By Paul Armentano
July 13, 2007
When Connecticut's Republican Gov. M. Jodi Rell vetoed legislation last month that would have allowed citizens with debilitating medical conditions to use medical cannabis under their doctor's supervision, she alleged that there was no proof of pot's therapeutic effectiveness and that legal alternatives are available by prescription. Now, a just-released clinical trial by researchers at Columbia University in New York is making the governor's statements ring hollow.
On June 21, just 24 hours after Gov. Rell's veto, the online database for the National Library of Medicine posted an a forthcoming study from the Journal of Acquired Immune Deficiency Syndromes that reports, "Smoked marijuana … has a clear medical benefit in HIV-positive [patients] by increasing food intake and improving mood and objective and subjective sleep measures."
But that's not all investigators found. In a "first" for HIV/AIDS clinical research, scientists not only compared the efficacy of inhaled cannabis to a placebo (in this case, marijuana lacking the primary therapeutic and psychoactive compound THC), but they also tested pot against doses of the so-called "legal marijuana pill" known as dronabinol (aka Marinol). For those unfamiliar with dronabinol, it's a gelatin capsule containing synthetic THC in sesame oil that was approved by the FDA in 1992 specifically to treat HIV/AIDS-related cachexia (weight and appetite loss).
So just how did the nearly $1,000-a-month synthetic alternative compare to the real McCoy?
According to the study, subjects experienced increased appetites after smoking cannabis or taking Marinol. Patients also experienced equivalent weight gains after using both drugs (a little more than 1.1 kilograms over a four-day period). Here's the kicker, though. Investigators reported that patients needed to take "eight times" the recommended daily dosage of Marinol to equal the same therapeutic relief they achieved after smoking relatively low-strength (2 percent or 3.9 percent THC) pot!
In other words, a few hits of the U.S. government's herbal "schwag" (the use of federally grown pot is required in all FDA-approved marijuana trials) was as efficacious as a mega-dose of Uncle Sam's synthetic pot pill.
Clinicians further reported that smoking higher-strength marijuana -- that's the 3.9 percent pot for this study's purposes -- subjectively improved patients' sleep better than oral THC. Perhaps more important, authors reported that HIV patients made far fewer requests for over-the-counter 'rescue' medications while using cannabis. Scientists reported that most of these requests were to treat subjects' gastrointestinal complaints (nausea, diarrhea and upset stomach) -- conditions that have long been reported by patients to be alleviated with medical pot.
Of course, among those living with HIV/AIDS, scientific trials like the Columbia study only reinforce what they've already known for decades. (According to various surveys, between 25 and 37 percent of HIV/AIDS patients in North America self-report using cannabis medically to combat both symptoms of the disease as well as the side effects of antiretroviral medications.) That for many with debilitating and life-threatening diseases, pot as a medicine works.
It's just unfortunate that politicians like Gov. Rell choose to take their marching orders from drug warriors in Washington rather than to heed the advice of those patients and doctors who know far better.
A previous version of this article originally appeared in The Hartford Courant.
Paul Armentano is the senior policy analyst for the NORML Foundation in Washington, DC.