Cannabis

[Guest guest]

March 3 / 4, 2007

It's Official

Cannabis Can Reduce Pain

By FRED GARDNER

The journal Neurology on Feb. 13 published an article by UCSF's I.

Abrams, MD, and colleagues establishing that smoked cannabis relieves

neuropathic pain (an intense tingling or burning sensation usually occurring in

the feet). Abrams et al conducted a study at San Francisco General Hospital with

50 patients whose neuropathy was HIV-related. (Neuropathic pain can also result

from diabetes, trauma, and other causes.) Another type of pain was induced by

applying capsaicin to a patch of each patient's skin.

The study participants were randomly divided into two groups -one that smoked

cannabis (3.5% THC, provided by the National Institute on Drub Abuse), and one

that smoked placebo joints from which the cannabinoids had been extracted (also

from NIDA). Patients smoked three times a day for five days. Those getting the

real thing reported a 34 percent reduction in pain whereas the placebo smokers

reported a 17 percent reduction. Capsaicin-induced inflammation was reduced,

too. " These results provide evidence that there is a measurable medical benefit

to smoking cannabis for these patients, " says Abrams.

Prospective randomized placebo-controlled trials are considered the " gold

standard " in clinical research, and Neurology is a prestigious journal. You may

be wondering, given this study, how the Prohibitionists can deny that marijuana

has a recognized medical use. Here's how: " Very promising result but it's just

one study... More research is needed. " And more research is on the way.

It didn't take long for Abrams et al's study to get cited. On Feb. 18 Philip A.

Denney, MD, wrote the following in support of a Workers' Comp claim by a retired

law enforcement officer:

" I am writing at Patient A.'s request regarding payment for the use of medicinal

cannabis to treat his occupational injuries... Patient A. is a 55-year-old

retired/disabled peace officer who sustained serious injuries in a work-related

motor-vehicle accident in 1998. As a result he suffers chronic pain in the neck

and lower back with radiation into the left upper and right lower extremities.

The pain, particularly in the right lower extremity, is reported to be sharp and

'electrical' in nature, consistent with neuropathic pain. My physical findings

are consistent with those reported by Dr. P. in his supplemental Qualified

Medical Examiner evaluation.

" Patient A. has found the modest use of inhaled cannabis to be very effective

for pain control and much preferred to previously prescribed medications,

particularly opiates. Patient A. reports that 14 grams per week moots his need

and denied any adverse effects. He does not use tobacco, alcohol, or any illicit

drugs. This history is very consistent with that obtained from many patients in

our practice with neuropathic pain syndromes, and a recent study has clearly

confirmed the efficacy of cannabis for the treatment of neuropathic pain. (D. I.

Abrams, et al. " Cannabis in Painful HIV-associated Sensory Neuropathy: A

randomized placebo-controlled trial, Neurology 2007 68 515-521.) " In summary...

medicinal cannabis is an appropriate treatment in this case and is preferred to

Marinol, opiate or other standard drugs. Whole plant cannabis is more effective,

better tolerated, and less expensive in my experience.

" The California Supreme court has addressed this issue in People v. Mower (2005)

and stated that as long as the statutory conditions are met, cannabis must be

treated as '... any other prescription drug.' "

Dr. Denney says that Patient A, like most other patients with severe chronic

pain, was extremely glad to be able to reduce his intake of opiates, which cause

grogginess and constipation, among other adverse effects. The remarkable ability

of cannabis to substitute for or potentiate the effect of other drugs has been

noted by every doctor who employs it in his or her practice. As Denney put it in

the current O'Shaughnessy's, " Cannabis allows significant decreased use or

elimination of many prescription medications, particularly narcotics. Patients

usually report decreases of 50% or better. "

By coincidence " Genentech Sales Could Take Hit on Lower Dosing, " read a Wall St.

Journal headline 2/23. A clinical trial has shown that a half dose of Avastin, a

costly drug given to advanced lung-cancer patients, is just as effective as a

whole dose (15 milligrams per kilogram of body weight). If doctors prescribe the

lower dose, Genentech and its parent company, Roche, lose $4,400 per patient per

month. Genentech's stock fell 2.5% on news of the study results. Capitalism can

be so crass. For all its pretensions, the class system is a crass system.

Fred Gardner is a former Public Information Officer for the District Attorney of

San Francisco. He can be reached at fred@...