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UK: Drug addicts get methadone on the NHS... why can't I have the cannabis spray that eases agonies of MS? Hilary Freeman Daily Mail Saturday 18 Jun 2011 Her condition has slowly deteriorated. "I can't feel anything in my right foot – it's like a piece of dead meat,' says the 49-year-old mother of one from Prestwich, Manchester. "When I walk, I often need to lean against a wall or ask for a friend to help support me. Every day I get painful spasms in my right leg, which make it stiffen and stop me sleeping." But there is a drug that can help MS sufferers like Susan. Sativex is the first cannabis-derived medicine to be licensed in the UK. It is applied under the tongue by an oral spray and absorbed into the bloodstream. The drug works by stimulating the cannabis receptors in the brain and nervous system, dampening overactive nerve cells and relieving spasticity by targeting the area of the brain that controls muscle tension. Sativex does contain THC, the chemical that gives recreational users of cannabis a 'high'. But patients using Sativex don't get high because the dose is much lower and it is a controlled form of the substance. Sativex comes with more than ten years of clinical trials proving its effectiveness in treating the symptoms of MS and is proven to help reduce pain and spasticity, improve sleep and causes few side effects. Indeed, Susan was on one of the trials for Sativex and found it incredibly effective. But, despite numerous requests from her neurologist saying she needs it and is eligible for it, her local Primary Care Trust, NHS Salford, refuses to prescribe her the drug. Susan, an HR manager for a tram company, is far from alone. Almost a year after Sativex was licensed by the UK Medicines and Healthcare Products Regulatory Agency (MHRA), the majority of those with MS in the UK who need it remain unable to obtain it. MS affects about 100,000 men and women in the UK. It is a neurological condition that damages the nerves and affects the transfer of messages from the central nervous system to the rest of the body. It affects everybody differently but common symptoms include blurred or double vision, numbness, limb weakness, spasticity and pain. At later stages there can be loss of co-ordination and speech impairment. The MS Society says it has been contacted by hundreds of sufferers unable to access Sativex despite their doctors’ requests, and thousands more have made enquiries about how to get it. Many PCTs are issuing blanket refusals to all patients on grounds of 'cost effectiveness' and 'no proof of efficacy'. "It doesn't seem fair': Susan Costello can't understand how drug users are prescribed methadone on the NHS but she is refused a cannabis spray which would ease her agony Susan says that when she took Sativex, her symptoms improved immediately. "An hour after the first spray I had sensation back in my right foot for the first time in years," she recalls. "It helped my balance, stopped the spasms and allowed me to move around much more easily. "I could co-ordinate my limbs again. My fatigue wasn’t so bad either." For 18 months after the trial ended, Susan paid for private prescriptions of Sativex, until she was no longer able to afford it. When the drug was licensed last year – for people who, like Susan, do not respond adequately to other anti-spasticity medication and who demonstrate a clinically significant improvement in an initial trial of the therapy – she assumed she would automatically receive it on the NHS. But her application was declined. A spokesman for NHS Salford said: "We follow guidance produced by the Greater Manchester Medicines Management Group, in July 2010, regarding Sativex. "The guidance is as follows: "The group does not recommend the use of Sativex for the treatment of moderate to severe spasticity due to multiple sclerosis (MS) who have not responded to other anti-spasticity medication and who demonstrate a clinical improvement during a trial of therapy. Although Sativex showed some benefits against placebo, as the data is not yet fully published the clinical significance of this is unclear. The main trial was 12 weeks; so longer-term safety data for Sativex are currently unknown. Sativex was deemed to be a low priority for funding. Why refuse to prescribe Sativex? Some NHS Trusts have refused to prescribe Sativex owing to its cost – about £11 a day, per patient, based on a dosage of eight sprays a day. Other trusts claim they have better ways of treating severe spasticity and claims the effects of Sativex have not been proven. Since she has been unable to get Sativex, Susan has been taking a drug called Baclofen for her spasticity. Not only is it less effective but it has unwelcome and unpleasant side effects, such as making her unable to control her bladder or bowels. Sativex had no side effects for her. Dr William Notcutt of the James Paget Hospital at Great Yarmouth says: "Imagine having continuous, severe cramps and pain and not being able to sleep. "Knowing that there's something that can help, but you can’t get it, seems very unjust. "Sativex is actually no more expensive than other drugs I prescribe for MS and rheumatoid arthritis." Susan says: "It doesn't seem fair that I can't get a drug I need and that works. Drug abusers are prescribed methadone on the NHS. Their condition is self-inflicted. Mine isn't." Read more: http://www.dailymail.co.uk/health/article-2005287/Drug-addicts-methadone-NHS--I-cannabis-spray-eases-agonies-MS.html#ixzz1Pi41vf2l
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