At last, some real progress on medical cannabis

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 na├»ve 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

NY Times story on Sativex

Information from GW Pharmaceuticals website about Sativex and planned additional products with higher and lower THC:CBD ratios.

[More here in this post on The American Street.]

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: