The Bay Area Reporter - August 27, 1996
Stephen LeBlanc and Jeff Getty, ACT UP/Golden Gate Writers Pool

While political activists on both sides engage the debate over these issues, the real losers in this contest are people with HIV/AIDS, multiple sclerosis, cancer, and other debilitating illnesses who claim their symptoms are alleviated by medical marijuana use but cannot safely get access to the drug.

That marijuana has important and beneficial medical effects is demonstrated by the fact that one important active compound in marijuana, THC (tetrahydrocannabinol), was approved by the FDA in 1985 as a treatment for nausea and vomiting (emesis) associated with cancer chemotherapy and later was approved as a treatment for AIDS-associated appetite loss. It is manufactured in an oral pill called Marinol, available by prescription.

However, for many people with AIDS, Marinol is a less desirable treatment than either smoked or ingested marijuana. Marinol has been associated with undesirable side effects, including anxiety and dysphoria worse than that seen with use of marijuana. This is consistent with studies indicating that THC used alone sometimes causes anxiety. However, a Brazilian study and other researchers have found that cannabidiol (CBD), another compound present in natural marijuana, reduces the anxiety produced by THC used alone.

Additionally, Marinol is extraordinarily expensive to those without insurance, costing roughly $300 per month, and many patients report that they can control their dosage more easily when using natural marijuana, using just as much as necessary to stimulate appetite or reduce symptoms, while avoiding unwanted side effects.

Legitimate proven uses of medical marijuana include appetite stimulation, nausea and vomiting reduction, and glaucoma relief. According to an article in the October 1988 issue of the New York State Journal of Medicine, smoked marijuana was effective in treating nausea in a majority of cancer chemotherapy patients who had failed other anti-nausea treatments. Additional medical reports suggest that marijuana is effective in treating chronic migraines and some types of seizures.

A review of the available literature leads to a conclusion that marijuana is medically necessary and beneficial for PWAs with wasting and nausea who either do not react well to THC alone in the form of Marinol or cannot afford it.

Reefer badness?

Marijuana use by PWAs does come with a dark side, however. Marijuana is widely thought to cause psychological dependence, especially when used recreationally and excessively, and can in some people lead to lethargy and lack of motivation. When this impacts a PWA's ability to stay on top of his or her medical care, keep doctor appointments, and stick to demanding anti-retroviral or OI prophylaxis regimes, excessive habitual marijuana use can be deadly.

This phenomenon is of special concern to Greg Szekeres, a staff member at the Healing Alternatives Foundation. "I've seen several of my younger HIV+ friends use marijuana in large amounts at times that it was really crucial that they be proactive about their health care," reports Greg.

"Rather than pay attention to what was going on with their bodies and get treatment for whatever HIV-related condition they were facing, they got stoned. Those people are dead now, from conditions that could have been treated."

While the legal and policy debate rages, the one indisputable fact about marijuana use among PWAs is that like many other natural therapies, scientific controlled studies must be done to determine what medicinal effects it possesses. HIV-experienced doctors are eager to perform such studies, and Dr. Donald Abrams at UCSF has even gotten one study fully approved by the FDA - only to see it stopped by the federal Drug Enforcement Agency.

"The protocol had been approved by the UC Institutional Review Board and the FDA and then the DEA blocked it," according to Abrams. "It's really frustrating." He said that inside sources told him fears the study would yield positive results led to its cancellation.

Learn about the immune system

ACT UP/Golden Gate will be sponsoring a 4 hour immunology intensive, currently scheduled for Saturday, September 28, 1996, from 10 a.m. to 3 p.m. The course will be taught by an Assistant Professor of Immunology at University of Massachusetts Medical School. Course topics will include the basics of human immune system function, including humoral and cellular immunity, HIV disease pathenogensis, and promising avenues of immune-based therapies. No prior knowledge of immunology is required. $5.00 course materials fee based on ability to pay. Call 252-9200 and leave a message with a phone number for Cameroon Lee to register.

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