MARIJUANA STUDY TRIES TO BRING FACTS TO HEATED DEBATE

A doctor takes a scientific look at the illegal drug's effects on HIV
patients with painful symptoms.

In March, in a hospital room tucked in a quiet corner of San Francisco
General Hospital, a 39-year-old AIDS patient made history of sorts when he
lighted a marijuana cigarette -- legally. He is the first of 16 volunteers
participating in a study of whether the illicit herb can relieve the pain in
the hands and feet that afflicts people with HIV.

Although anecdotal stories abound about marijuana's therapeutic powers,
there is no data to support such claims. Dr. Donald I. Abrams, who's heading
the study at UC San Francisco, says his research -- and similar studies that
are getting underway -- are an attempt "to inject some facts into this very
emotionally charged debate."

Scientific interest in medicinal marijuana is blooming. It has been kindled,
in part, by the recent discovery of a molecular signaling system in the
brain and other parts of the body activated by cannabinoids, naturally
occurring compounds that are chemical cousins to THC (tetrahydrocannabinol),
the active ingredient in marijuana, according to Abrams. Research suggests
this system affects movement and emotional excitability, appetite and the
growth of cancerous tumors -- and may be as potent as morphine in reducing
pain. These findings may explain why smoking marijuana has a calming effect,
combats nausea or gives users the munchies.

Smoking, of course, is a crude and hazardous way of delivering THC, and
scientists eventually hope to synthesize marijuana's medicinal compounds
into a pill. But right now, Abrams' main objective is doing bulletproof
science. Because of the tremendous controversy, he says, "we have a burden
to do this correctly."

An AIDS doctor since the epidemic began, Abrams knew many of his patients
smoked pot to curb nausea and stimulate their appetites, which is why he
wanted to study its medicinal potential. In 1998, after a lengthy battle to
get funding from the National Institute on Drug Abuse, Abrams conducted the
first test of pot on people with HIV. That study showed marijuana helped
patients gain weight without weakening their immune system.

If all goes well, his current study will be broadened to involve 100
subjects, half of whom will receive a placebo or dummy cigarette. Abrams is
also in the initial phase of tests that use cannabis to ease pain in
patients with bone metastases from advanced breast and prostate cancer.
"We're looking to see if there is a beneficial interaction between cannabis
and morphine, and if pot can decrease the side effects of these opiates," he
says.

A potential powerhouse

The San Francisco study is the first sponsored by the Center for Medicinal
Cannabis Research. Managed by the University of California, the center is
funded by a 1999 state law that provides $3 million annually for three years
to study marijuana's potential use.

The active ingredient in marijuana appears to be the Swiss Army knife of
therapeutics: a powerful painkiller that also can combat cancer, curb
nausea, stimulate appetite, reduce anxiety, ease joint stiffness and control
muscle spasms.

The center has so far given the go-ahead to 15 projects, two-thirds of which
have cleared many federal regulatory hurdles, including scrutiny from the
Drug Enforcement Agency, the National Institute on Drug Abuse and the Food
and Drug Administration. Four studies -- on AIDS patients, multiple
sclerosis sufferers and people with metastatic cancer -- are already
underway, and several more are gearing up, making this "the largest program
ever done in the U.S. on this topic," says Dr. Igor Grant, a psychiatrist at
UC San Diego.