UC STUDY: POT MAY CUT NERVE PAIN

Smoking marijuana can ease HIV-related nerve pain, UC San Francisco
researchers are reporting today in a study being hailed by
legalization advocates as proof that federal pot policy is deeply misguided.

The rigorous study, appearing in today's issue of the journal
Neurology, was funded by a state effort to provide answers in the
long debate over whether marijuana makes good medicine.

Primary investigator Dr. Donald Abrams, a professor of clinical
medicine at the University of California, San Francisco, was not
surprised that about half the people studied with burning, tingling
nerve pain got relief smoking marijuana.

"It has a 5,000-year history of safety and effectiveness as a
medicine that we've ignored quite grandly in the last 70 years," he
said. "It's been used ... in China, in India and also in Middle
Eastern cultures as a medicinal substance."

Yet the study comes on the heels of an unrelated analysis, published
in Monday's Archives of Internal Medicine, that links long-term
exposure to marijuana smoke with coughing, wheezing and other
respiratory complaints common among tobacco smokers.

"The bottom line is, it certainly needs to be looked into further,"
said Dr. Jeanette Tetrault, a general internal medicine fellow at
Yale University who is among those investigating possible lung cancer
or respiratory disease links to marijuana smoking.

If marijuana is ultimately found to deliver better pain relief than
existing medications, she said, research into the safest possible
delivery mechanisms would be critical.

The UC San Francisco study is among the first published results
funded by the UC Center for Medicinal Cannabis Research, which was
created by state law to improve the science on marijuana after
California voters supported medical pot use.

So far, the center has spent roughly two-thirds of the $9 million it
received, devoting the money to research into nerve pain, sleep
difficulties, muscle spasms and other conditions.

Some studies, including ones for cancer pain and nausea, had to be
discontinued for lack of volunteers, said center director Dr. Igor
Grant, a UC San Diego psychiatry professor.

The center will remain active until all the money is spent,
supporting about a dozen studies, which Grant acknowledges are "not a
lot" but still much more than just a few years ago.

"The results of these studies will provide some real information into
whether cannabis is or isn't helpful," Grant said.

Federal policy has long discouraged investigations of marijuana,
setting up numerous regulatory and practical hurdles, said Bruce
Mirken, a spokesman for the Marijuana Policy Project, which backs legalization.

In such an environment, the state-backed study is "truly
gold-standard" research, Mirken said. It was a placebo-controlled and
double-blind study.

About half of the 55 people who initially enrolled were given placebo
cigarettes, with a key active ingredient stripped out. Both they and
the researchers analyzing results were "blinded" -- that is, not told
who got the real thing.

Such measures are used to prevent bias and to account for the
powerful way people are known to respond to dummy medications. In the
UC San Francisco study, for example, about one-fourth of the people
smoking placebo cigarettes experienced significant pain relief,
compared with half of those smoking marijuana.

But researchers acknowledged that their double-blind effort was
imperfect because smokers might have been able to recognize whether
they were inhaling active cannabis or not.

"I knew immediately because I could feel the effects," said one study
subject, Diana Dodson. "I did get the cannabis." Her impression was
later confirmed in a letter from researchers.

Dodson, who lives near Santa Cruz, gets burning, bruising, sometimes
jolting nerve pain on the bottoms of her feet, a complication of the
HIV she contracted more than 20 years ago from a tainted blood product.

"It's like an ice pick stab with an electric shock," she said, and
stronger painkillers leave her less aware and less alert than
marijuana does. She participated in the study in hopes that "we'll be
able to have safe access to this medicine."

It's important to have as many safe drugs as possible in doctors'
arsenals, said UC San Francisco medical professor Abrams.

Individuals respond differently to each drug's benefits and side
effects, and drug interactions can make it tough to find the right
match for each person.

Abrams is seeking volunteers for a study that will look into whether
cancer patients taking morphine or OxyContin for pain might be able
to use a lower dose or suffer fewer unpleasant side effects if they
combine the treatment with marijuana.

Those interested in participating -- which would involve a five-day
stay in a San Francisco clinic -- can contact researchers at (415)
476-9554, ext. 315.