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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4079.0: Tuesday, December 13, 2005 - Board 4

Abstract #106317

Sativex and tolerance: Sativex cannabis based medicine provides long-term clinical efficacy without dosage increases or withdrawal

Ethan Russo, MD, GW Pharmaceuticals, 2235 Wylie Avenue, Missoula, MT 59802, 406-542-0151, erusso@montanadsl.net

Many psychoactive drugs induce tolerance: a temporal loss of pharmacological effects. This presentation will review historical and new data from long-term safety studies (SAFEX) of patients employing Sativex®, a 1:1 tetrahydrocannabinol (THC):cannabidiol (CBD) cannabis based medicine (CBM) administered oro-mucosally, now an approved pharmaceutical in Canada.

Cannabinoid tolerance is mainly pharmacodynamic in nature with changes of cannabinoid receptor density in the brain. In humans, marked tolerance is observed to cannabis side effects in chronic administration: tachycardia, hypothermia, orthostatic hypotension, dry mouth, and ocular injection, while tolerance to subjective effects is noted with high dose oral THC.

The use of CBM oro-mucosally for MS symptoms of pain, spasticity and sleep disturbance, peripheral neuropathic pain, bladder dysfunction, rheumatoid arthritis and intractable cancer pain in clinical trials and SAFEX studies employing Sativex, with over 800 patient-years of exposure is reported. Data will demonstrate low-nil subjective patient intoxication scores, with progressively diminished adverse event profiles over time of usage, and consistent maintenance of symptom control with stable or even diminishing dosage. Sativex in chronic administration demonstrates tachyphylaxis to side effects, with no tolerance developing to its clinical benefits, and little evidence of withdrawal upon temporary experimental discontinuation.

Learning objectives for this session will be: 1) understanding the symptomatic benefits of Sativex oromucosal cannabis based medicine, 2) lack of tolerance to and intoxication with Sativex in chronic usage, and 3) absence of serious withdrawal effects.

Learning Objectives: Learning objectives for this session will be

Keywords: Alternative Medicine/Therapies, Marijuana

Related Web page: www.gwpharm.co.uk/

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Sativex is an approved cannabis based prescription pharmaceutical in Canada, but not the USA.

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF full-time Senior Medical Advisor to GW Pharmaceuticals, manufacturer of Sativex.

Alternative and Complementary Health Practices and Public Health

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA