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Spain to test cannabis as aid for patients
Ben Sills in Madrid and Jo Revill The Observer
Sunday 06 Feb 2005 Spain's socialist government has given the go-ahead for the most wide-ranging trial of therapeutic cannabis ever conducted, putting the country at the forefront of drug policy. Four hospitals, 60 pharmacies and up to 1,500 patients in Catalunya will take part in a year-long pilot programme sponsored by the regional government to establish the drug's effectiveness in treating a range of conditions. 'Experts agree cannabis has interesting therapeutic possibilities,' said Rafael Manzanera, Catalunya's director of health resources. 'We want to evaluate its efficacy across different groups of patients. That has never been done before.' Patients will be prescribed cannabis capsules for four conditions: multiple sclerosis (MS); the side effects of chemotherapy; lack of appetite among Aids sufferers; and pain not eased by existing therapies. The move follows decisions around the world to overcome anti-drug sentiments and carry out more studies into cannabis, many years after research first showed it could relieve pain. In the next few weeks Canada is expected to approve the use of Sativex, which delivers cannabis derivatives into the bloodstream via a mouth spray. It is the world's first prescription drug made from marijuana, and is manufactured by GW Pharmaceuticals. There is growing frustration in the UK among people with chronic pain, such as MS sufferers, that nothing similar has been allowed here. The Medicines and Healthcare Products Regulatory Agency has asked GW for a confirmatory study of the product, although it does not dispute its safety or efficacy. In most European countries, including Spain, cannabis remains illegal, although authorities often turn a blind eye to those using it for therapeutic purposes. The plan for a trial using a marijuana compound was initially blocked by Spain's conservative government but won support after Jose Luis Rodriguez Zapatero's socialists came to power last March. Zapatero has set an unapologetically left-wing social agenda since taking office. He has angered Spain's conservative establishment with bold reforms on gay marriage, social housing and religious education, and his drugs policy is expected soon to include a programme of heroin prescription for long-term addicts. Therapeutic cannabis use is widespread in Spain, but users have to rely on informal networks for support and information about the drug. And with no controlled source, supplies can vary considerably in strength. 'The majority of the people we spoke to said using cannabis had improved their quality of life,' said Rafael Borras, a committee member at the College of Pharmacists. 'But there was a real lack of information. So we proposed this pilot.' Montse Domenech, of the Association of Breast Cancer Patients in Barcelona, says her group gets three or four calls a day from women all over Spain looking for advice about cannabis. But while its use is widespread among her members, it remains frowned upon. 'We're older women and we have our hang-ups,' she said. 'When I started I had my oncologist's support but I didn't tell my husband.' She says most oncologists in Barcelona will give patients the go-ahead to try cannabis, even if they won't admit it publicly. 'We might as well provide support and control, since people are going to take it anyway.' British patients could be included in the Spanish programme if they registered at one of the participating hospitals, but they wouldn't receive NHS funding. 'The prescription will be tightly controlled,' said Manzanera. 'But if patients from outside Spain meet our criteria, they will be included.'
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