Helpful Or Harmful? Medicinal Value of Marijuana Remains Unclear

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Helpful Or Harmful? Medicinal Value of Marijuana Remains Unclear

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Despite limited evidence of effectiveness, many epilepsy and multiple

sclerosis patients believe marijuana is an effective treatment and are

actively using it, according to two Canadian studies.

Newswise ‹ Despite limited evidence of effectiveness, many epilepsy and

multiple sclerosis patients believe marijuana is an effective treatment and

are actively using it, according to two Canadian studies published in the

June 8 issue of Neurology, the scientific journal of the American Academy of

Neurology.

Multiple sclerosis patients in Halifax, Nova Scotia, and epilepsy patients

in Edmonton, Alberta, recently participated in a questionnaire and a

telephone survey, respectively, regarding patterns, prevalence and perceived

effects of marijuana use. Results of these surveys may raise more questions

than they answer.

In the study of epilepsy patients from the University of Alberta Epilepsy

Clinic, 136 subjects responded to the phone survey. Of these, nearly half

had used marijuana in their lifetime; one in five had used marijuana in the

past year; 20 (15 percent) had used in the past month; 18 (13 percent) used

more than 48 days per year; and 11 (8 percent) used more than half the days

of the year. Four patients were actually considered marijuana dependent.

Odds of frequent marijuana use were eight times greater for patients with

frequent seizures and 10 times greater for those who had had epilepsy for at

least five years.

One possible explanation for the association of marijuana use with seizure

frequency is that patients who experience more frequent seizures might be

more likely to try alternative treatments.

³Studies suggest one-third of the general population use alternative health

care on a yearly basis,² notes study author Gross, MD, FRCP, of the

University of Alberta, Edmonton. ³Not surprisingly, patients tend to look to

alternative therapies in situations where conventional medicine has been

unsuccessful, in particular, for chronic medical conditions. The finding of

increased marijuana use in epilepsy patients with longer duration of disease

and frequent seizures is consistent with the findings regarding other forms

of non-conventional therapies.²

Another possible explanation for the correlation between increased seizure

frequency and more frequent marijuana use is that there is a causal

relationship between marijuana use and seizures, i.e. marijuana use leads to

increased seizure frequency.

In the study of multiple sclerosis patients from Halifax, 205 subjects

completed a survey questionnaire. Of the 34 identified medical marijuana

users, more than half perceived it as being a very effective treatment, and

more than half also reported using it within the previous 24 hours. Nineteen

patients reportedly used marijuana more than one time per week, with eight

patients reporting more than one daily use.

³We have learned several things from these patients,² concludes study author

Mark Ware, MBBS, MRCP, of McGill University, Montreal, who co-authored the

study with , MD, FRCPC, of Capital Health and the Dalhousie

University Faculty of Medicine, Halifax. ³Firstly, that pain and spasms are

not the only reasons for use, and the effects of marijuana on mood, sleep

and stress are important areas of therapeutic need and should be addressed

in clinical trials. Secondly, there is a wide variance in doses used,

ranging from single puffs to more than a gram at a time. Clinical trials

will also need to include early dose-finding phases and allow for subject

variability in dose adjustments. Thirdly, marijuana appears to be

well-tolerated, though some subjects experienced intolerable side effects

and deterioration of symptoms.²

Access to marijuana also emerged as an important obstacle in the use of this

drug for medical purposes.

Nearly one in four epilepsy patients and one in six multiple sclerosis

patients believe that marijuana is an effective form of treatment for their

disease symptoms, and many are currently using marijuana therapeutically.

Carefully controlled clinical trials are recommended by both study teams to

determine the efficacy of marijuana in the treatment of epilepsy and

multiple sclerosis.

The study by Gross et al received support from the University of Alberta

Hospital Foundation. The study by Ware et al received support from a

Dalhousie University summer research student award, Canadian Institutes of

Health Research and the Fonds de la Recherche en Santé du Quebec.

The American Academy of Neurology, an association of more than 18,000

neurologists and neuroscience professionals, is dedicated to improving

patient care through education and research. A neurologist is a doctor with

specialized training in diagnosing, treating and managing disorders of the

brain and nervous system such as stroke, Alzheimer¹s disease, epilepsy,

Parkinson¹s disease, and multiple sclerosis.

For more information about the American Academy of Neurology, visit its

website at www.aan.com.

Editor¹s Note: An editorial commenting on these studies is also published in

the June 8 issue of Neurology.