Initial results are in from the first government-approved study of marijuana's effects on people infected with the AIDS virus. The research, done by a team headed by Dr. Donald Abrams of the University of California at San Francisco, found that smoking pot does not disrupt the workings of antiviral drugs that inhibit the growth of the AIDS virus -- and the patients involved gained weight.
Abrams announced the initial results at the 13th Annual AIDS Conference in Durban, South Africa, last week. Further results will be released soon, Abrams told reporters at the conference.
In an indication of the politically charged atmosphere in which research on marijuana in the US currently takes place, Abrams' research proposals dating back to 1992 could not win government approval as efficacy studies (research that would demonstrate the effectiveness of marijuana in improving the appetite, body weight, and general well-being of AIDS patients and others suffering from wasting syndrome).
Instead, Abrams' research was designed to see whether the components of marijuana interfered with the body's ability to break down the components of protease inhibitors, which are antiviral drugs used by thousands of HIV-infected people to maintain their immune systems.
Some 62 subjects participated in the study, and all were confined in a unit of San Francisco General Hospital for the experiment's 21-day duration. Some were given marijuana from the National Institutes of Health (NIH), some received marinol, and others received placebos. The 20 patients who received marijuana smoked it three times a day in a closed, ventilated room so that second-hand smoke would not affect other participants in the study. Each patient had a refrigerator stocked with snacks at bedside. The fridges were locked at midnight.
In all three groups, the study showed that levels of the AIDS virus either dropped or remained unchanged. Neither marijuana nor marinol interfered with the breakdown of protease inhibitors. Also, although the research was not designed as an efficacy study, Abrams announced that patients gained weight under the experimental regime, an average of 7.7 pounds for the marijuana smokers and 7 pounds for those who took marinol pills.
The findings have been greeted with enthusiasm by both medical professionals and medical marijuana activists.
"Any good clinician with his eyes and ears open has known for a long time that cannabis is very useful in the treatment of AIDS reduction syndrome and does not harm patients," Dr. Lester Grinspoon told the Associated Press. Grinspoon is a professor of psychiatry at Harvard and author of "Marijuana: The Forbidden Medicine."
"When all the dust settles and when marijuana is admitted into the US pharmacopoeia, it will be seen as one of the least toxic drugs in the whole compendium."
"I guess this refutes Gen. McCaffrey's statements about 'Cheech and Chong' medicine," snorted Dale Gieringer, leader of California NORML. "It confirms common sense. AIDS doctors have been using pot widely in the Bay area and California in general for years now," he told DRCNet.
Still, said Gieringer, "medicine has to confirm common sense," but the study's greater significance may lie in the fact that "it got done."
"This is the only study on medical marijuana initiated and completed since Proposition 215 (legalizing medical marijuana in California) passed," Gieringer noted. "It shows the outrageous slowness of the government's response to the mandate of the voters."
"It's astounding that we could only get one study done, and not even an efficacy study at that," he added. "In a sense, we are not one step closer to winning government approval of medical marijuana because it was not an efficacy study."
Gieringer's complaints about government inaction are understated; the attitude of the federal government could fairly be described as obstructionist. The saga of Dr. Abram's research helps explain why.
Abrams had to overcome a series of politically motivated bureaucratic obstacles, beginning with the DEA's 1994 refusal to allow Abrams to import Dutch marijuana for a study of AIDS wasting syndrome. The study had been designed with help from the Food and Drug Administration (FDA) and had already won approval from the university and the California Research Advisory Panel. None of that mattered to the DEA.
Next, Abrams applied to the National Institute on Drug Abuse (NIDA), requesting to use some of its marijuana supply for his study. After nine months, NIDA Director Dr. Alan Leshner turned him down, saying Abrams' FDA-approved study was unscientific.
"I wrote him back and said, well, gee, it's been approved by a number of august bodies, and for you to tell me it's not scientific was a little bizarre," Abrams told the Chronicle of Higher Education in a June interview.
When Leshner then suggested he might approve a request that had "favorable peer review," Abrams dutifully applied for a grant from the National Institutes of Health (NIH). His proposal, modified to address Leshner's concerns, was rejected.
NIH reviewers expressed concerns about marijuana's toxicity -- which is far lower than that of many approved prescription drugs -- and about patient risk from high cholesterol levels due to increased appetite. "That is really not something people with AIDS wasting have the luxury of worrying about," Abrams told the Chronicle.
By then, Abrams told the Chronicle, he was willing to concede that the obstacles in his path were more political than scientific. Belatedly wising up, Abrams changed his research proposal to examine marijuana's potential negative effects. This must have been just what the NIH doctors ordered, as Abram's revised research project to study whether marijuana interferes with the body's processing of protease inhibitors was finally approved, some five years after he presented his original research proposal.
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