HOSPITAL STARTS TRIAL OF MARIJUANA TABLETS

Marijuana tablets that relieve pain without giving a high are to be tested
on people for the first time this week, doctors say.

In the study at the University of California some patients will given the
new tablets, which contain a synthetic version of one of the drug's
ingredients. Their progress will be compared with that of patients who
smoke marijuana three times a day.

The initial aim of the research is to see what effect the new drug has on
the nausea suffered by patients receiving experimental Aids drugs and how
it interacts with new drugs being developed.

The trials are scheduled to last for a year, and if they are successful,
the team hopes to investigate the use of a tablet containing some of the
active ingredients of marijuana as a treatment for other conditions such as
depression and multiple sclerosis.

A team led by Professor Donald Abrams designed the trial, in which 64
people will take part.

"So far we have enrolled 27 patients out of the 64 we are looking for. They
are here as in-patients for 25 days and they will smoke marijuana three
time a day, or take oral doses of delta-9-tetrahydrocannabino (THC), a
constituent of marijuana, or take a placebo. We are trying to do an
effectiveness study to see what effects there are in smoking and
swallowing," says Abrams.

The volunteers will undergo a series of tests to see how the drug affects
the immune system, hormone levels and appetite.

Doctors are keen to see if there is any difference between the effects of
natural marijuana and the tablet. THC is a large component of marijuana but
it is one of only 400 compounds that have been isolated from it.

"It may be that other compounds have an effect as well, or that they work
together to have a combined effect," says Abrams.

It can take some time for the tablet to take effect after it has been
swallowed, whereas smoking gets the therapeutic compounds into the
bloodstream much more quickly. The tablet also stays effective for a much
longer period, which may not be needed in all cases.

Another problem with the tablet is that for some people it can produce a
greater high than is achieved by smoking marijuana. However, others
experience no high, and the team hopes to work out what causes these
reactions.

Many Aids patients have benefited from the arrival two years ago of a new
family of protease inhibitor drugs. Doctors found that the progress of the
disease was being slowed and that many patients were spared from suffering
with a wasting syndrome associated with the disease. But one side-effect of
the new drugs was that they caused gastro-intestinal problems, including
nausea and vomiting.

The Californian study hopes to find a way of legally using marijuana to
combat these effects and providing a synthetic version of the drug that
does not give patients a high but simply relieves their pain.

The study is the first of its kind and comes as a British pharmaceutical
company is going ahead with plans to grow 20,000 marijuana plants for
research into medicinal uses of the drug.

Marijuana is said to have beneficial effects in a wide range of disorders,
including cancer, multiple sclerosis, glaucoma, epilepsy, migraine and
depression. It is also claimed to have been useful in tinnitus, diabetic
gastroparesis, Crohn's disease and schizophrenia.

The budget for the research at the university in San Francisco is $1m. It
will receive 1,400 marijuana cigarettes from the US National Institute for
Drug Abuse.