BATH, England, Nov. 9 - An oral spray containing marijuana extracts has offered pain relief to rheumatoid arthritis (RA) patients, according to British researchers. The patients did not have the typical highs achieved by smoking marijuana.

Called Sativex, the agent was tested in a five-week randomized, placebo-controlled trial that the investigators said was the first formal study using cannabis-based medications to treat rheumatoid arthritis.

"Anecdotally, of course, people have been using it for centuries," said Candy McCabe, Ph.D., of the Royal National Hospital for Rheumatic Diseases here. "We've known in our clinic that patients are using street-based cannabis."

The drug, made by GW Pharmaceuticals, of Salisbury, England, is a blend of whole plant extracts and contains two key ingredients in approximately equal amounts -- delta-tetrahydrocannabinol (THC) and cannabidiol -- that have been shown in animals to have beneficial effects for RA. Minor cannabinoids, including cannabinol, cannabichromene, and cannabigerol were also present in trace quantities.

Not approved in Britain or the U.S., the drug was licensed earlier this year in Canada for use in neuropathic pain associated with multiple sclerosis. The product is also being tested for cancer pain.

In the RA study, Dr. McCabe and colleagues reported online in the journal Rheumatology, 58 patients with active disease, not adequately controlled by standard medication, were randomized to Sativex or placebo.

Patients began with one use of the oral spray half an hour before bedtime and increased the number of uses -- to a maximum of six a day -- depending on response. Each use of the Sativex spray delivered 2.7 mg of THC and 2.5 mg of cannabidiol. Dosing was restricted to the evening hours.

The main efficacy measure was morning pain on movement on a one-to-10 scale. Secondary outcomes were morning pain at rest, morning stiffness, sleep quality, the Short-Form McGill Pain Questionnaire (SF-MPQ) and the 28-joint disease activity score (DAS 28).

The study found:
1. For those in the treatment group, morning pain on movement was reduced significantly compared with placebo, as was pain at rest. The results were significant at p=0.044 and p=0.018, respectively.

2. There was no significant difference in morning stiffness.

3. Quality of sleep was significantly improved for those getting Sativex, at p=0.027.

4. The DAS 28 scores for the treatment group were also significantly improved, at p=0.002.

5. On the McGill pain questionnaire, patients getting the drug rated their pain as significantly less intense than did the placebo patients, at p=0.016.

6. On two other aspects of the McGill questionnaire, there was no significant difference.

The authors described the effects on pain as "small and variable across the population; but they represent benefits of clinical relevance." However, the beneficial effects occurred with a regimen restricted to evening dosing and may have been larger with 24-hour usage.

"Most important, the quality of sleep was improved, which we know in patients makes a big difference in how they perceive their pain the next day," Dr. McCabe said. "It's a very fatiguing disease."

She said the improved sleep did not appear to arise because the patients were intoxicated by the drug. "They were getting the effect without feeling high," she said.

Ronald Jubb, M.D., a rheumatologist, at the University Hospital Birmingham NHS Foundation Trust and a co-author of the study, said abuse of the medication appears to be "a very rare event."

"The motivation of medicinal users of cannabis-based medicine is entirely different from recreational users," Dr. Jubb said. "The former simply want symptom relief and the ability to go about their normal lives, and for them intoxication would be a distinct disadvantage; for the latter, smoking marijuana is infinitely more intoxicating than Sativex."

Dr. McCabe said the study, while showing good efficacy, was mainly intended as a tolerance study, to establish the types and severity of adverse events and the risk of intoxication.

The researchers found that adverse events were mild or moderate, including mild dizziness, and there were no treatment-related withdrawals or serious adverse events in the active group.

Also, there was no indication of intoxication. "The patients' perception was that this was a drug that was going to get them high, but we didn't find that," Dr. McCabe said.

The next step, she said, is to do a larger study in the same patient population. "This pilot study has given us sufficient data and good results to warrant a further, larger study," she said.
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If it helps their pain, that is great.

I don't know the exact remedy, but there's this old mexican that I *Think* it's rubbing alcohol... he puts a wad of marijuana in it and soaks it. Heck, it could be vodka. Anyway he soaks it for like a week or something, then uses it as a topical ointment and says it "cures" his arthritis. Meaning probably that it temporarily deadens the pain to a point he can do some pretty nimble things still yet....

I've heard of people spraying WD-40 on their joints to relieve arthritis. The good people at WD-40 don't condone this of course.

I do think that eventually Cannabis will be legalized in the U.S. Too many people are discovering its positive qualities. As many reading this probably know, I work in law enforcement and the worst thing that I've seen pot do is cause people to go to jail. If it were legalized, the Government could tax the heck out of it and maybe even make a dollar or two!

I wonder how much money is lost in the U.S. every year through legal fees, jail upkeep, prison upkeep, and lost tax dollars due to workers being incarcerated on marijuana charges? All so the "Public Defenders" can make a buck by getting thier clients to take plea bargins.

It's cold but... it smells. It's not something you can just cover up either. I wonder why they think it would work?

The reason I've been led to believe Cannibis isn't legal here in the USA is because the U.S. Government can't tax it, because it grows naturally.

Here is a list of the therapeutic effects of Cannabis

Pain relief (especially headaches and cramps).
Increased appetite, food subjectively tastes better.
Reduced nausea, (especially from chemotherapy), though may cause or exacerbate nausea for some.
Dilation of alveoli (air sacs) in lungs, resulting in deeper respiration.
Increase in productive coughs
Dilation of blood vessels (vasodilation), resulting in:
Increased blood flow and heart rate
Reddening of the conjunctivae (red eye)
Lower intra-ocular pressure (beneficial to glaucoma patients).
Lower blood pressure while standing. Higher blood pressure while sitting (note that this can lead to instances of orthostatic hypotension).
Increased metabolism of glucose, reducing blood sugar levels.
Induces drowsiness (beneficial to sufferers of insomnia and sleep deprivation).

I can think of a bunch of legal drugs, that aren't good for you at all.

LEGALIZE IT!!! But, make chocolate flavored rolling papers illegal, because they smell bad.

I don't know about your hypothisis on why it's illegal. Beans can grow in the wild as do blackberries and they are not ilegal. I'd be more likely to blame the people who make grass ropes. Hemp rope would be stronger and longer lasting. One of the so called ligitamate reasons for keeping it illegal is because it's harder to tell if the person is stoned than to tell if he is drunk. You stand a better chance of smelling alcohol than of seeing the effects of pot. If I were going to be working on a high scaffold I want to be sure that person next to me is perfectly sober! The "whiz quiz" won't tell you when the person smoked it last. You can't tell if it was yesterday or last week. You can kind of guesstimate but, that's not accurate enough for court testimony.

I don't know who first thought of using WD-40 on thier joints but, those who do it swear by it. It's probably not altogether safe, though.

My grandmother used to use DMSO for the same thing. I think that it's a laundry detergent. I haven't seen that stuff in years though. Once again, it's probably not altogether safe either.

As for modern drugs, all I can say is think of how many new ones have come on the market in the past forty years and then try to name one thing that has actually be cured.

With nano tech emerging all of the medications that are currently on the market will become pointless. What do they mean when they say "oral spray".. do you just spritz it in the mouth and swallow?

I hope they do more tests

DMSO is used intravenously to treat the West Nile virus in horses. It is also used topically on the legs of endurance, military and mounted patrol horses for soreness and I use it on my messed up hand when that is sore.

Lapi'che