STUDY: MANY HIV PATIENTS USE POT FOR MENTAL HEALTH

SAN MATEO -- Results coming out of the medical marijuana research project
at the San Mateo Medical Center are making waves in the scientific community.

The first clinical trials, which ended in February, are still being
analyzed. But psychologists were treated to some surprising data from an
initial Medical Center survey of HIV patients at the American Psychiatric
Association conference in May. The study indicated that more HIV patients
smoked marijuana for mental rather than physical reasons.

"We expected to see people smoking marijuana to alleviate nausea, pain and
to increase their appetite -- all the reasons that are commonly cited,"
said Diane Prentiss, a research epidemiologist with the Medical Center. "In
this case, we were surprised that 57 percent say they smoked to relieve
anxiety or depression."

To gather baseline information for use in clinical trials of medical
marijuana, researchers at the San Mateo Medical Center surveyed 252 HIV
patients. Of that number, 23 percent (58 patients) admitted to smoking
marijuana in the last four weeks.

When asked for the main reasons they used the drug, most cited several
reasons. Mental health issues topped the list. Curbing nausea and
increasing appetite was the second, with 52 percent. Recreational use came
in third with 33 percent. Only 28 percent said they smoked to alleviate pain.

The prevalence of the mental health issue is a significant finding that
raises some interesting questions, said Dr. Dennis Israelski, chief of
staff and chief research officer at the Medical Center.

"In terms of understanding the whole field, it is safe to say that there is
a fair amount of self-medication that physicians are not aware of," he
said. "It does speak to whether it's appropriate medication. Are physicians
doing a good enough job when patients are using outside medication? Do we
have better treatments for anxiety and depression? These are very important
issues related to quality of life."

Mental health is especially important for HIV patients, Israelski said,
pointing to studies showing that mental health impacts a patients' ability
to adhere to the strict medical regimens used to combat the often-fatal
disease.

Dr. Cheryl Koopman, an associate professor of psychiatry at Stanford, said
that many of her colleagues were intrigued by the results of the Medical
Center's study presented at the conference.

"There was a lot of interest. A number of clinicians in the room felt it
was relevant to patients they are working with," she said. "Because of the
illegality of marijuana there's a lack of research. We don't know if
self-medication is systemic. It's another reason for large studies to be
conducted in a scientifically rigorous way."

The San Mateo Medical Center's work with medical marijuana is the only
publicly funded research of its kind in the country. "It is not an easy
field to study," said Israelski. "People don't want to touch it for
political reasons."

The Bush administration has come out strongly against any legalization of
marijuana, even for medical purposes, claiming there is no research proving
it has health benefits.

"It's a Catch-22," said Israelski. "If they make it tough to study, how do
you get scientific evidence?"

The Medical Center has managed to complete one round of clinical trials
studying medical marijuana and HIV patients, but Israelski is still
negotiating for federal approval for two more studies. The AIDS researcher
credits the political support at the county level -- particularly from
Supervisor Mike Nevin and County Manager John Maltbie -- for the success of
the project so far.

The first round of the Medical Center clinical trials focused on
marijuana's affect on peripheral neuropathy, a severe debilitating leg pain
associated with HIV.

For the next trials, the Medical Center research team wants to expand the
study to include potential effects on nausea, gastrointestinal disorders
and wasting syndromes associated with HIV. A third round of trials would
study the drug's effects on cancer patients. These second and third trials
are still awaiting federal approval.

Significant benefits to marijuana, marijuana-related or "cannabinoid"
products may not be found, even if studies are conducted, Israelski said.

"I'm not a believer. I am approaching this as a scientist to see if there
are merits, and then let the dust settle," he said. "I have no axe to
grind, but we should be able to do the study."