The Lesson of Sativex

On April 19, the Canadian government delivered what should be the final blow to the U.S. government's irrational prohibition against the medical use of marijuana. It approved prescription sale of a natural marijuana extract -- for all practical purposes, liquid marijuana -- to treat pain and other symptoms caused by multiple sclerosis.

Sativex, produced by GW Pharmaceuticals in Britain, brings the medical marijuana debate full circle. Though the technology has advanced in 70 years, this product is a direct descendent of the marijuana extracts and tinctures that were a standard part of the medical armamentarium until the late 1930s -- universally recognized as being safe and effective for certain conditions. These products were taken away from patients and doctors as a result of the prohibition on marijuana that began in 1937, despite the public opposition of the American Medical Association.

In short, the Canadian government has just certified that virtually everything our own government has been telling us about marijuana is wrong. In defiance of a large and growing pile of scientific studies, our government still claims that marijuana has no medical value. White House Drug Czar John Walters even compared medical marijuana to "medicinal crack."

Such statements were always scientifically ridiculous, as has been noted by a wide range of authorities, including the American Public Health Association, the American Nurses Association, and the state medical societies of New York, California and Rhode Island, to name just a few. Now, GW Pharmaceuticals' research has definitively put such nonsense to rest.

Make no mistake: Sativex is liquid marijuana. It is nothing like Marinol, the synthetic THC pill sold in the U.S. and sometimes falsely touted as an adequate substitute for marijuana.

Sativex is a whole-plant extract, containing the rich variety of naturally occurring compounds called cannabinoids that are unique to marijuana. It also contains trace elements of other compounds contained in the plant, which scientists believe contribute to its therapeutic value.

On its web site, GW Pharmaceuticals explains, "We believe very strongly that many of the advantages of using the whole plant come from the inclusion of other components of cannabis [marijuana]," not just THC. "In the cannabis plant, it appears that some of the components added together give better effect. Some components seem to work to counteract some of the side effects of others, and the whole plant is generally well tolerated by humans."

Sativex is to marijuana as a cup of coffee is to coffee beans. If Sativex is safe and effective, marijuana is safe and effective. And Sativex is safe and effective. Studies have shown significant effect against pain and other symptoms caused by multiple sclerosis and other debilitating conditions. Over 600 patient-years of research have established a remarkable record of safety.

Sativex should certainly be approved in the U.S., but the process may take years -- if it is allowed to happen at all. Sadly, our government's reflexive hostility to the medical use of marijuana shows no sign of abating.

But an even larger issue looms: Now that we know beyond doubt that marijuana is a safe, effective medicine, how long will our government continue to arrest patients who use it?

And even if Sativex is approved here someday, it won't be the answer for every patient now benefiting from medical marijuana. For one thing, it has been clearly shown that different strains of marijuana -- with different blends of cannabinoids -- work better for some conditions and less well for others. Sativex just comes in one formula, and it won't be right for everyone.

And Sativex will be expensive. Will we force patients to buy a pricey pharmaceutical version of a plant they could grow themselves for pennies? At a time when our healthcare system is drowning in rising costs, that's insane. We could end up with a policy every bit as silly as telling coffee drinkers that they can buy a cappuccino, but they'll be arrested on sight if caught in possession of coffee beans.