Pubdate: Fri, 14 Jul 2000
Source: San Francisco Chronicle (CA)
Website: http://www.sfgate.com/chronicle/
Contact:  2000 San Francisco Chronicle
Forum: http://www.sfgate.com/conferences/
Author: Sabin Russell, Chronicle Staff Writer

STUDY FINDS POT SAFE FOR AIDS PATIENTS

Government funding for research a first

Durban, South Africa -- In the first government-sanctioned test of the
effects of marijuana on people infected with the AIDS virus, a San Francisco
study has found that the patients on pot came out of a 21-day trial just as
fit and quite a bit fatter than when they started.

Dr. Donald Abrams, a researcher at the University of California at San
Francisco, reported the results of the one-year, $1 million study yesterday
at the 13th International AIDS Conference.

His findings may be less significant than the fact that research involving
marijuana took place. Abrams secured funding for the experiment from the
National Institute of Drug Abuse only after years of failed attempts to
convince the government that research was needed on the medical effects of
street drugs routinely consumed by HIV-infected patients.

``It's exciting. It's historic. It confirms that all the states that have
allowed patients to use medical marijuana have not made a serious mistake,''
Abrams said.

In San Francisco yesterday, Dale Gieringer, the California director of the
National Organization for the Reform of Marijuana Laws (NORML), which wants
legalization of marijuana, said the Abrams report ``certainly establishes
what we've said all along -- that marijuana is safe and effective and that
the government hasn't got a leg to stand on by preventing its medical use.''

According to Gieringer, thousands of patients are already using marijuana
``semi-legally'' as a result of the solid victory that Proposition 215, the
medical marijuana initiative, scored in 1996.

Medical uses of pot are theoretically legal in California as a result of
that vote, but federal drug enforcement officials have insisted they would
enforce the federal ban anyway.

At least half the Californians now using marijuana at the suggestion of
their physicians are AIDS patients, Gieringer said, and they know it helps
subdue the nausea and loss of appetite that are common side effects of the
antiviral medicines they must take.

Medical marijuana is legal in seven other states besides California: Alaska,
Arizona, Hawaii, Maine, Nevada, Oregon and Washington.

SPECIFIC PURPOSE

By design, and at the insistence of government funders, the Abrams study did
not set out to prove or disprove the contention of medical marijuana
advocates that smoking pot can improve the appetite, body weight and
well-being of patients with AIDS, cancer and other wasting diseases.

Abrams' stated goal in this study was to determine whether the chemical
components of marijuana in any way interfered with the body's ability to
break down the components of protease inhibitors. These are the newest class
of antiviral drugs that, taken in combination with others, have helped
thousands of HIV-infected patients retain the health of their immune
systems.

Previous lab tests had hinted that there could be a problem with drug-
to-drug interaction, because the active ingredients of both pot and protease
drugs are broken down by the same enzyme.

After examining results from 62 subjects who completed the trials, Abrams
concluded that there was no change in the level of virus in the blood of
patients who smoked marijuana or who took Marinol, a prescription drug
containing the active ingredients of marijuana.

``We also took a little peek to see if there was any change in appetite,
caloric intake and body composition,'' Abrams said. In simple terms, did the
marijuana give the HIV-infected patients ``the munchies,'' causing them to
eat more and gain weight? The study results show that they certainly did.

The 20 patients who smoked marijuana -- three times a day for 21 days --
gained an average of 7.7 pounds during the study period while 22 patients
taking Marinol gained 7 pounds, and the remaining 20 given a placebo gained
only 2.9 pounds. The patients assigned to smoke pot were given three joints
of what Abrams called ``government grade'' marijuana, which is about
one-third as potent as marijuana commonly sold on the streets or purchased
at buyers' clubs.

Patients taking either the Marinol or the placebo were given unlabeled
pills. They did not know whether they were taking the active ingredient or
the dummy pill. One of the curious findings of the study was that nine of
the 20 patients given the dummy pill thought they were given Marinol.

21-DAY STUDY

By any standard, the marijuana study was an unusual event in the annals of
science. Patients from all around the country who heard about the study
volunteered to enroll in it. They were essentially locked up in a unit of
San Francisco General Hospital for the 21 days of their trial. Those who
smoked marijuana had to do so in a closed room with ventilation, so that
secondhand smoke would not affect the test subjects taking the pills.

Each patient had a refrigerator loaded with snacks next to his or her bed.
The refrigerators were locked at midnight.

Abrams acknowledges that the consumption of psychoactive substances produced
some interesting behavior, but he said he will be reporting on that at a
later time. ``You saw what you might expect from people smoking marijuana in
a confined setting for 21 straight days,'' he said. Typically, there were
three patients being tested at the hospital during any given day.

The experiment did produce a number of adverse effects. One patient who
smoked marijuana left the study after experiencing ``neuropsychiatric
symptoms.'' Among those taking Marinol, one left with neuropsychiatric
symptoms; one quit after suffering headaches and nausea; and one patient
died 58 days after completing the test from an internal hemorrhage that is
believed to have been unrelated to the study.

San Mateo County health officials said yesterday that they have received
``informal and conditional approval'' for a somewhat similar marijuana study
from the National Institute on Drug Abuse and are awaiting the required
approval from the Food and Drug Administration plus authority to obtain the
marijuana from the Drug Enforcement Administration.

According to Ron Robertson, chief operating officer at San Mateo Community
General Hospital, the county's proposal would involve AIDS patients smoking
marijuana or placebo as outpatients rather than being confined to a hospital
setting during the controlled clinical trial.
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