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Respectable Reefer

Respectable Reefer
By Gary Greenberg, MotherJones.com
Posted on November 14, 2005, Printed on November 14, 2005
http://www.alternet.org/story/27996/
If it weren't for the little photo gallery on the wall, the office where Dr.
William Notcutt's research assistants keep track of their patients would be
just like any other cubicle at the James Paget Medical Center in England. As
phones ring and stretchers wheel by and these three women go about their
business, the snapshots -- Cheryl Phillips, one of Notcutt's staffers,
gently holding an emerald green bud of marijuana; a group of people in lab
coats smiling for the camera, sinsemilla towering over their heads; a
hangar-sized greenhouse stuffed to the gills with lush pot plants -- are
about the only evidence that this hospital in East Anglia is at the
epicenter of one of the most extensive medical marijuana research projects
in the world.

In part, that's because there's no actual pot here; by the time it gets to
Paget, GW Pharmaceuticals, the British startup that owns the greenhouses,
has turned the plants into Sativex, a pure extract of pot that comes in a
pharmacy-friendly bottle and is designed to be sprayed into the mouth. And
in part it's because the frivolity is carefully confined to the photos,
taken against company policy during a field trip to the secure, undisclosed
location where GW grows its weed. After five years, Phillips and her
colleagues have grown used to having cannabis -- as the British call
marijuana -- in their workaday lives. Not only that, but their boss has been
on a bit of a campaign to keep things sober.

"To get to the perception that this is a medicine," Notcutt says, "we've had
to move away from the funnies that relate to the pot world. So no pot
jokes."

Over a beer at the end of his day, this rumpled, 59-year-old
anesthesiologist and contract researcher for GW is positively ebullient
about the news that just today the Canadian government approved Sativex, a
success he thinks is likely to be repeated soon in England and eventually in
the United States. He'll gladly tell you how important earnestness has been
in getting GW to this point, how Sativex owes its success not only to the
rigorous science of its successful clinical trials but also to painstaking
attention to matters of perception.

Take the spray concept. There are sound medical reasons for spraying
cannabis under the tongue rather than smoking or eating it. The mucosa of
the mouth will absorb the drug faster than the digestive system, indeed
almost as fast as the lungs, but without irritating the respiratory system.
And Sativex can be precisely metered -- a single one-tenth milliliter spray
contains 2.7 milligrams of tetrahydrocannabinol (THC), pot's main
psychoactive chemical; 2.5 milligrams of cannabidiol, which doctors think
reduces anxiety and muscle tension; and all of pot's active ingredients
known as cannabinoids -- so that it can be accurately studied.

But it also has "the advantage of looking like a medicine to the outside
world," Notcutt says. "It has been served up like a medicine, prepared like
a medicine, researched like a medicine. It looks like a medicine, and it's
prescribed like a medicine." Taking pot out of joints scored on the street
and putting it into bottles found on pharmacy shelves shows that "we're not
just being silly about the herb, even though in the end that's exactly what
it is. It's as if you just squeezed the plant," he says, wringing an
imaginary stalk in his hands.

Notcutt began trying to medicalize cannabis more than a decade ago, and has
been working with GW and its founder and executive chairman, Geoffrey Guy,
since the company's inception in 1998. He credits Guy (who wouldn't be
interviewed for this article) with hitting upon the spray, just one of the
measures he's taken to distance Sativex from its unsavory origins.

Guy has styled GW, which he started solely to develop cannabis medicines, as
just another drug company seeking to develop just another drug. He raised
money in the usual ways -- first from private investors, then with a 2001
stock offering that garnered $48 million, and finally, in 2003, with an
estimated $65 million licensing deal with German pharmaceutical giant
Bayer -- and used it to purchase the rights to pot varieties that a Dutch
company had spent millions of dollars and more than a decade developing for
their medicinal properties.

Guy presents himself as neutral in the drug wars and gained the support of
the British government by offering to institute extraordinary security
measures at his grow facility to prevent "diversion." The British
government, in turn, gave him permission to grow his pot and test it on
human subjects and so exempted GW from an international treaty forbidding
private production of outlawed drugs. Guy developed a way to blend the
plants (a process he has likened to making blended burgundies) into precise
mixtures whose chemical profiles can be standardized (which regulators
like), patented (which investors like; cannabis itself can't be patented),
and then described in company press releases as "a novel prescription
pharmaceutical product derived from components of the cannabis plant."

Having successfully distilled pot's reputation as a medicine from its
reputation as a way to get high, Notcutt says, "the powers that be at GW
worked hard to maintain this myth. We start in that comfort area, we don't
talk about anything outside this comfort area."

This hard work has no doubt paid off in Canada and England, reassuring
regulators that, as Notcutt put it, "we're talking about a serious medical
subject here." The real audience for all this mythmaking, however, isn't
Britain or Canada, which will ultimately account for only a small percentage
of the cannabinoid drug market, estimated to be almost $1 billion a year.
It's the United States, where, Notcutt says, things are different.
"Marijuanaphobia is much greater on your side of the pond," he told me.
"We've never had the reefer madness."

Gary Greenberg is a contributing writer for Mother Jones. His writing on
science and public policy has also appeared in The New Yorker, Rolling Stone
and Harper's Magazine. For information on reprinting this article, contact
featurewell@featurewell.com
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