LONE PATIENT QUITS MARIJUANA STUDY

One evening last week, AIDS activist Phillip Alden unpacked some groceries
in the kitchen of his stylishly appointed Redwood Shores condominium and
prepared for his daily pre-dinner ritual.

Alden, a long-time AIDS survivor, pulled a tightly rolled joint of
marijuana from a plastic medicine jar, noted it on an index card, and then
settled back into his recliner and took a long drag.

Seeds in the cigarette sparked and popped.

"I know after I take a few hits that within 10 minutes I'm going to be
hungry and my nausea is going to go away," said Alden, who suffers from
chronic persistent wasting syndrome, a condition that inhibits the body's
ability to absorb nutrients.

He says the drug gives him the appetite to keep the pounds on.

Last Thursday, however, in a development that could be a serious setback to
San Mateo County's groundbreaking study on the medicinal use of pot,
Alden's participation came to an abrupt end.

A sudden throat inflammation, which he blamed on the poor quality of the
pot, left Alden unable to eat and gulping for air,

Alden said the marijuana was not as good as the pot he was used to getting
from Bay Area cannabis clubs.

"The pot was stale and it was full of seeds. When marijuana seeds burn,
they smell and taste really bad."

Apparently, the two joints a day that he was required to smoke through the
study had aggravated a throat condition. The doctor issued an edict - no
more smoking.

"I feel really bad about the whole thing," Alden added. "I'm a big
proponent of medical marijuana and I'm very much in support of the study."

For the last several months he has been the sole patient in the novel
clinical trial in the use of medical marijuana to treat AIDS-related symptoms.

The study, being conducted by San Mateo County Health Center, is the first
to be done with the aid and support of the federal government.

The study, which has involved cautious cooperation among county government
officials, health care professionals and federal policy makers, has been
off to a slow start.

It was launched to great media fanfare in April, but so far the only
confirmed participants are Alden, who has been in the study since early
July, and another patient who joined in the past two weeks.

The trials have stringent participation requirements that bar many
potential participants. Subjects must have used marijuana before, but
cannot be active recreational drug users.

"It is a long, tedious process," said Jonathan Messinger, an assistant to
program director Dr. Dennis Israelski. "We just have to let the research
run its course."

The marijuana is grown in a federal government laboratory at the University
of Mississippi, and then shipped to the San Mateo County Hospital, where it
is kept under lock and key. It arrives dried and frozen and is rehydrated
the night before it is dispensed to patients.

"In terms of the quality of the marijuana, we have to go by what the
patients say since we're not trying it ourselves," Messinger said. "We know
the level of THC is lower in this federal-provided marijuana, but
unfortunately we don't have nay control over that. We have to use whatever
we're given by the federal government for this study."

The joints are rolled in tobacco-company cigarette paper, rather than
traditional rolling papers. Alden said that besides the poor quality of the
pot he believed the cigarette paper was harsher on his throat.

Messinger said he was hopeful other subjects would fare better with the
treatment.

"It's built into any study that you'll have people that don't complete the
study," he said

"We're optimistic that most people who enter will be able to complete it.
We realize that isn't going to be the case with everyone, however."

Doctors have said that they hope to recruit 60 participants over the next
two years and to have some results of their research next fall.

Messinger said he believed the study was still on track to meet those
estimates. "We've been fine-tuning our recruiting process," he said.

A clean-cut man who opposes recreational drug use and rarely finishes a
glass of wine, Alden is an unusual spokesman for medical marijuana. But he
credits the drug with enabling him to live with his disease.

"I think a lot of people, even those who support medical marijuana, think
it's a party scene.

"In the (pot) clubs, what I see are very sick people. These are people with
canes and with limps. They have multiple sclerosis or cancer or advanced
AIDS. It's not a bunch of hippies trying to get stoned."

For him, marijuana has been particularly effective in alleviating
peripheral neuropathy, a condition that causes stabbing pains in the hands
and feet.

"All of a sudden, it'll feel like someone stuck a knife through my foot,"
he said.

That pain was severe during the control arm of the study, when Alden was
prohibited from smoking.

"When I left the control arm of the study and started smoking again, I had
no neuropathy pain at all. It worked really, really well."

Alden also says marijuana controls the anxiety attacks he has suffered from
for years and the nausea and stomach pains that are chronic side effects of
AIDS medication.

When he started taking one particular protease inhibitor, "I couldn't work
for a month. I literally did not leave the house," he said.

"Medical marijuana was a godsend for me."

Such results motivated Alden to take part in the study, which requires a
demanding schedule from its participants.

Subjects fill out daily logs, go for weekly blood tests and check-ups and
follow strict protocols for consuming the joints.

They are given three containers: one for new joints, one for those in
progress and a third for the butts, or "roaches," which must be logged in
at the pharmacy when they receive a new supply.

Patients get less than a week's supply at a time and must log all their
consumption.

During the study, Alden would smoke a marijuana cigarette in the evening
before dinner to stimulate his appetite and another before bed to calm his
stomach.

Once his throat condition clears, Alden says he will go back to treating
himself at the cannabis clubs.

"It works. I have no doubt about that," he said.