Source: Knight Ridder Newspapers
Date: May 13, 2002

Study subjects: Government giving out bad pot


SAN JOSE, Calif. - The pot is unsmokeable, they say, full of sticks, stems and seeds. The leaves have gone stale after at least a year of storage, freezing and then thawing.

Marijuana supplied to researchers from the government farm in Mississippi isn't quality product, according to a range of observers, from Redwood Shores HIV patient Phillip Alden to a cop-turned county supervisor.

Alden said he knows from experience - he's smoked it. And the result? An upper respiratory infection and an early departure from a landmark research study, the first publicly funded analysis of HIV patients smoking cannabis in their homes.

In 10 months, fewer than 10 subjects have been accepted into San Mateo County's marijuana study, which took years to get funded and approved. The county's medical chief of staff, Dr. Dennis Israelski, had planned for 60.

Some say it must be the pot.

"I couldn't smoke the stuff anymore," said Alden, a freelance writer who relies on marijuana to ease HIV-related wasting disease. "I was disgusted with the federal government."

Dale Gieringer, California coordinator for the National Organization for the Reform of Marijuana Laws, agrees. "It's unconscionable that they would be giving this marijuana to patients," he said. "It's stale, low-potency ditch weed."

The National Institute on Drug Abuse, which grows the marijuana plants that are pre-rolled, frozen and sent out to officially sanctioned researchers across the country, denies its research product is substandard.

"The marijuana we provide does not contain sticks and seeds. The problem is re-humidifying - it makes it kind of harsh," said Steve Gust, special assistant to the director of NIDA. "Certain procedures are needed to make it smoke right."

Gust said researchers themselves aren't complaining about quality. He thinks groups like NORML are looking for something to blame if the results of the studies show it has little medicinal value. "Then they can say the marijuana isn't of sufficient quality," Gust said.

Cannabis trials in San Mateo County began last July, but few patients so far meet the strict standards to enroll. There is no hard evidence that the quality of the cannabis used in the study is hindering recruiting.

But stories - and rumors in some cases - have slowed progress, said Israelski, an associate clinical professor at Stanford University. When Alden was forced to drop out of the study late last year because of an inflamed throat, for example, published reports of his experience swirled quickly through Internet circles and HIV support groups.

"We've been hurt by word on the streets," Israelski said. "But the word on the street might not reflect reality."

To counteract the slow start, the county is trying to broaden its study.

In a letter sent to regulatory agencies this month, researchers ask to expand the HIV patient pool to include people suffering from nausea, weight loss and wasting disease.

Supervisor Mike Nevin is frustrated that the county is once again asking for approvals from the myriad agencies that must OK any changes to the research plan. He spent three years fighting for funding and regulatory approval.

Nevin envisioned his county's research program after a beloved colleague, Joni Commons, died of breast cancer in 1998. Commons won him over, convincing the former San Francisco police inspector that marijuana brought her critical pain relief.

"We've put too much effort into this, and we don't want to be playing games here," Nevin said. "It needs to be a certain grade of substance, and unless it's stronger, they'll set us up for defeat."

Medicinal marijuana research is moving steadily forward in other parts of the country, with multiple sclerosis, cancer and AIDS patients. The newly inaugurated Center for Medicinal Cannabis Research in La Jolla will soon oversee studies at 15 university sites.

Most researchers interviewed, unlike marijuana advocates, did not complain about the quality of the NIDA product. According to strict protocols, they can't unroll the carefully measured, frozen joints they receive, although several said they can hear seeds popping when some of their patients smoke, or they fall out the untwisted end. They've heard that the sticky buds gum up the government's rolling machine.

But that hasn't stopped more than 500 people from joining waiting lists for clinical trials at the La Jolla center, where in contrast, two recently enrolled subjects complained that the pot was too potent.

"They've reported getting high shortly after the first few puffs," said Dr. Andrew Mattison, the center's co-director. "These are people with a chronic, debilitating illness who do not want to get high. They want to get pain relief."

Dr. Donald Abrams, a University of California-San Francisco professor of medicine, agreed that most patients don't want their heads spinning, even though years ago he fought with federal regulators for more potent pot.

Now, he's satisfied. "Nobody is saying they don't want to participate in our study because they hear the marijuana isn't good," Abrams said.

Researchers concede that the less a patient has to smoke, the better. More potent cannabis delivers a more concentrated effect, with fewer smoking-related hazards.

Advocates say this is why they complain about the government-grown marijuana. According to a 1999 NORML survey, the government's cannabis scored lowest on levels of THC - marijuana's essential ingredient - when compared with 48 samples.

Dr. Ethan Russo, a Montana neurologist and editor of the Journal of Cannabis Therapeutics, said NIDA's marijuana is "medically inexplicable and inexcusable." He said American patients in any other drug study would not be given a stale product, and cannabis subjects deserve equal treatment.

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