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UK: Lords hustle dope trials

Helen Pearson

Nature

Thursday 22 Mar 2001

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A House of Lords report calls for faster moves towards therapeutic use
of cannabis.

The pace of progress towards cannabis-based medicine should be stepped
up, says a House of Lords report published today[1]. Although it praises
Britain's steps towards clinical trials of such drugs, the report
highlights unnecessary hold-ups in the process.

Sufferers of chronic pain and multiple sclerosis (MS) who currently use
cannabis to relieve their symptoms do so illegally in the UK.

Trials of cannabis-based medicines are also underway in the US and
Canada, but they are less well-advanced than those in the UK. In Europe,
a softening of attitudes towards recreational use of the drug is also
apparent: Switzerland is making moves to come into line with Holland,
where use of cannabis in licensed cafes is legalised, and several other
European countries turn a blind eye to possession of small amounts of
the drug.

The recommendation that doctors be allowed to prescribe cannabis-based
treatments was made by the House of Lords Select Committee on Science
and Technology in November 1998[2]. But the government firmly and
immediately rejected the idea.

"They didn't want to know," says Lord Perry, chairman of the inquiry.
"It was a drug of addiction -- the therapeutic aspect was not being
looked at." The committee hoped that future scientific evidence on
therapeutic cannabis use might force the government to change its tune.
Today's report outlines the conclusions of an inquiry set up to
establish the state of such research.

"The good news is that we are one of the only countries in the world
doing large-scale trials. We could be the first to generate real medical
data," says Leslie Iverson, professor of pharmacology at the University
of Oxford and specialist adviser to the committee.

The Medical Research Council has put up £1.5 million to fund two new
trials into the use of cannabis in treating MS and pain after surgery.
But progress has been slow -- one trial is only just recruiting patients
and the other hasn't even got that far. The report suggests that the
stigma surrounding cannabis is inhibiting research.

"If the research does turn out to be positive, there will still be a
long way to go before a cannabis-based medicine is available," says
Iverson. For one thing, no one is volunteering to sell it. "Big
pharmaceutical companies won't have anything to do with it."

In contrast, private company GW Pharmaceuticals is well advanced in
developing cannabis-based treatments. The company has produced a spray
that delivers the drug under the tongue. This improves on available
delivery methods: capsules, in which drug dosage is difficult to
control, and smoking, which is seen as medically unacceptable.

The committee's report also expresses concern about the attitude of the
Medicines Control Agency (MCA), the body responsible for licensing
cannabis-based drugs. The MCA insists that cannabis be treated as a new
medicine. This means that toxicology data on chemicals in cannabis
extract must be collected, a process that could delay trials by as much
as two years. "I'm pleased at the progress but concerned at the heel-
digging going on," Iverson concludes.

But overall, the report detects a softening in the government's official
line towards genuine therapeutic use of cannabis. It suggests that,
presented with sufficient scientific evidence, the government is now
likely to recommend licensing of these medicines. "They've suddenly
woken up the fact that we're not asking for recreational use -- just
that doctors can prescribe clinical preparations of cannabis to MS
sufferers," says Lord Perry.

David Harrison of the Multiple Sclerosis Society agrees that the
government is starting to come round now trials are underway. "We've
been pushing for proper research for a long time and we're very pleased
they're underway," he says.


References
1. House of Lords Select Committee on Science and Technology.
Therapeutic Uses of Cannabis (HMSO, London, March (2001).
2. House of Lords Select Committee on Science and Technology. Cannabis:
The Scientific and Medical Evidence (HMSO, London, November (1998).

 

 

 

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