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Marijuana has promise as a painkiller, but a lack of clinical research keeps it out of sufferers' hands

Bruce Bumstead / Brandon Sun</p><p>Brit Burch uses medical marijuana to help treat her pain using edible forms such as the cookies she pulls out of her oven. </p>

Bruce Bumstead / Brandon Sun

Brit Burch uses medical marijuana to help treat her pain using edible forms such as the cookies she pulls out of her oven.

Hey there, time traveller!
This article was published 27/6/2016 (968 days ago), so information in it may no longer be current.

Brit Burch was determined to get some pot.

It wasn’t that the Brandon University student was looking for a buzz. She wanted it to combat the negative side-effects of chemotherapy treatment for Hodgkin’s lymphoma.

But finding a physician to prescribe it was more challenging than anticipated.

“I literally asked seven different doctors because I didn’t want to take all the different pills,” says Burch, who was diagnosed in 2010. “I wanted the plant because I had heard that it had so many different properties to help with pain and appetite.”

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Hey there, time traveller!
This article was published 27/6/2016 (968 days ago), so information in it may no longer be current.

Brit Burch was determined to get some pot.

It wasn’t that the Brandon University student was looking for a buzz. She wanted it to combat the negative side-effects of chemotherapy treatment for Hodgkin’s lymphoma.

But finding a physician to prescribe it was more challenging than anticipated.

"I literally asked seven different doctors because I didn’t want to take all the different pills," says Burch, who was diagnosed in 2010. "I wanted the plant because I had heard that it had so many different properties to help with pain and appetite."

Eventually she was referred to one of Canada’s leading physicians in treating cancer-related pain with cannabis: Dr. Paul Daeninck.

"He supported me in my decision," she says.

An oncologist who specializes in pain management and palliative care at CancerCare Manitoba, Daeninck has been prescribing cannabis since the early 2000s, shortly after Health Canada allowed access.

"In reading the research at the time, I realized there was something to it," says the assistant professor at the University of Manitoba’s faculty of medicine.

Medical marijuana has since become one of many options — albeit not a primary one — to treat pain and other negative symptoms for cancer patients.

"At the pain-and-symptom clinic, my colleague, Dr. Joel Gingerich, and I are interested making sure patients have appropriate access," he says. "And it’s a lot freer discussion today than it was 10 years ago."

The recent explosion in illegal medical dispensaries in Toronto and Vancouver points to skyrocketing demand, while polls have consistently showed strong support for medical-marijuana access. Add to that Prime Minister Justin Trudeau’s election-campaign promise to legalize recreational use, and one might assume legal access is easy in Canada.

Yet Daeninck and his colleague are among a minority of Canadian physicians prescribing marijuna (especially in provinces such as Manitoba). Meanwhile, the number of Canadian medical-marijuana users roughly equals the population of Brandon, and the number is growing.

RUTH BONNEVILLE / WINNIPEG FREE PRESS</p><p>Dr. Paul Daeninck specializes in pain management at CancerCare Manitoba.</p>

RUTH BONNEVILLE / WINNIPEG FREE PRESS

Dr. Paul Daeninck specializes in pain management at CancerCare Manitoba.

However, access remains a challenge.

In part that’s because many physicians are uncomfortable prescribing marijuana because of a dearth of large clinical trials pointing to its efficacy and safety, Daeninck says.

Despite anecdotal evidence and some laboratory research indicating its potential to treat depression, fibromyalgia, anxiety, psychosis and even malignant tumours and Alzheimer’s disease, cannabis’s reputation as an illicit street drug has hindered the necessary studies other medications must undergo. Consequently, many physicians are not confident enough to prescribe it.

That’s not to say marijuana hasn’t been extensively examined. For decades, its potential harms have been studied, but results have often proved the opposite: Cannabis is less toxic than most over-the-counter medications such as acetaminophen and ibuprofen, and it’s less likely to lead to dependence than, for example, opiates.

Yet research into its benefits has been fragmented.

"There are a lot of labs researching in bits and pieces," Daeninck says.

There’s plenty to study. While THC (tetrahydrocannabinol) is recognized as the key medical ingredient and now regarded as a viable pain treatment — particularly for chronic conditions — recent research has discovered another cannabinoid, cannabidiol, may be effective in treating psychosis, epilepsy and inflammation.

But researchers have also found administering THC and cannabidiol on their own — in drugs like nabilone —are often not as effective as using the whole flower (or its extracts like oil).

That’s likely due to the role played by the more than 100 other cannabinoids, once thought to be inactive, found in the plant, Daeninck says.

"It’s called the ‘entourage effect,’ where it’s not just the THC; it’s the THC with everything else that gives the benefit."

Moreover, scientists are increasingly interested in the potential of flavonoids and terpenes — aromatic chemicals — that may alter the effects from one strain of cannabis to the next.

Despite its promise, many major drug-makers are reluctant to spend hundreds of millions on research because of uncertain access to the U.S. market, where marijuana is still officially considered to have no medical use, Daeninck says.

Still, research is taking place in the U.S. as well as other jurisdictions, including Canada, where legal producers are taking up the challenge.

Brit Burch uses medical marijuana to help treat her pain, using it in edible forms such as cookies.

BRUCE BUMSTEAD / BRANDON SUN

Brit Burch uses medical marijuana to help treat her pain, using it in edible forms such as cookies.

One of Canada’s largest producers, Nanaimo, B.C.-based Tilray, has already conducted a handful of small studies, including a recent patient survey.

"What we found is patients use medical cannabis for chronic pain and mental health, and often times, those two are intertwined," says Philippe Lucas, vice-president of patient advocacy at Tilray.

Now the company is about to embark on its largest research project yet, a clinical trial with the University of British Columbia to treat post-traumatic stress disorder.

"It will be the largest clinical trial for cannabis in Canada in at least 30 years."

Yet for patients like Steven Stairs, who suffers from glaucoma, research into cannabis’s potential will only confirm what he and other users already know: it improves quality of life.

"I was told when I was 16 I would be totally blind by the time I turned 40," says the 32-year-old Winnipeg father. "Then I started using medical marijuana at 26 and they don’t give me a timeframe anymore."

Stairs consumes about seven grams a day of a high-THC/cannabidiol strain called Conkushion produced by a Steinbach company — often vapourizing or eating cannabis-infused food.

"Sure, it makes me feel good, but it’s not like ‘Huh-huh, look at my hands, man!’" he says. "I don’t feel incapacitated or inebriated."

Burch too prefers vapourizing and eating cannabis, often baking goodies infused with her favoured strain, Super Lemon Haze, produced by Delta 9 Biotech, a Winnipeg producer.

Though no longer battling cancer, she remains a medical user.

"Now I’m being treated for fibromyalgia," she says. "And I’ve also got symptoms of PTSD from being diagnosed with cancer and the many cancer deaths in my family."

Moreover, cannabis has an equally important benefit.

"It improves my mood and gives me a better outlook," Burch says. "There is a lot of good in it, and it should be researched more."

 

joelschles@gmail.com

 

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History

Updated on Monday, June 27, 2016 at 8:29 AM CDT: Tweaks headline, rearranges photos

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