Weed Land. Peter Hecht

the hot ingredient in chili peppers, into their skin. Dr. Jody Corey-Bloom, director of the UC San Diego Multiple Sclerosis Center, set out to see if marijuana could relieve spasticity in MS patients whose use of pharmaceuticals often failed to alleviate their suffering. Donald Abrams and Dr. Ron Ellis, a UC San Diego neurologist, worked to see if pot could quell tingling and shooting pains that would start in the feet of AIDS and HIV patients and move to their fingers and hands, disrupting their ability to sleep, to exercise, and, often, to cope.

      

      In separate, overlapping studies between 2002 and 2006, patients with neuropathic pain from HIV smoked pot under the supervision of Abrams’s nine-member research team at UC San Francisco’s General Clinical Research Center and Ellis’s eight-member team at the UC San Diego Medical Center. In San Francisco, fifty-five patients, mostly men with HIV infection for fourteen years, smoked three marijuana cigarettes or placebo joints a day in five-day trials. In surveys for chronic pain during the trials, cannabis was found to reduce the subjects’ pain by an average of 34 percent—double the rate of the marijuana placebo. Tests in which brushes were stroked against the subjects’ skin showed pot could quell shooting pain sensations in HIV patients, for whom things as benign as pulling a bedsheet over their toes could trigger lightning bolts of agony. Yet in tests involving applying heat to HIV patients’ shoulders, Abrams’s team failed to show similar benefits of marijuana in cases of acute pain such as might be experienced after an injury or surgery.

      In San Diego, research subjects were given placebo joints or three potency levels of marijuana. Ellis’s team monitored twenty-eight HIV subjects as they toked on marijuana or the pot placebos over two-week periods, with a two-week break with no marijuana use allowed between each new research stage. Notably, Ellis also had all subjects continue taking their pharmaceutical pain medications during the study. He found they still got a boost from cannabis, with the pot group reporting pain relief at two and a half times the frequency of the placebo group. Ellis also measured impairment. He tested people’s ability to connect random letters and numbers on a page, and he had them operate a driving machine, in which they were to avoid simulated traffic obstacles and follow lights and signs. In both tests, patients scored worse after smoking cannabis than before.

      One of Ellis’s original thirty-four enrolled research subjects had to be excused when he developed an intractable cough from smoking pot. Another subject, who had never before used marijuana, gave researchers a scare. After smoking his first joint, he started staring into space. He stopped responding to questions. The man was in a catatonic state, “attending to what was going on in his head,” Ellis observed. Doctors and nurses watching from outside the study room rushed in. They checked his vitals. His heartbeat was normal. He was fine. He came to in a couple of hours with no memory of what happened. He was dropped from the study.

      Afterward, University of California researchers enrolled only research subjects who had previously smoked cannabis. They also required drug testing to ensure that subjects were weed-free for thirty days before any clinical research. In every trial, subjects reported a degree of impairment. Pot, even at low, government-grade doses, got them high.

      Dr. Corey-Bloom reported that MS patients given cannabis showed modest cognitive impairment. However, her study on thirty patients also demonstrated that smoking marijuana could reduce painful, often disabling symptoms of spasticity. At UC Davis, Dr. Wilsey found something he wasn’t counting on. In outpatient sessions of three to twenty-one days, Wilsey and his seven-member team monitored thirty-two patients with nerve injuries as they smoked marijuana with 7 percent or 3.5 percent THC or toked on THC-free placebo joints in a university research center at the Veterans Administration Hospital in Sacramento County. Subjects in both marijuana groups found significant relief from chronic pain. What surprised Wilsey is that they got the same relief with the lower cannabis dose as with the higher dose, only with less impairment. That set Wilsey on a new quest. He sought to find out if patients with painful neuropathy could get relief from marijuana that had further-reduced levels of THC—and without getting stoned.

      By the end of Wilsey’s first study, Abrams had demonstrated the effectiveness of a healthier marijuana delivery system in another trial. Abrams brought fourteen healthy research volunteers to UC San Francisco and monitored them as they smoked joints or inhaled cannabis from a German-made Volcano Vaporizer, a smokeless delivery device that heated marijuana without lighting it. The heat released cannabis particles into a plastic bag, from which the subjects would breathe medicinal vapors. Abrams found that people using the vaporizer took in significantly reduced levels of carbon monoxide. THC detected in the blood after six hours was the same for people smoking joints and for those consuming cannabis by vaporizing, but vaporizing produced much higher THC levels for the first hour. Abrams’s study showed that the vaporizer delivered medicinal effects more efficiently. More important for political acceptance of cannabis research, the vaporizer also could deliver low-tar marijuana.