A British company called GW Pharmaceuticals has developed a sublingual spray called Sativex which contains all the psychoactive chemicals in natural cannabis, and that medicine is likely to be approved in Britain for the treatment of MS within months. The rest of Europe and Canada will probably follow quickly, and it’s quite possible that the US won’t be too far behind.
Sativex, an extract of the whole plant rather than a blend of synthetics, contains — unlike the whole plant material itself — a constant ratio of the many active cannabinoids. The first version to be approved will have a 1:1 ratio of cannabidiol (CBD) to delta-9-tetrahydrocannabinol (THC). That’s somewhat more cannabidiol than most illicit-market cannabis, which should make using the spray somewhat more anxiolytic and somewhat less intoxicating than smoking a joint. (One of the reasons the only currently marketed cannabinoid medication, Marinol, has not been widely used is that its pure-THC formulation leads to a relatively high incidence of panic and dysphoria.)
The method of administration means that the effects will also be somewhat slower to come on. The manufacturer claims that most MS patients can get relief from spasticity and the related pain without becoming subjectively stoned.
A naïve observer would expect to find the proponents of medical marijuana dancing in the streets, and its opponents mourning and grumbling. After all, approval of Sativex would amount to a concession that cannabis has in fact had therapeutic value all along, and that by stubbornly refusing to approve it the government has been denying relief to large numbers of patients, some of them suffering very badly. (Yes, there are advantages to a standardized — and perhaps optimized — cannabinoid profile, and to using a sublingual spray to avoid the throat and lung insult of smoking, but those are clearly second-order questions.)
But in fact the drug czar’s office is cautiously welcoming the new development, while the only criticism of Sativex is coming from prominent advocates of medical marijuana such as Lester Grinspoon and the Marijuana Policy Project.
Medical marijuana has been one of the very few drug-policy issues where the public sided with the “reformers” rather than the “drug warriors,” and Sativex may represent a way for the warriors to get out of an argument they can’t win without taking the (to them) unthinkable step of admitting that pot-smoking can actually be therapeutic.
LA Times story on Sativex