in GW's greenhouses are bred to be identical so scientists can be sure exactly what chemicals are in them. Armed with that information, scientists are working to develop a plant extract that has a low dose of THC and another component of marijuana, cannabidiol (CBD). Researchers believe cannabidiol mitigates the psychoactivity of THC, Rogerson says. GW's scientists are currently testing under-the-tongue sprays that have varying amounts of THC and CBD. The aim is to strike the right balance that would produce pain relief without the high, Rogerson says. The firm plans to have a prescription ready by 2003, he adds. The spray will have a mechanism, possibly a microchip, that prevents the user from taking more than the prescribed dose, Rogerson says. 'What will happen is, you'll get pain relief quickly at a dosage level well below the amount you'd need to get high,' he says. What To Do To read studies on medical marijuana, visit the Schaffer Library of Drug Policy, or the National Institute on Drug Abuse. To read the first part of this series, click here.

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