Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
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San Fransisco Examiner - July 13, 2000
Ulysses Torassa, Examiner Medical Writer
The results were announced Thursday at the 13th International AIDS Conference and are the first to be released from research conducted at San Francisco General Hospital into the use of marijuana by people infected with HIV. Given the scarcity of data about the possible medical uses of marijuana, the results have been eagerly awaited by advocates in this heavily debated issue.
It took four years for UC-San Francisco professor Donald Abrams to jump through hurdles erected by the federal government to get the research under way, and in the process he was restricted to focusing on marijuana's safety rather than its effectiveness. The 67 people who participated in the study were kept in the hospital during the 25-day study period.
"The fact of the matter is that any good clinician with his eyes and ears open has known for a long time that cannabis is very useful in the treatment of the AIDS reduction syndrome and does not harm patients," said Dr. Lester Greenspoon, professor of psychiatry at Harvard University and author of "Marijuana: the Forbidden Medicine."
"When all the dust settles, and when marijuana is admitted to the U.S. pharmacopia, it will be seen as one of the least toxic drugs in the whole compendium. What Don (Abrams) has done is put the seal of approval on a new drug with his double blind study."
Researchers were especially keen to study people on drug regimes that contain protease inhibitors, because the key ingredient in marijuana is metabolized by the same system in the liver as those drugs.
The participants, nearly all men, were divided into three groups, with one set smoking marijuana, another taking a Food and Drug Administration-approved pill containing marijuana's main ingredient, and a third taking a placebo pill. In all groups, tests showed that the level of virus in the blood dropped or remained undetectable by current tests. But those taking marijuana either by smoking or in a pill form saw their level drop slightly more than those on the placebo.
Furthermore, researchers found that those using the pill or smoking marijuana gained an average of 2.2 kilograms, compared to .6 kilograms in the placebo group. Marijuana was first used widely by people with AIDS to combat the nausea and extreme weight loss that comes with the disease.
Abrams called the lower viral levels in the marijuana patients intriguing, but said it was not statistically significant.
"The good news is that there is no statistical difference between the three groups," he said.
"Now that we've demonstrated the safety in a population as vulnerable as people with HIV, I think it paves the way for doing studies of efficacy," Abrams said.
Indeed, Abrams, an oncologist, said he hopes to soon begin studying the use of smoked marijuana for cancer patients to see if it can control nausea and pain, including the nerve-based pain that is often beyond the reach of opiate painkillers like morphine.
Abrams said he expects to release more results from the study soon, including marijuana's effect on appetite, testosterone levels and body composition.
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