STREET drugs, such as ecstasy (MDMA) and cannabis, are being examined for their medicinal value.
“When it was banned, it was written off the pendulum,” says Dr John Kelly about ecstasy. Dr Kelly, of NUI Galway’s department of pharmacology and therapeutics, says the stigma of ecstasy made it harder to research.
“Rave culture made it difficult to study MDMA therapeutically, initially,” he says. “However, soldiers returning from war are very vocal, they aren’t going to put up with post-traumatic stress disorder (PTSD). They aren’t worried if the drug is legal or illegal — they think the law should be changed if a drug has benefits.”
But today illegal drugs are being tested up to clinical trials and even therapeutic use. In the US, doctors Michael and Annie Mithoefer, of MAPS (Multidisciplinary Association for Psychedelic Studies), use MDMA to treat war veterans with PTSD, in South Carolina. They say MDMA decreases fear and defensiveness and increases trust, taken as part of a therapy programme. Mithoefers’ research, in 2010, found that after two months of treatment, 80% of the patients no longer had PTSD. A follow-up in 2012 found that 74% were still clear.
The Mithoefers are treating firefighters and police officers, who have chronic PTSD, with MDMA, in a study that lasts until 2014. MDMA is is only administered a small number of times in a controlled setting. Psilocybin (magic mushrooms) is being used to treat depression, in conjunction with counselling. Peer-reviewed papers advocate cannabinoid, found in cannabis, for treating breast cancer, glaucoma, chronic pain, MS and other conditions.
Dr David Finn, also of NUI Galway’s department of pharmacology and therapeutics, organised the sixth European workshop on cannabinoid research in Trinity College Dublin, earlier this month.
His research shows we naturally have cannabinoid in our bodies, which reduces stress and pain. “Our understanding of the body’s own cannabinoid system has grown enormously — it is clear, now, that it plays a key role in health and well-being, and represents a promising therapeutic target for a range of diseases and disorders.”
The drug Sativex, formulated from two chemical extracts derived from the cannabis plant, is available for MS sufferers across Europe. Sativex contains two cannabinoids, THC and CBD. The Irish Medicines’ Board have recommended Sativex for the Irish market, subject to legislative changes. The department of health says “it is hoped to bring forward legislative proposals” this year.
John Lindsay, vice-chair of Chronic Pain Ireland, says “We would like to see it (Sativex) prescribed. There are a lot of people at the high end of the pain spectrum for whom even opiates aren’t strong enough.”
Some sufferers are acting alone. Sandy Moran* has two conditions. The first is closed-angle glaucoma, and the second is termed by the doctors as ‘severe arthritis due to bone displacement’. The severe arthritis came about as a result of a car accident.
Glaucoma is a degenerative disease that can lead to blindness. “The available medicine cannot stop the degeneration,” she says. Whereas cannabis does stop the degeneration. “I was first diagnosed with glaucoma 20 years ago and was told that my eyesight would be severely limited inside 11 years. Today, and as a result of using cannabis to alleviate the disease, my eyesight has not got any worse.” Cannabis prevents the eyes from inflating above the normal pressure. “As a result, I am not affected by the related pain and degeneration,” she says.
Cannabis is expensive, while growing her own medication would be illegal and stressful. In her native US, she would be allowed to grow six plants for medicinal use. In fact, a glaucoma sufferer initiated the legislative change for the medical use of cannabis in the US in 1976. Robert Randall sued the US government for access to cannabis, out of “medical necessity”. Randall argued that any sane person would break the law to save their eyesight. The judge agreed.
Irishman Gordon McArdle ran a medical cannabis dispensary in the Napa Valley, California, for two years. “The law required every county to have a dispensary, to prevent travel over county lines to purchase medication, and to prevent concentration in one area. It was a recognition that patients live in various places.”
Experts worry about potential side-effects of unstudied cannabinoids. Finn says that while growing your own is “better than the street” it has “a very mixed pharmacology.”
Dr Eric Downer, of the department of anatomy and neuroscience in UCC, researches MS sufferers and cannabinoids. His research suggests that MS patient cells are “uniquely sensitive” to cannabinoids.
Downer says we don’t know the full role of the cannabinoids “whether individually or acting together — and this is important, as the plant contains some 60-70 cannabinoids”. He’s not aware of Sativex resulting in any “intoxication-like” symptoms.
But Sativex is expensive. Moran estimates it would cost her €153 per week here. Patients in the UK have found Sativex difficult to get on the NHS. Even in the US, medical cannabis use on prescription has led to health insurance and work issues for patients — as cannabis is illegal at federal level.
Researchers of illegal drugs in Ireland are frustrated that, as Dr Kelly says, “it’s also about politics, and not just science”.
Finn wants people to separate the drug of abuse from cannabinoids. “People equate the two, which is like equating heroin and codeine. You can buy codeine almost over the counter, in cough mixtures.”
How legislation, pharmaceutical giants, safety, affordability and other issues will effect sufferers, like Sandy, remains to be seen.
*(not her real name)
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