San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Thursday, October 9, 1997 - Page A1
Sabin Russell, Chronicle Staff Writer

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 HIV-positive 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. One-third 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 large-scale trial.

Peron said that he is convinced that even the small-scale trial will quickly show the beneficial effects of pot on HIV-positive 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, D-San 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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