Zilos

In a bold venture that puts Spain at the forefront of the medical use of cannabis in Europe, 60 pharmacies and four hospitals in Catalonia are to prescribe marijuana for therapeutic use where other treatments have failed.

The pioneering scheme surpasses measures taken by the Dutch, leaders in the field, and puts British efforts in the shade. A British drug company has been denied permission to produce medicinal cannabis for trials - because of lack of political will, critics say.

Doctors in Catalonia will be able to prescribe cannabis in capsules or as an infusion to help four specific conditions: anorexia among Aids patients; nausea caused by chemotherapy in cancer patients; constant pain - including migraine - that has been unresponsive to other treatments; and muscular problems among those with multiple sclerosis. About 150,000 patients are expected to benefit.

Spain's Health Minister, Elena Salgado, said she accepted that cannabis "has some therapeutic value". She approved "the controlled use of tablets in specific cases and under medical supervision", but insisted on the need to fight drug addiction. Spanish health policy is devolved to the regions, but must receive Madrid's blessing.

Catalan doctors back the scheme, so long as cannabis use is carefully controlled. "Prescriptions must be made under medical supervision, and only in extreme cases ... It's a humane response to understandable demand for an improved quality of life," said Guillermo Sierra, president of Barcelona's medical council.

"We must ensure the therapeutic use of cannabis is not treated frivolously among the young," he added. "We don't want to give the impression we support smoking joints, or that cannabis is good for you."

The pilot project, which begins next month - initially for a year - stems from a proposal by Barcelona's College of Pharmacists, following a similar experiment in the Netherlands in 2003, although that has just 8,000 patients.

The plan was agreed by Catalonia's left-wing regional government, a coalition of socialists, Greens and independent republicans. The initiative, due to be approved by the Spanish Health Ministry after more than a year of strenuous lobbying, is expected to prompt Spain's other autonomous regions to adopt similar measures.

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