MEDICINAL POT STUDY HAS ONE PATIENT

Research Tests Claims That Marijuana Eases Pain, Stirs Appetite

There are 600 government-issued marijuana cigarettes in a San Mateo County
public hospital freezer waiting to be distributed -- but so far only one
patient deemed trustworthy and sick enough to take a few home.

The county has been recruiting for its pioneering medicinal marijuana study
for three weeks, since the arrival of the cannabis from a federal farm in
Mississippi.

But only AIDS activist and freelance writer Phillip Alden has met the
study's strict criteria. Within weeks, he'll be smoking carefully marked
joints on his second-floor balcony overlooking the San Francisco Bay. He
says he's doing it for science -- and to help prove that a remedy he has
long relied on can save other lives as well.

That's why Alden doesn't much care if neighbors in his upscale Redwood
Shores condominium complex see him smoking. "I'm not embarrassed or ashamed
of using medical marijuana,'' he said. "In fact, I'm a huge fan of it.''

San Mateo County's cannabis study is out to separate science from anecdotes
like Alden's. The county-funded study is unique in that it releases
marijuana into the possession of patients at home. Most marijuana studies
require smoking in hospital wards or other clinical settings.

Participants being recruited will be free to smoke as many 35 joints a
week, but must keep detailed logs of their smoking as relief for
HIV-related joint pain.

Alden, 37, is the first to meet the study's 18 requirements. He's accepted
the inconveniences of multiple physical exams and at-home observations, in
part to repay his doctor, Dennis Israelski, who oversees AIDS treatment and
research at the county hospital. Alden, who has no medical insurance, lives
with his partner, a high-tech patent attorney.

Israelski is well-known among HIV patients from Daly City to East Palo
Alto, who like his personal approach and ability to work comfortably with
patients from varied ethnic and socioeconomic backgrounds.

"He wants to make a difference, and I want to help him,'' Alden said. "I'm
hoping Dennis' study will legitimize the use of medical marijuana.''

Candidate requirements

Jonathan Mesinger, the study's program manager, said dozens of
inappropriate candidates have called wanting to participate in the study,
which has room for 60 patients. Recruits must be infected with the human
immunodeficiency virus and have neuropathy, a hard-to-treat condition
causing excruciating pain in the arms, feet, hands and legs.

What's more, they must be experienced smokers with no recent record of
abuse. They must have a stable home life and be reliable enough to keep the
marijuana cigarettes in a locked box.

This presents a challenge for recruitment among the HIV patients at the
county hospital, many of whom got infected through intravenous drug use and
worry that marijuana could cause them to relapse.

Participants must know how to smoke marijuana, but can't indulge in other
drugs.

"Everybody in this trial has to have been a user before,'' Mesinger said.
"We're not introducing anybody to this drug. We don't want to start anybody
smoking.''

Six smoke-free weeks

Alden -- diagnosed with HIV in 1994 -- has smoked marijuana for medicinal
purposes for the last four years. He had to stop smoking for six weeks to
participate in the county drug trials. He will then spend six weeks
smoking, and the two time periods will be compared by researchers.

Alden said pot counteracts nausea he gets from his HIV medicine. A daily
toke before dinner also helps build up his appetite. For years, he has
suffered from an AIDS-related chronic wasting syndrome. No matter what he
eats, his body doesn't absorb the nutrients.

But when he smokes, he's hungry. And a good appetite is crucial to keeping
a patient with wasting disease alive.

"I start cooking dinner and take a couple hits off my pipe,'' he said.
"Then I eat dinner, dessert, snacks -- and keep eating right up until
bedtime. I eat the extra food I need to eat.''