SCIENTISTS WEIGH MERITS OF POT AS PAIN RELIEVER

SAN DIEGO -- Can you inhale your way past the pain and nausea of diseases
such as cancer and AIDS? Plenty of marijuana advocates say you can, but
scientific evidence has been nearly nonexistent.

Now, scientists are stepping up their research into the painkilling
properties of marijuana and drugs derived from it. Several research projects
are underway at UC San Diego, which is home to the two-year-old Center for
Medicinal Cannabis Research.

However, pain experts from around the globe learned Tuesday that a variety
of obstacles may keep marijuana pills out of medicine cabinets for some
time.

"We've got a long way to go," said Dr. Andrew Rice, a senior lecturer in
pain research at Imperial College in London, in a session before thousands
of attendees at the 10th World Pain Congress at the San Diego Convention
Center.

The conference, sponsored by the International Association for the Study of
Pain, is held every three years in a different country and will last through
Thursday. Several scientists are presenting their research into how
marijuana works and whether it could be a useful painkiller.

The drug itself has been around for thousands of years, Rice said. Humans
first began to cultivate marijuana about 8000 B.C., and Chinese and Indian
people used it to treat pain as early as 2800 and 2000 B.C. The drug
experienced a rebirth in the 19th century when even Queen Victoria used it,
although reports differ as to whether she smoked it or took it in her tea.

But while scientists know plenty about the workings of powerful painkillers
like morphine, researchers have largely stayed away from marijuana because
it's a dicey subject politically.

"The existing evidence (about medical marijuana) is too insufficient in
quality to allow any kind of informed debate," Rice said.

That's changing, however. Six years ago, California became the first of
eight states to allow ill people to smoke marijuana to relieve their
symptoms. And in 1999, the state Legislature allowed three years of medical
marijuana research to begin at UC San Diego and UC San Francisco.

While researchers must go through several hoops to get their research
projects approved, they can bypass federal laws that prevent citizens from
growing marijuana for sale to sick people. In fact, the marijuana for
research projects actually comes from the federal government, which grows
it.

In one UCSD study, scientists are stinging the arms of four test subjects
with capsaicin, the active ingredient in red chili peppers, and comparing
their responses to those after they've smoked some marijuana. More than a
dozen subjects will be enrolled later.

In another UCSD study that hasn't begun yet, researchers plan to enroll 40
cancer patients and test whether they get relief from severe pain by smoking
marijuana.

According to the center, other studies will look at the effects of marijuana
use upon multiple sclerosis patients -- doctors think the drug may reduce
muscle spasms -- and AIDS patients who suffer from nerve pain.

While doctors can choose from a wide variety of painkillers, from simple
aspirin to Oxycontin, many kinds of persistent pain remain immune to
treatment, said experts at the conference.

"We need clinical studies on the medicinal use of marijuana so we can settle
once and for all whether it is a useful medicine for the treatment of
various ailments such a pain, nausea and vomiting," said Dr. Mark Wallace,
chief of the Center for Pain and Palliative Medicine at UCSD.

It will take about two years to complete the capsaicin study, and three
years for the cancer study, he said.

Meanwhile, Rice told conferees researchers are trying to find ways around
the down sides of marijuana -- its tendency to make people get stoned and
its failure to work when swallowed in a pill form.

Researchers are currently looking at a variety of ways to "deliver" the
active ingredient of marijuana to patients without making them high. Among
other things, they are considering inhalers, suppositories and tablets that
you place under your tongue like a heart drug, Rice said.

Considering the early state of research, it's too early to predict when the
public will get a marijuana medicine by prescription, he said.

But UCSD's Wallace says he thinks the day will come. "I don't think it's
going to be a cure-all. That's not going to happen," he said in the
interview. "But it will be another option for us."