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Illegal Pain Relief

This article was featured in the June 2007 edition of FaMily
by Kathy Longley (

Cannabis plantThe medicinal use of cannabis has shot back into the limelight following the conviction of three people with multiple sclerosis charged with conspiring to supply an illegal drug. The trio were involved in producing chocolate bars containing cannabis and supplying them to other sufferers with multiple sclerosis throughout the UK. To date they have sent out more than 20,000 bars.

Cannabis is renowned for its relaxation properties and many people with chronic pain claim that it reduces muscle spasms, helps them rest and allows them to be more independent.

Kate, who was diagnosed with fibromyalgia 4 ½ years ago, is a regular user of cannabis, "I find I get much greater relief from it than I do from my painkillers," she says. "I was actually advised by my pain consultant that 'unofficially' it's the best thing for my condition. It doesn't take all the pain away but it does allow me to concentrate on other things rather than being immersed by the pain. To be honest I found it a small saviour in alleviating some of the intensity of this horrible condition."

Terry, who was diagnosed with fibromyalgia two years ago and also has cervical spondylosis and degenerative disc disease in his lumbar spine, agrees wholeheartedly with Kate. He had a period when he was smoking four joints of cannabis every day and found it made him feel very relaxed and helped with restful sleep. "I found cannabis to be more effective than anything I have taken to date," he says. "I am currently on morphine every 4-6 hours as required, robaxin as a muscle relaxant and diazepam but would say that cannabis is far more effective and in my opinion the best painkiller there is."

Despite many reports of its beneficial qualities by people with chronic pain, cannabis remains illegal in the UK. In the April edition of Disability Now a Home Office spokesman is reported as saying, "Cannabis is a Class C drug and is harmful. Its cultivation, supply and possession are illegal and will remain illegal. We have sympathy for those with severe pain and serious illnesses such as multiple sclerosis. Any cannabis-based medicine would have to be approved by the Medicines and Healthcare products Regulatory Agency (MHRA). If that body approved any products we would then have to consider seeking Parliament's agreement to make necessary changes in the law."

To people like Jane, who has fibromyalgia and works as a psychiatric nurse, this is welcomed news. "I'm on the 'no way' side of the fence when it comes to legalising cannabis. I've nursed too many people with paranoia and long term schizophrenia that was triggered by cannabis use," she explains. "I know a lot of people think the paranoia thing is just a scare tactic from the government, and I used to think the same until I met umpteen teenagers and adults receiving months of inpatient psychiatric care after regular cannabis use. It's not a miracle cure, it's another chemical substance that has potential serious psychotropic side effects and a strong potential for psychological addiction even if you don't go on to try other stuff. People who smoke cannabis might do this believing that it's a new form of self care and end up never living their 'normal' life ever again. Would you risk it? I know I wouldn't."

Irene is in strong agreement. She has no personal knowledge of using cannabis to relieve her pain but feels strongly about drug use having worked with young people. "I have worked with too many young people who have been addicted to all sorts of substances," she says. "The thing to remember is although society appears to accept cannabis as a harmless non-addictive drug it can cause lethargy, paranoia and many other symptoms. I am strongly against the use of drugs although I would never condemn anyone for trying to ease their pain," she adds.

Terry finds it interesting that people can feel so strongly about cannabis but are happy to take other prescribed medications with what he sees as far worse side effects. "I would be more concerned about the addictive properties of antidepressants that are prescribed for fibromyalgia and also things like diazepam and to a lesser degree tramadol or morphine," he says. "I am not at all worried about the supposed addictive properties of cannabis. When I stopped smoking it a while ago I did not have any withdrawal type symptoms. I would say that any evidence of reduced mental capacity is seriously flawed since I have previously used enough cannabis to knock a herd of elephants over and have known other people who have been or are long-term users of cannabis and hold high profile professional positions and show no evidence of any decreased mental capacity let alone any signs of mental illness as a result," he continues.

To Terry it seems crazy that a 'soft' Class C. drug is illegal when, in his opinion, it has far better pain relieving qualities than the Class A drug, morphine, he is currently prescribed. "It saddens me that there are so many misconceptions around the use of cannabis when it is such a good painkiller and muscle relaxant all in one," he says. "Think of the money the NHS could save by prescribing cannabis over combinations like morphine, diazepam and low dose antidepressants as sedatives. The one drug but does it all and that is the one that isn't legal?"

