Yesterday GW Pharmaceuticals announced that it has received FDA approval for Phase III clinical trials of its cannabis extract spray, Sativex, which the Canadian government last year approved as a treatment for neuropathic pain in patients with multiple sclerosis. The U.S. study will test Sativex's effectiveness in treating the pain of cancer patients who do not get adequate relief from narcotics–an application that has shown promise in a European study. GW, which is based in the U.K., reports that the FDA let it skip Phase I and Phase II trials, which focus on establishing safety and appropriate dosage, because it had already conducted substantial research on Sativex in Europe.
GW's success with Sativex, which is sprayed into the mouth, once again contradicts American drug warriors' repeated denials of marijuana's therapeutic utility. At the same time, it's another step toward a future in which legal alternatives to smoked, vaporized, or ingested whole cannabis will render the medical marijuana debate moot.
Another such step is Philip Morris' medical inhaler, which is based on technology developed for its unsuccessful smokeless cigarette. The device delivers aerosol medicine to the lungs for quick absorption. If used with THC and/or other useful cannabinoids, it would have all the medical advantages of smoked marijuana (immediate action, patient control over dosage, no capsules to swallow and keep down) without the drawbacks (variable strength, combustion products). Such a product would be more expensive than homegrown or club-dispensed marijuana, but presumably it would be covered by insurance.
These developments, while a boon to patients, will pose a challenge to the drug policy reform movement, which has gotten a lot of mileage out of the federal government's cruel, know-nothing intransigence on the issue of medical marijuana. Once legal, equally effective aternatives to marijuana are readily available, reformers will be forced to switch their focus back to recreational use (which is, after all, the main form of marijuana consumption), seemingly confirming the accusation that all their talk about the drug's medical virtues was just a cover. And having emphasized the sympathetic claims of suffering patients for so long, they will be in a weak position to argue that people shouldn't need a special excuse to smoke pot.