Pubdate: Wed, 31 Jan 2001 Source: British Medical Journal (UK) Copyright: 2001 by the British Medical Journal. Contact: http://www.bmj.com/ Author: Owen Dyer, London CANNABIS TRIAL LAUNCHED IN PATIENTS WITH MS The world's biggest clinical trial of the cannabis plant got under way this week at Derriford Hospital, Plymouth; the trial is looking at the control of pain and tremors in multiple sclerosis. Twenty patients were given their first doses of capsules containing cannabis oil, tetra hydro cannabinol, or placebo. After three months, if all goes to plan, the trial will be slowly extended across the country, eventually taking in 660 participants in 40 centres. The cannabis in multiple sclerosis (CAMS) study is sponsored by the Medical Research Council and approved by the government, which has arranged for the drug to be imported from Switzerland. A parallel study will examine the effect of the drug on lower urinary tract symptoms. Patients will undergo up to five weeks of titration, followed by two months at a steady dose. "We're looking for a dose that can help relieve symptoms with minimal side effects," said research registrar Dr Patrick Fox. "We find that few patients want to be stoned or high when they have to take the drug all the time." Patients who benefit from the treatment can opt to continue for a further nine months. They may legally take their medication home because each has been granted a licence by the Home Office to possess schedule 1 drugs. Participants have been advised not to drive during the study period. Cannabis has been a schedule 1 drug since 1971, when the World Health Organization pronounced it medically useless. Two years ago a House of Lords select committee argued that more research was necessary in view of widespread anecdotal reports of the drug's efficacy in controlling pain and tremor, particularly in multiple sclerosis. The government has announced its willingness to amend drug laws if the benefits of cannabis can be shown. This would mean giving cannabis a legal status similar to morphine. The CAMS study is the fourth cannabis trial to begin in Britain in recent months. Three smaller phase II trials have been under way since the autumn--in Guernsey, Oxford, and Norfolk. The drug used in these trials is a sublingual spray, taken from plants grown by G W Pharmaceuticals in Kent. The researchers expect to extend these trials to 2000 patients over the next two years. Professor William Notcutt, who heads the trial at the James Paget Hospital, Gorleston, Norfolk, has enrolled not only people with multiple sclerosis but also patients with various chronic pain syndromes, such as neuralgia and lower back pain. "We're looking at overall quality of life as well as pain relief," he said. "If a patient says they feel better since starting the drug, I'm not going to panic that some of that might be drug induced euphoria and cut their dose on moral grounds." - --- MAP posted-by: Kirk Bauer