Pubdate: Mon, 13 May 2002
Source: Arizona Republic (AZ)
Copyright: 2002 The Arizona Republic


SAN JOSE, Calif. - The pot is unsmokeable, they say, full of sticks, stems 
and seeds. The leaves have gone stale after at least a year of storage, 
freezing and then thawing.

Marijuana supplied to researchers from the government farm in Mississippi 
isn't quality product, according to a range of observers, from Redwood 
Shores HIV patient Phillip Alden to a cop-turned county supervisor.

Alden said he knows from experience - he's smoked it. And the result? An 
upper respiratory infection and an early departure from a landmark research 
study, the first publicly funded analysis of HIV patients smoking cannabis 
in their homes.

In 10 months, fewer than 10 subjects have been accepted into San Mateo 
County's marijuana study, which took years to get funded and approved. The 
county's medical chief of staff, Dr. Dennis Israelski, had planned for 60.

Some say it must be the pot.

"I couldn't smoke the stuff anymore," said Alden, a freelance writer who 
relies on marijuana to ease HIV-related wasting disease. "I was disgusted 
with the federal government."

Dale Gieringer, California coordinator for the National Organization for 
the Reform of Marijuana Laws, agrees. "It's unconscionable that they would 
be giving this marijuana to patients," he said. "It's stale, low-potency 
ditch weed."

The National Institute on Drug Abuse, which grows the marijuana plants that 
are pre-rolled, frozen and sent out to officially sanctioned researchers 
across the country, denies its research product is substandard.

"The marijuana we provide does not contain sticks and seeds. The problem is 
re-humidifying - it makes it kind of harsh," said Steve Gust, special 
assistant to the director of NIDA. "Certain procedures are needed to make 
it smoke right."

Gust said researchers themselves aren't complaining about quality. He 
thinks groups like NORML are looking for something to blame if the results 
of the studies show it has little medicinal value. "Then they can say the 
marijuana isn't of sufficient quality," Gust said.

Cannabis trials in San Mateo County began last July, but few patients so 
far meet the strict standards to enroll. There is no hard evidence that the 
quality of the cannabis used in the study is hindering recruiting.

But stories - and rumors in some cases - have slowed progress, said 
Israelski, an associate clinical professor at Stanford University. When 
Alden was forced to drop out of the study late last year because of an 
inflamed throat, for example, published reports of his experience swirled 
quickly through Internet circles and HIV support groups.

"We've been hurt by word on the streets," Israelski said. "But the word on 
the street might not reflect reality."

To counteract the slow start, the county is trying to broaden its study.

In a letter sent to regulatory agencies this month, researchers ask to 
expand the HIV patient pool to include people suffering from nausea, weight 
loss and wasting disease.

Supervisor Mike Nevin is frustrated that the county is once again asking 
for approvals from the myriad agencies that must OK any changes to the 
research plan. He spent three years fighting for funding and regulatory 

Nevin envisioned his county's research program after a beloved colleague, 
Joni Commons, died of breast cancer in 1998. Commons won him over, 
convincing the former San Francisco police inspector that marijuana brought 
her critical pain relief.

"We've put too much effort into this, and we don't want to be playing games 
here," Nevin said. "It needs to be a certain grade of substance, and unless 
it's stronger, they'll set us up for defeat."

Medicinal marijuana research is moving steadily forward in other parts of 
the country, with multiple sclerosis, cancer and AIDS patients. The newly 
inaugurated Center for Medicinal Cannabis Research in La Jolla will soon 
oversee studies at 15 university sites.

Most researchers interviewed, unlike marijuana advocates, did not complain 
about the quality of the NIDA product. According to strict protocols, they 
can't unroll the carefully measured, frozen joints they receive, although 
several said they can hear seeds popping when some of their patients smoke, 
or they fall out the untwisted end. They've heard that the sticky buds gum 
up the government's rolling machine.

But that hasn't stopped more than 500 people from joining waiting lists for 
clinical trials at the La Jolla center, where in contrast, two recently 
enrolled subjects complained that the pot was too potent.

"They've reported getting high shortly after the first few puffs," said Dr. 
Andrew Mattison, the center's co-director. "These are people with a 
chronic, debilitating illness who do not want to get high. They want to get 
pain relief."

Dr. Donald Abrams, a University of California-San Francisco professor of 
medicine, agreed that most patients don't want their heads spinning, even 
though years ago he fought with federal regulators for more potent pot.

Now, he's satisfied. "Nobody is saying they don't want to participate in 
our study because they hear the marijuana isn't good," Abrams said.

Researchers concede that the less a patient has to smoke, the better. More 
potent cannabis delivers a more concentrated effect, with fewer 
smoking-related hazards.

Advocates say this is why they complain about the government-grown 
marijuana. According to a 1999 NORML survey, the government's cannabis 
scored lowest on levels of THC - marijuana's essential ingredient - when 
compared with 48 samples.

Dr. Ethan Russo, a Montana neurologist and editor of the Journal of 
Cannabis Therapeutics, said NIDA's marijuana is "medically inexplicable and 
inexcusable." He said American patients in any other drug study would not 
be given a stale product, and cannabis subjects deserve equal treatment.
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