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Local Doctor Heads Study on Medical Pot
By Mark Robinson
Is marijuana good medicine?
For the first time, scientists have received government funding to explore that question. Starting in January, a team of San Francisco researchers, led by Noe Valley resident Donald I. Abrams, M.D., will study the effects of smoking marijuana on a group of HIV-infected patients.
The two-year study, to be carried out by researchers at the University of California, San Francisco, will cost $1 million.
Getting that funding -- which will come from the National Institute on Drug Abuse -- was a four-year struggle that played out during a growing controversy over prescription of medical pot.
In November 1996, California voters approved Proposition 215, which legalized the use of marijuana to ease the symptoms of diseases like cancer and AIDS. The measure, and a similar one in Arizona, sparked a backlash among federal and state anti-drug officials, who tried to crack down on users and their doctors. The law is still being hashed out in the federal courts.
Meanwhile, Abrams, a UCSF researcher and professor of medicine, rewrote and tinkered with his team's research application several times. Approval came only after a panel of experts assembled by the National Institutes of Health called for more research on medical marijuana in February.
Abrams says his proposal probably got a more favorable reception this time around because it focuses on the potentially harmful interaction of marijuana with protease inhibitors, one of the new generation of anti-AIDS drugs. Past applications had stressed marijuana's potential benefits. "We decided maybe the thing to do was to look and see if there is toxicity," Abrams said.
But the study will also look for preliminary evidence of the benefits -- such as increased appetite and weight gain -- often attributed to smoking pot.
The researchers plan to compare three groups of 31 HIV infected patients. One group will smoke marijuana, one group will receive an oral tablet of a drug called Marinol -- which contains THC, the active ingredient in marijuana -- and a third group will take neither drug. The marijuana will be supplied by the Institute on Drug Abuse from a government farm in Mississippi.
The study's volunteers will be drawn from the patients of the Community Consortium, a group of San Francisco doctors who treat HIV-infected people.
The research will take place at S.F. General Hospital, where small groups of volunteers will be housed for 21 days for close study. The scientists will monitor the volunteers' viral load, hormone levels, caloric intake, weight gain, and appetite to see what effect marijuana has.
Abrams has not been an advocate in favor of medical marijuana, but he has concluded that pro-pot advocates are right when they say that government officials have been paranoid about moving ahead with legitimate research on the drug's effects. The advocates have accused the officials of dragging their feet while sick people suffered.
Does the funding of this grant mark a turning point in the government's views?
"I don't know about that," Abrams said. "It's too early to call. Certainly we have learned a lot in how to apply for a grant and how to make an application. I appreciate their giving us the go-ahead. Now we need to do the work."
While Abrams is not an advocate of medical marijuana, his partner, writer and journalist Clint Werner, definitely is. The couple have lived together in Noe Valley for 12 years but managed to keep their distinct political outlooks intact. Werner is working full time on a book about the saga of legalizing the drug, tentatively titled Pot Wars: The Battle for Medical Marijuana. (The Voice wrote about Abrams' and Werner's separate lines of research in the November 1996 issue.)
By coincidence, Werner sent off the first three chapters plus an outline of the book to New York literary agent Richard Pine the same week (the first week in October) that Abrams and his team got word that their study had been funded.
Werner has not heard from the New York agent, but he's still pushing to finish the book by the end of spring. "The real challenge isn't in finding great stuff to write about," he said. "It's shaping this huge mass into something manageable."