Pubdate: Tue, 13 Feb 2007
Source: Oakland Tribune, The (CA)
Copyright: 2007 MediaNews Group, Inc. and ANG Newspapers
Author: Rebecca Vesely, Staff Writer
Note: The Associated Press contributed to this report.
Cited: Center for Medicinal Cannabis Research
Cited: The Institute of Medicine report
Cited: Americans for Safe Access
Cited: National Association of People with AIDS
Bookmark: (Donald Abrams)
Bookmark: (Marijuana - Medicinal)
Bookmark: (Chronic Pain)


Three Marijuana Cigarettes Daily Effective, According to New Report From UCSF

HIV patients who smoked three joints of marijuana per day for five 
days experienced relief from chronic foot pain associated with the 
disease, researchers at the University of California, San Francisco, 
reported Monday in a rare U.S. study on medical marijuana.

"These results provide evidence that there is a measurable medical 
benefit to smoking cannabis for these patients," said study lead 
author Dr. Donald Abrams, UCSF professor of clinical medicine.

The study involved 50 HIV patients with sensory neuropathy, a 
peripheral nerve disorder that causes intense, sharp pain, numbness 
and tingling in the hands and feet. The condition affects about one 
in three HIV patients.

Patients assigned to smoke cannabis experienced a 34 percent 
reduction in intense foot pain -- twice the rate experienced by 
patients who smoked a placebo.

The first cannabis cigarette patients smoked reduced chronic pain by 
a median of 72 percent compared to 15 percent for patients who smoked 
the placebo, according to the study, published in the journal Neurology.

Half the patients were assigned randomly to smoke cannabis while the 
remaining 25 patients smoked an identical-looking placebo that lacked 
the drug's active ingredient. They had to be off any medication to 
treat neuropathy, including private-use marijuana. The patients were 
required to have some prior experience smoking the drug but could not 
have substance abuse problems.

The patients were sequestered at San Francisco General Hospital for 
seven days, where they underwent frequent testing. Over five 
consecutive days, they smoked cannabis or a placebo three times per 
day in rolled cigarettes. The National Institute on Drug Abuse 
provided the identical machine-rolled marijuana cigarettes.

Diana Dodson, 50, of Santa Cruz was among the 25 patients who 
received cannabis. She contracted HIV after receiving tainted blood 
product in 1985 and has been living with AIDS for 10 years.

Dodson, who smokes marijuana on her own to control her pain and 
nausea associated with AIDS, said the drug has been a lifesaver. "I 
really attribute cannabis to why I am still alive today," she said.

Her neuropathy symptoms include an extreme burning on the soles of 
her feet. "It's like an electrical poker going through me," she said. 
"I'll scream in the kitchen. Sometimes it's like a jabbing ice-pick pain."

Just a few puffs gives her relief for two hours without the 
grogginess associated with taking opiates such as morphine, she said.

The UCSF study indicated that pain relief from cannabis was on par 
with that from morphine.

The quality of the marijuana used in the trial wasn't as good as what 
Dobson gets on her own, she said, but she still felt relief from pain.

"It gives me a quality of life I wouldn't otherwise have," she said.

By contrast, previous studies of marinol -- the FDA-approved drug 
containing a synthetic version of THC, the active ingredient in 
cannabis -- showed little promise in relief for HIV-associated neuropathy.

"There are other compounds in smoked marijuana besides THC," said 
UCSF study co-author Dr. Cheryl Jay, a professor of clinical 
neurology. "That's one of several explanations why our study had a 
positive result while previous marinol studies did not."

David Murray, chief scientist at the Office of National Drug Control 
Policy, said people who smoke marijuana are subject to bacterial 
infections. He added that the study, considering its small size is 
"not a convincing demonstration."

Treatment for HIV-related neuropathy includes antidepressants and 
seizure drugs, but these medications don't always work and some 
patients cannot tolerate them. Opiates such as morphine are also 
sometimes used. There are no drugs approved by the FDA specifically 
for the condition.

The study is the first of several clinical trials of medical cannabis 
being conducted through the University of California's Center for 
Medicinal Cannabis Research, based at UC San Diego.

Dr. Igor Grant, director of the cannabis research center at UCSD, 
said the findings in this study suggest that cannabis "may be useful" 
in treating HIV-associated neuropathy. He noted that it has been many 
years since clinical trials of cannabis have been conducted in the 
United States.

"As a result, there has been insufficient light shed on the possible 
therapeutic value of cannabis," Grant said.

A 1999 report by the Institute of Medicine reviewed the scientific 
literature on medical marijuana and found that though it is a 
powerful drug, it is safe and should not be excluded from some medical uses.

Studies have indicated that cannabinoid drugs could help with pain 
relief, control of nausea and vomiting and appetite stimulation, 
according to the IOM report.

Americans for Safe Access and the National Association of People with 
AIDS today plan to call for congressional hearings to implement the 
IOM report findings, which include further scientific studies of cannabis.

"Bolstered by the preliminary findings in the Abrams (UCSF) study, we 
will go to Congress and familiarize them with the IOM report so we 
can move forward with the research," said Dr. Barbara Roberts, 
director of medical and scientific affairs at Americans for Safe Access.
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