SMOKING POT REDUCES PAIN IN HIV PATIENTS, STUDY FINDS

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 UC 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. During 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.

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 cannabiniod drugs could help with pain
relief, control of nausea and vomiting and appetite stimulation,
according to the IOM report.