Marijuana study suggests relief for MS.

Byline: From Register-Guard and news service reports

LONDON - A marijuana pill appeared to relieve some of the symptoms of multiple sclerosis in the first scientifically rigorous study of the strongly debated drug.

The research, published this week in The Lancet medical journal, found that even though improvements could not be detected by doctors' tests, a greater proportion of patients taking the drug reported reduced pain and muscle stiffness than those taking fake capsules.

Experts said the mixed results make them tricky to interpret. Some said they were encouraged that any improvement was noted, while others said if there had been a major effect, it would have shown up in the doctors' tests.

One study leader, Dr. John Zajicek of the University of Plymouth in England, said the research raises questions about what's more important: a doctor's measurements or the patient's perspective.

``I think if there's a conflict, it's what the patient feels which is important, so I think it's quite encouraging,'' said Roger Pertwee, a professor of neuropharmacology at University of Aberdeen, who was not connected with the study.

The study could have reverberations in Oregon, where voters approved a medicinal marijuana law in 1998. Federal authorities have challenged Oregon's law and similar ones in eight other states, but suffered a setback last month when the U.S. Supreme Court refused to hear a Bush administration request to consider whether the government can punish doctors who recommend marijuana to sick patients.

In Lane County, the British study's results didn't surprise some local doctors.

"Marijuana has a definite role in treating certain medical problems, MS being one of them," said Dr. Mark Herring, a Springfield neurologist who's prescribed marijuana to patients. "It would have surprised me if (the study) had not found an effect."

Herring said he's found marijuana helpful for alleviating a number of symptoms, including pain and spasms. His patients ingested marijuana through smoking, while those in the study took pills.

Dr. James Morris, co-founder of the Lane County Pain Society, said the study is useful because there's not enough reliable research about marijuana's efficacy and potential side effects. "We don't have enough information to say it's useful for one medical condition but not another," he said.

Todd Dolatto, executive director of the Compassion Center, a medical marijuana clinic in Eugene, said the latest study should help boost marijuana advocates' claims.

"Cannabis therapies have been used for thousands of years with very few negative side effects, but in the modern day you have to rely on clinical studies published in medical journals for the kind of credibility that translates into further acceptance in society and government," he said.

The Eugene clinic has assisted more than 1,300 people whose doctors have prescribed medicinal marijuana, though probably fewer than 30 are MS sufferers, Dolatto said.

Multiple sclerosis is not listed in Oregon's law as one of the illnesses for which medicinal marijuana can be prescribed; however, several symptoms common to MS sufferers are among those that the law says can be treated with marijuana, Dolatto said.

A common nervous system disease, multiple sclerosis causes a range of chronic symptoms, including muscle stiffness and spasms, pain, tremor, fatigue, depression and bladder problems. The disease is difficult to study because it is unpredictable and its symptoms are hard to measure.

Orthodox treatments often provide inadequate relief, so many MS sufferers experiment with alternatives, including cannabis and its major active components - cannabinoids.

There have been anecdotal reports of the success of cannabis - the Latin word for marijuana - in treating MS symptoms, particularly muscle stiffness. However, there has been little scientific evidence.

The British study was set up to test the theory that cannabis and cannabinoids reduce muscle stiffness and may alleviate other MS-related symptoms.

It involved 630 multiple sclerosis patients from around Britain. One-third received a capsule containing whole cannabis oil; another third took one containing a synthetic version of a cannabinoid known as tetrahydrocannabinol, or THC. The rest got a fake capsule.

``The stiffness as you move the limb on the bed and measure it carefully does not pick up a difference,'' said one researcher, Dr. Alan Thompson. ``But when you look at the impact that (muscle stiffness) has on everyday life - on what the patient feels - then there is a difference.''

Fifty-seven percent of the patients taking the whole cannabis extract said their pain had eased, compared with 50 percent on THC and 37 percent on dummy capsules.

For muscle stiffness, 61 percent on cannabis extract and 60 percent on THC reported an improvement, compared with 46 percent on fake treatment.

Patients reported improved sleep and fewer or less intense muscle spasms. Those who could walk showed improved walking ability.

However, when an objective test of muscle stiffness was used, no difference was detected. One explanation for the mixed results could be the muscle test, called the Ashworth scale, is not sensitive enough to detect changes that are meaningful to patients.

About 77 percent of those on cannabis and 50 percent of those on dummy medication guessed what they were on because of marijuana's recognizable side effects, such as dry mouth and a lightheaded high.

``It makes their perception suspect in that there could have been, in effect, an enhanced placebo effect,'' said Dr. Andrew Goodman, director of the MS center at the University of Rochester in New York. ``You know you're getting it, so therefore it feels like it works even better, perhaps. That's why the results are tricky to interpret.''

Register-Guard reporter Jeff Wright contributed to this report.