Pubdate: Mon, 09 Jun 2003
Source: San Francisco Examiner (CA)
Copyright: 2003 San Francisco Examiner
Contact:  http://www.examiner.com/
Details: http://www.mapinc.org/media/389
Author: Sara Zaske, The Examiner Staff
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)

STUDY: MANY HIV PATIENTS USE POT FOR MENTAL HEALTH

SAN MATEO -- Results coming out of the medical marijuana research project 
at the San Mateo Medical Center are making waves in the scientific community.

The first clinical trials, which ended in February, are still being 
analyzed. But psychologists were treated to some surprising data from an 
initial Medical Center survey of HIV patients at the American Psychiatric 
Association conference in May. The study indicated that more HIV patients 
smoked marijuana for mental rather than physical reasons.

"We expected to see people smoking marijuana to alleviate nausea, pain and 
to increase their appetite -- all the reasons that are commonly cited," 
said Diane Prentiss, a research epidemiologist with the Medical Center. "In 
this case, we were surprised that 57 percent say they smoked to relieve 
anxiety or depression."

To gather baseline information for use in clinical trials of medical 
marijuana, researchers at the San Mateo Medical Center surveyed 252 HIV 
patients. Of that number, 23 percent (58 patients) admitted to smoking 
marijuana in the last four weeks.

When asked for the main reasons they used the drug, most cited several 
reasons. Mental health issues topped the list. Curbing nausea and 
increasing appetite was the second, with 52 percent. Recreational use came 
in third with 33 percent. Only 28 percent said they smoked to alleviate pain.

The prevalence of the mental health issue is a significant finding that 
raises some interesting questions, said Dr. Dennis Israelski, chief of 
staff and chief research officer at the Medical Center.

"In terms of understanding the whole field, it is safe to say that there is 
a fair amount of self-medication that physicians are not aware of," he 
said. "It does speak to whether it's appropriate medication. Are physicians 
doing a good enough job when patients are using outside medication? Do we 
have better treatments for anxiety and depression? These are very important 
issues related to quality of life."

Mental health is especially important for HIV patients, Israelski said, 
pointing to studies showing that mental health impacts a patients' ability 
to adhere to the strict medical regimens used to combat the often-fatal 
disease.

Dr. Cheryl Koopman, an associate professor of psychiatry at Stanford, said 
that many of her colleagues were intrigued by the results of the Medical 
Center's study presented at the conference.

"There was a lot of interest. A number of clinicians in the room felt it 
was relevant to patients they are working with," she said. "Because of the 
illegality of marijuana there's a lack of research. We don't know if 
self-medication is systemic. It's another reason for large studies to be 
conducted in a scientifically rigorous way."

The San Mateo Medical Center's work with medical marijuana is the only 
publicly funded research of its kind in the country. "It is not an easy 
field to study," said Israelski. "People don't want to touch it for 
political reasons."

The Bush administration has come out strongly against any legalization of 
marijuana, even for medical purposes, claiming there is no research proving 
it has health benefits.

"It's a Catch-22," said Israelski. "If they make it tough to study, how do 
you get scientific evidence?"

The Medical Center has managed to complete one round of clinical trials 
studying medical marijuana and HIV patients, but Israelski is still 
negotiating for federal approval for two more studies. The AIDS researcher 
credits the political support at the county level -- particularly from 
Supervisor Mike Nevin and County Manager John Maltbie -- for the success of 
the project so far.

The first round of the Medical Center clinical trials focused on 
marijuana's affect on peripheral neuropathy, a severe debilitating leg pain 
associated with HIV.

For the next trials, the Medical Center research team wants to expand the 
study to include potential effects on nausea, gastrointestinal disorders 
and wasting syndromes associated with HIV. A third round of trials would 
study the drug's effects on cancer patients. These second and third trials 
are still awaiting federal approval.

Significant benefits to marijuana, marijuana-related or "cannabinoid" 
products may not be found, even if studies are conducted, Israelski said.

"I'm not a believer. I am approaching this as a scientist to see if there 
are merits, and then let the dust settle," he said. "I have no axe to 
grind, but we should be able to do the study."
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