Pain and Mary Jane

>> McGill scientists offer pot to hurting patients in a pilot study

by Patrick Lejtenyi

Montreal General Hospital physician and researcher Dr. Mark Ware got turned on to pot, appropriately enough, in Jamaica. As a clinical research scientist at the Kingston Sickle Cell Laboratories between 1996 and 1999, he became interested in traditional, natural sources of pain relief like roots or teas. "Then when I asked a couple of Rastafarian guys what they do for pain," Ware explains, "they said, 'It's the herb, doctor.'"

As the spokesman for a new pilot project funded by the Canadian Institute for Health Research (CIHR), the 36-year-old England-born Ware will be looking at the potential benefits smoking cannabinoids (the chemical compounds that are the active principles of marijuana) brings to sufferers of long-term acute pain among the non-HIV or Multiple Sclerosis population.

The first-of-its-kind study in Canada is intended, Ware says, for patients suffering from pain related to "trauma or surgery, and the associated symptoms as a result of neuropathic pain." Meaning nerve endings damaged in a car crash or a fall. "It's a very different kind of pain to manage and to understand. We're hoping this trial will provide a meaningful result and be the basis to design a larger trial."

Ware and his four scientist colleagues will be recruiting 32 candidates for the study. Eligibility requires they be currently attending the McGill Pain Centre and have been suffering from severe pain for at least three months. The trial takes place over a four-week period, with patients toking from a pipe three times a day, five days a week. The doses' weight will remain constant, with the pot's THC levels the variable. The first doses will be administered at the Centre, where the doctors will observe the effect on the patient.

"The hypothesis is to see if smoking cannabis containing higher levels of THC than the placebo is effective in reducing pain intensity," Ware says. "The definitions and measurements have to be extremely precise because it is a scientific experiment."

While a group of pointy-headed, lab-coat-wearing doctors poking and prodding and asking someone who just smoked some grass a bunch of questions might be 'noid-inducing, the experiment's scientific rigour has to be beyond reproach: Ware's proposal won the CIHR's $235,000 grant, and the test will be peer-reviewed, meaning an anonymous group of doctors will be scrutinizing it, making suggestions, offering criticisms and otherwise going through it with a very fine, very scientific comb.

As for the weed itself, Ware is getting it from the University of Mississippi, which is licensed to grow it for research and clinical studies like this one, in partnership with the American National Institute on Drug Abuse (NIDA). The homegrown Flin Flon, Manitoba hydroponic medicinal marijuana mineshaft stash is another potential source for Ware. "If the necessary approvals are made in time," he says, "and if the Canadian supply is up and running, we will definitely consider it." (The plants are said to be ready for harvesting in October and may be distributed by February.)

Recruiting for patients begins in January. Ware hopes to have the study results ready for release by the fall of 2002.

Marc Boris St-Maurice, head of the Bloc Pot, welcomes all serious studies into the use of marijuana but has some reservations about Dr. Ware's tests. "I'm somewhat concerned about it because it is such a small sample of people taking part," he says. "I hope they don't try to draw any wide-ranging conclusions because it's by no means huge."