MEDICAL POT CUTS PAIN, STUDY FINDS

First Rigorous Research Looked at HIV Patients

Doctors at San Francisco General Hospital reported Monday that
HIV-infected patients suffering from a painful nerve condition in
their hands or feet obtained substantial relief by smoking small
amounts of marijuana in a carefully constructed study funded by the
state of California.

Although the study was small, it is the first of its kind to measure
the therapeutic effects of marijuana smoking while meeting the most
rigorous requirements for scientific proof -- a randomized,
double-blind placebo-controlled trial.

As such, the results of the trial are being hailed by medical
marijuana advocates as the most solid proof to date that smoking the
herb can be beneficial to patients who might otherwise require
opiates or other powerful painkillers to cope with a condition known
as peripheral neuropathy.

The federal government has taken a hard line against marijuana use
for medical purposes, maintaining that smoking it is harmful and that
there is no scientific evidence to support its legitimacy for
treatment in the United States. The U.S. Supreme Court in 2005 ruled
that medical marijuana patients can be prosecuted by the government,
even in states like California where medical use has been legalized.

"It's time to wake up and smell the data," said Bruce Mirken,
spokesman for the Marijuana Policy Project, a group advocating the
legalization of the drug for medicinal purposes. "The claim that the
government keeps making that marijuana is not a safe or effective
medicine doesn't have a leg to stand on."

The study found that most volunteers who were given three marijuana
cigarettes a day experienced a significant drop in the searing pain
of peripheral neuropathy, which patients liken to a stabbing or
burning sensation, usually on the bottoms of their feet. HIV patients
are not the only group to experience peripheral neuropathy -- many
types of the condition have been identified, and it can also afflict
diabetics, cancer patients and people with injuries or infections
that affect nerve tissue.

On average, the experiment's participants reported at the start that
their pain was roughly at midpoint on a 100-point scale, where zero
was no pain at all and 100 was "the worst pain imaginable."

At least half the volunteers who smoked the active marijuana
experienced a 72 percent reduction in pain after their first
cigarette on the first day of the trial. Over five days, the median
reduction in pain reported by the marijuana smokers was 34 percent,
compared with 17 percent reported by those who smoked placebo
cigarettes that had the active ingredient THC removed in a process
akin to decaffeinating coffee.

"This is evidence, using the gold standard for clinical research,
that cannabis has some medicinal benefits for a condition that can be
severely debilitating," said Dr. Donald Abrams, lead author of the
study released Monday by the journal Neurology.

The trial was conducted over a two-year period beginning in May 2003,
during which 50 volunteers each spent a week at a secured laboratory
at San Francisco General. Patients were required to stop their
marijuana use before the start of the experiment. After a two-day
orientation period, they were given one cigarette three times a day.
Half of the volunteers received marijuana containing about 3.5
percent THC, the active ingredient of the drug. That's significantly
weaker than what can be purchased on the street or in medical
marijuana dispensaries. The other half received the placebo.

Abrams said that the placebo cigarettes looked and smelled identical
to the ones containing active ingredients.

One volunteer, Diana Dodson, a 50-year-old Santa Cruz woman,
subsequently learned she had been given the active ingredient. She
has tried the FDA-approved pill containing THC, a drug known as
Marinol, but said it does not control her pain as well. "For four or
five hours, it puts me in a fog," she said.

Smoking marijuana, she said, helps control nausea and her peripheral
neuropathy. "I attribute my cannabis use to my staying alive 21 years
with HIV," she said.

Dobson described the pain of peripheral neuropathy as a constant
sense of burning on the bottoms of her feet, with periodic jabbing
pains "like a sharp ice pick, or an electric shock."

After stopping her marijuana use for the required two-day period and
then resuming it for the experiment, she said the effect of receiving
the real drug again was powerful. "I was a little surprised the
results were so dramatic, as they were using low-quality cannabis," she said.

Because of the unusual nature of the experiment, Abrams first had to
receive clearance from eight different government agencies, including
the University of California, the federal Drug Enforcement
Administration and the National Institute on Drug Abuse.

The cigarettes were made from marijuana grown on a federal marijuana
farm in Mississippi, and stored in a locked freezer at San Francisco General.

Publication of the paper is a milestone for Abrams, who has been
exploring the medicinal effects of marijuana among AIDS patients
since 1984 and fought a long battle to win permission from federal
agencies to conduct the study.

In the end, it took the taxpayers of California to pay for the
research. Under legislation signed by then-Gov. Gray Davis in 1999,
the state created the Center for Medicinal Cannabis Research,
headquartered at UC San Diego and operating in partnership with UCSF.

Dr. Igor Grant, executive director of the research center, said a
total of $8.7 million has been allocated to the program by the state
Legislature since it was launched in 2000. Abrams' study, the first
of a dozen similar clinical trials now under way, cost $849,000.

Grant said that the findings were "very promising," but stressed that
the results of any single trial, no matter how well constructed, are
not necessarily definitive. He said that data are now being analyzed
from a similar trial that was conducted at UC San Diego. A second
trial, also completed at UCSD, enrolled volunteers who were not HIV
patients. Their sensitivity to pain was measured using
well-established monitoring tests using capsaicin, a cream that
stimulates heat-sensing nerves.