S.F. Study of Marijuana, AIDS Patients Is Approved
Key to debate over medicinal use

Sabin Russell, Chronicle Staff Writer

San Francisco researchers have won approval for the first federally
sponsored study of the medical effects of marijuana on AIDS patients.

With $1 million from the National Institutes of Health, doctors at San
Francisco General Hospital will spend two years studying how the drug
interacts with the latest AIDS medicines.

The results of the study are certain to play a central role in the debate
over medical use of marijuana, not only for AIDS patients, but for
sufferers of numerous other diseases. It is a debate that led California
voters last year to legalize the medical use of pot, and has since become a
major issue in the wrangling over national drug policy.

In the San Francisco study, each of 63 volunteers will be confined to the
hospital for 25 days during the experiment. Because of limited space at the
hospital, only three or four patients will be studied each month.

The grant was a significant victory for Dr. Donald Abrams, the San
Francisco AIDS doctor who has fought an uphill battle for federal approval
of a serious scientific examination of marijuana's effects on patients.

``I'm happy we've evolved to the point where we can ask some very important
scientific questions,'' said Abrams. ``In all honesty, I think we've
learned a lot during this process. The study we've proposed this time is
really the best.''

Advocates of medical use of marijuana contend that it promotes appetite and
suppresses nausea making it a potential lifesaver for patients
undergoing chemotherapy for cancer or battling the wasting syndrome caused
by the human immunodeficiency virus.

``I know this experiment will work, because I know marijuana gives you the
munchies. Now, let's prove our point,'' said Dennis Peron, director of
Californians for Compassionate Use, a group that helped win passage of
Proposition 215, which legalized the use of marijuana in California for
medical purposes.

The stated purpose of the San Francisco General Hospital study will be to
determine whether or not marijuana therapy is safe for patients taking the
new protease inhibitor drugs, which in combination with older AIDS drugs
such as AZT and 3TC have caused dramatic improvements in many patients.

Abrams said that because marijuana is metabolized by the same liver enzymes
that process protease drugs, there is a chance that pot consumption could
render the new drugs either dangerous or ineffective.

Accordingly, all the patient volunteers must be HIVpositive and be taking
a protease inhibitor drug.

Test subjects will have to live in special, ventilated rooms at San
Francisco General Hospital currently used for study of tobacco smoking.
Onethird of the subjects will be asked to smoke three rolled marijuana
cigarettes each day. Researchers will weigh the unsmoked portions each day
to measure consumption.

A second group of patients will take instead the approved prescription drug
Marinol, which contains the active ingredient of marijuana, THC. A third
group will be given a dummy pill that resembles Marinol, but contains no
medication.

Patients in all three groups will each be paid $1,000 for their time. But
they will have to endure frequent blood tests that researchers will use to
determine the effects of the experiment on their blood chemistry.

Abrams said that, although the study will measure factors like increase in
appetite and weight gain, it will take a larger study than this to prove or
disprove such effects. The proposed research will determine, however,
whether it is safe to conduct such a largescale trial.

Peron said that he is convinced that even the smallscale trial will
quickly show the beneficial effects of pot on HIVpositive people. ``They
will have to shorten the study as soon as it starts looking good,'' said
Peron. ``They will watch the placebo person die, and as moral people, they
will say this isn't right.''

The issue of medical testing of marijuana's effectiveness has created some
strange political bedfellows. Attorney General Dan Lungren, a staunch
opponent of Proposition 215, threw his support behind a bill by Senator
John Vasconcellos, DSan Jose, last month that would have provided state
money to study the effects of marijuana. ``Past studies of marijuana
notwithstanding, California needs a definitive study,'' he argued.

Lungren spokesman Matt Ross said yesterday that the attorney general had
not yet heard about the National Institutes of Health approval of Abrams'
study. ``His point all along is he wants to see a study to see the true
effects of marijuana. He said that before 215, and he called for it after
215,'' said Ross.

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