Kate concurs: "Personally I think it's ridiculous that doctors will prescribe us opiates and other strong drugs with horrendous side-effects, yet can't prescribe us cannabis and in the eyes of the law I am a criminal for using it," she says.

One of the fears surrounding people who use cannabis for pain relief is the source of their supply. Currently, to obtain this drug you may have to deal with some rather unscrupulous people, hand over large sums of money and in the end you may end up with a concoction that has been mixed with all manner of other substances that could do you no end of harm. An alternative option is to grow your own supply but even so you are still breaking the law.

A solution may soon be available in the form of a product called Savitex, a spray containing distilled marijuana. It is being produced by GW Pharmaceuticals, a UK company, and will be the first prescription medication based on real, rather than synthetic versions of, cannabis and will contain all of the plant's pain relieving properties. Being a spray, it is easy and convenient to take, just a few sprays under the tongue and the drug is rapidly absorbed to give swift relief.

A recent research study headed up by ProfessorChristine Collin, a consultant neuro-rehabilitation specialist from the Royal Berks and Battle NHS Trust, shows the spray to be highly effective significantly reducing spasms and stiffness in people with multiple sclerosis. "Our findings provide encouraging evidence of the effectiveness of Savitex in reducing spasticity even in difficult to treat patients who have failed to gain enough improvement from currently available medication," she told Disability Now. In the study, involving 189 participants, two out of five people experienced a further improvement in spasticity of more than 30% when taking Savitex.

Savitex is already licensed for use in Canada. In the UK it is currently awaiting full licensing, but can be made available to individual patients with a doctor taking responsibility for the prescription to a named patient. This means that some people will be able to access it whereas others are likely to be refused until Savitex is fully licensed.

Helen Yates, managing executive of the M.S. Resource Centre, still believes that it would be a 'cheaper and better option' to make it legal for disabled people to grow their own cannabis for their own use due to the potential cost of prescribing Savitex. She may have a point. Will GPs be prepared to prescribe this medication for pain relief? Only time will tell.

Terry stopped using cannabis because he gave up smoking but says that if it were available in any other way he would gladly take it, "If there was another way to take cannabis that was clean and easy to use then I would gladly give over all my morphine, diazepam and anything else for it, that is how effective I think it is," he said.

Nabilone-a synthetic drug based on cannabis
Nabilone belongs to a group of drugs known as cannabinoids, so named because their chemical structure is very similar to that of cannabis. It is most commonly used to treat nausea and vomiting caused by chemotherapy medicines used to treat cancer, but tends to be reserved for people who do not respond to other anti sickness drugs for fear that it may cause changes in mood and behaviour similar to that of cannabis.

About 18 months ago, Yvonne Castleford was offered nabilone to treat her fibromyalgia symptoms by a consultant at her local pain clinic and has been taking it ever since with good results. "I find it absolutely brilliant," she says. "I don't have any side effects and it makes me feel extremely relaxed. It relaxes the muscles so you don't have those awful spasms and I haven't had any irritable leg syndrome symptoms at all since taking it, except on one night when I forgot to take the tablets."

Yvonne takes two tablets at 7:30 p.m. in the evening and says that the relaxation feeling kicks in within about 20 minutes. The reaction of nabilone with her other medications can make her feel sleepy so once she has taken her tablets she stays in and would not consider getting behind the wheel of a car. She is allowed to take one extra in the daytime if she needs to and says that you can tell the difference in her voice within 20 minutes. "If I take one during the day it doesn't make me feel sleepy," she says, "I just feel so relaxed."

When she first went to the pain clinic she was offered various medications to help with her pain and then asked if she would be willing to give nabilone a try. "I was also put on a beta blocker around the same time for other symptoms and since then I have progressed in leaps and bounds," she says. " I haven't been in a bad flare for over 18 months and I can walk better, often using one crutch rather than two, and managing around the house without sticks at all. I think the nabilone has made a huge difference because it relaxes the muscles. Even if I only get one or two hours sleep at night I am relaxed, my legs aren't jumping about all over the place and I know I am resting."

When asked if she was worried about dependence Yvonne was adamant, "Definitely not," she said. "Why worry about dependence on tablets when I have got to take them to keep me going and to allow me to be independent. I don't see any point in worrying as I am bound to be on some form of medication for the rest of my life. I don't really care if I'm dependent on them or not as long as they work."

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