Friday, 28 July 2017

Legalising Cannabis. What's your view?

Should we be legalising cannabis for use in multiple sclerosis? 

There is an article in the Guardian about it.

https://www.theguardian.com/society/2017/jul/27/legalise-cannabis-as-treatment-of-last-resort-for-multiple-sclerosis-says-charity


Currently there is a licensed version of Cannabis called Sativex, the problem is it costs too much and so it is not approved for use in Scotland, Northern Ireland and England yet it is available in NHS in Wales. Surely this is wrong! 

Another example of the post code lottery.

In the paper it says

“We (the MS Society) think cannabis should be legalised for medicinal use for people with MS to relieve their pain and muscle spasms when other treatments haven’t worked,” said Genevieve Edwards, the MS Society’s director of external affairs".

"The charity is also urging NHS bosses to make Sativex, a cannabis-based drug used by some people with MS, available on prescription across the UK so that patients who can afford it no longer have to acquire it privately, at a cost of about £2,000 a year. Wales is the only home nation to provide the mouth spray through the NHS".

Pharma make the existing (Cheapish) drugs  but if street cannabis becomes legalised, will pharma bother developing new drugs, if they can't make a return. I suspect the answer is No.  

It is simply not worth it.

A longer-acting version of baclofen has been approved in US but where is it?

As someone who has been developing a new treatment, this question is very pertinent. Will someone invest in its further development?

I am detached from the financial issues and have no power to influence costings/pricing, but I am acutely aware that cheap price may mean no interest

Sativex is not approved in the USA, yet now there are loads of States that have Medical Marijuana at a fraction of the cost, 
I suspect it may never get approved.

Therefore, the profits from the American sales cannot be used to offset cheaper drug prices for the NHS. 

Should the MS Society really get behind Off-label prescription, as there are alternatives to many of the current MS medications and their high cost is no doubt is causing rationing. 

Should Marijuana be legalised for MS, I have my views but I'll keep them to myself.

CoI. I am developing an alternative to Cannabis and so I will keep my mouth-shut aout the merits of Lagalisation

15 comments:

  1. Might be ok to legalise low level THC cannabis but not the high THC skunk. I've seen a few friends become mentally unwell from smoking skunk.

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  2. The story of medical marijuana highlights the failure of government agencies to recognize its potential. Desperate patients are relegated to self-medicate due to the draconian policies regarding medical cannabis. This means they are required to go to marijuana dispensaries and haphazardly try different strains of cannabis (with varying amounts of THC and CBD) in the hope that they will find a match. Also, delivery of THC/CBD by smoking is harmful to the lungs. The makers of Sativex have done the proper research and studies yet they cannot get their product approved. The FDA classifies marijuana as a schedule I drug with no medical benefit, on par with heroin. Yet marinol is a marijuana based prescription drug used to increase appetite in patients with HIV and cancer. Frustrating to say the least.

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  3. I live in New York State, where the legal medical marijuana laws are quite stringent. The only products permitted are oils derived of various mixtures of pure THC and CBD.

    For the uninitiated, THC is the stuff that makes you high. It also has anti-inflammatory, anti-pain, anti-spasm, and anti-spasticity properties, in addition to perhaps being neuroprotective.

    CBD has little psychoactive effect, but has strong anti-inflammatory, anti-spasm, and anti-spasticity properties.

    I received my medical marijuana license from New York State last week, and visited a dispensary just last weekend. I received various forms of THC and CBD mixtures, both in vaping and pill form.

    One formulation I received is 1:1 THC to CBD. Used this in my vaping device (also sold by the dispensary), after being told it would create a "mild euphoria". Well, if that's mild euphoria I can't even imagine what a stronger euphoria might feel like. Stuff knocked me on my backside. Even as a teenager I never liked the marijuana high, so I wasn't thrilled with the effects of this mixture.

    The other formulation I received is 1:20 THC to CBD. Have this in pill form. This stuff, so far, is fantastic. It has served as an almost magic elixir as far as taking care of my spasms and spasticity, and its anti-inflammatory properties have reduced the pain resulting from my horrifically painful Avascular Necrosis – a terrible degenerative bone disease that attacks the major joints – which I developed as a result of intravenous steroid use early in my "MS career". This CBD heavy formulation has allowed me to sleep through the night for the first time in years. It does produce a kind of "warm fuzzy" feeling, quite pleasant, barely noticeable and nothing at all like the effects of the THC formulation.

    In summation, for those who can tolerate the THC high, you may get some neurologic as well as symptomatic benefits from medical MJ. The CBD heavy concentrations will provide symptomatic relief for spasms, spasticity, and inflammatory pain, which is just what I was looking for.

    That's my take away, and I hope this summation helps some of the folks wrestling with this issue out there… In short, not all medical MJ is created equal…

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    Replies
    1. Dear WK
      Can I take you to task here and ask you what information sources you are basing your comments on.

      I have stopped going to certain a cannabis-related science meeting because it was being populated by stoner cannabis producers, of this there are now loads since the legalisation of medical cannabis use, who were claiming that cannabis does every thing. The aspirin of the twenty-first century. When ask where is the evidence, the response what through self-medication. However, we can't accept this as proof

      THC has "anti-inflammatory, anti-pain, anti-spasm, and anti-spasticity properties, in addition to perhaps being neuroprotective".

      I would agree on all of these, perhaps reserving concerns about inflammation, our experience is the imunosuppressive potential is an artefact in animals. However the human data is lacking and limited to anecdote. The class I trial data is not lacking.

      THC is licenced to get rid of cancer-related emesis (vomiting) and to limit wasting associated with HIV infection.

      Cannabidiol has "strong anti-inflammatory, anti-spasm, and anti-spasticity properties". Where is the data.

      I have tested both these compounds 98-99% pure and have data that do not support these claims. In humans CDB is being assessed for epilepsy.

      Some of the so called high CBD preparations have loads of THC in them. So the claims are a load of tosh. However, you have hit the nail of the head as many of the CBD varieties sold as medical are full of THC (10-25%).
      CBD may have some blocking effect on the activity of THC.

      In the sixties/seventies the THC content was up to 5% now some of the stuff has 50% THC. This is crazy and no wonder why the high is unpleasant and why psychosis is a problem with some cannabis strains.

      I am very happy that CBD:THC (20:1) is of benefit and I believe there are explanations for the benefit for CBD, but they have nothing to do with the CB1 and CB2 cannabinoid system and are ion channel related.

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    2. MD – appreciate the response. Admittedly, I have found little class I research regarding the efficacy/potentials of medical cannabis. Here in the US, marijuana is still classified as a class a drug, so there have been very few, if any, traditional trials done on the stuff, as it is forbidden by law.

      I'm basing my assertions on the information provided to me at the marijuana dispensary by a fully licensed and certified PhD pharmacist. As I said, the regulations here in New York are quite stringent, so this was definitely not a "stoner" operation. New York State forbids the sale of any form of medical MJ other than oils derived from pure THC, CBD, or a combination of both. No leafy stuff or edibles are allowed.

      The claims I made for THC in CBD in my previous comment are basically what I was told verbatim by the consulting pharmacist. He didn't get into possible mechanisms of action.

      I have previously tried self-medicating with high-grade (at least that's what the dealer told me) marijuana in the past, and found the unpleasant high outweighed whatever benefits I might have seen.

      This time around, though, using the 1:20 THC to CBD oil (in pill form), I have noticed a marked improvement in spasticity, spasms, and the pain caused by my osteonecrosis. Certainly, could be placebo, but I was highly skeptical about any possible benefits going in.

      For the last several years the pain in my joints has been such that I couldn't sleep for more than 90 to 120 minutes at a time, before the pain forced me awake. Since starting on the CBD oil (with a touch of THC) about a week ago, I've managed to get 5 to 6 hours of continuous sleep each night. Whatever the reason, I'll take it…

      Spasticity and spasms have been noticeably reduced, as well.

      I wish you tremendous success on whatever anti-spasticity medication you are working on. There is certainly great need for improved approaches for this troublesome symptom…

      Regarding the increased strength of today's marijuana compared to the stuff I smoked as a teenager in the 70s, it's almost a completely different animal. Back in high school I could share a joint with a friend and then spend my algebra class time in a pleasant buzz. Today's stuff, one toke and I am stupefied, ossified, and otherwise of blotto, not a pleasant experience at all…

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    3. The said meeting also had pot docs...it was embarrassing going to a science meeting to see them sneaking off to "medicate". I am not being a prude but it should be professional, it's not OK to get a volcano out and use it in public forum especially when federal government employees are present.

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    4. I am wondering why people really take/smoke the stuff? If it's not for pain and symptom relief then is it because they are bored with life? Escaping from something in their personal lives or following the cool crowd?
      I disliked the 'high' when I tried it. It made a visit to the toilet a mission, as in it made doing things an real effort to do. It was unproductive and like WK said not a pleasant experience. It was pedestrian.

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    5. Agreed to, shocking they would do that. Great way to undermine your own message. I imagine they weren't imbibing for medicinal purposes.

      My primary reason for trying the medical MJ is the pain relief from the osteonecrosis. The condition is hideously painful, and at this point I'm existing with the equivalent of two broken hips and two broken shoulders. Would have had joint replacements years ago, but my body isn't up to tolerating the surgery.

      I hate taking opioids, so I figure medical MJ, at the very least, is the lesser of two evils. So far, so good… Especially with the CBD heavy mixture…

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    6. in some cases of pain cannabinoids are better because the opioid receptors are down regulated leaving the cannabinoid receptors

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  4. Just adding this to receive notifications of responses to this post…

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  5. My view - it should be legal for all uses. Not the government's business whether I would like to use a drug that provides a mild euphoria. As long as I'm not hurting anyone, why not?

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  6. I take a CBD supplement and it may just be psychosomatic but I really feel it helps my spasticity. Baclofen on the other hand just makes me tired. I actually hadn't realised sativex was £2,000 a year, for me this is affordable so I may look into a private prescription.

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  7. "Legalize it
    Don't criticize it
    Legalize it, yeah yeah
    And I will advertise it.........................
    Singers smoke it,
    And players of instrument, too
    Legalize it, yeah yeah
    That's the best thing you can do
    Doctors smoke it
    Nurses smoke it
    Judges smoke it
    Even lawyer, too

    t's good for the flu
    Good for asthma
    Good for tuberculosis
    Even numara thrombosis"

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  8. I have Secondary Progressive MS and I lived for nearly three years in North Wales. I applied for Sativex but was turned down - because I had been refused when I lived in West Kent, England. The neurological department of North Wales NHS is administered from...the Walton Centre in Liverpool, England so the West Kent decision over-ruled any Welsh approval of Sativex. Postcode lottery gone viral?

    Anyway, I then tried CBD oil and that seemed to relieve some of my symptoms and helped me rest at night. No scientific evidence of course, but it worked for me, whereas with Baclofen I had most of the negative side-effects the product warned were possible.

    Unfortunately, I now live in Idaho, one of the States where the legalisation of marijuana, even for medical purposes, is highly unlikely and the use of CBD oil is illegal as well.

    It seems as if the cannabinoid avenue will remain closed for my lifetime.

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