Dr. Donald Abrams Tells Us How Medical Marijuana Helps AIDS Patients – Pt 1
Transcript: There are patients able to overcome their nausea and vomiting from their chemotherapy and perhaps even be cured of these malignancies by using cannabis. But what really started me in my research was in my work with HIV AIDS patients. Again seeing them being eaten alive if you will by the AIDS wasting syndrome, which was a common sort of end of life phenomenon that we had before we discovered effective anti retroviral drugs and about the time Delta-9 THC was approved, thats the drug durnabinol or marinol, for treatment for this wasting syndrome in HIV patients.
We began to hear from these patients that they actually preferred smoking the cannabis because of their ability to titrate the effect better than swallowing a pill. We know now that cannabis taken by mouth either as baked product or the medication Delta-9 THC has much different absorbs ion and kinetics. It takes a much longer time to reach a much lower peak and then it stays in the system for quite a while. Whereas when it is inhaled, either smoked or vaporized, the peak plasma concentration is actually reached in about 2 minutes and then falls over the next 30 minutes.
So the effect happens more rapidly and perhaps dissipates more rapidly. When taken by mouth, the Delta-9 THC, then main psychoactive component is metabolized in the liver to a 11 hydroxy form that is also psychoactive. So when eaten as either a baked product or as the pill the Delta-9 THC creates this psychoactive metabolite that makes people have even more of a psychoactive effect that when it is smoked. And for many patients this is unpleasant.
So in 1992 I was challenged, if I may, to study smoked marijuana in patients with the Aids wasting syndrome and to compare it to marinol or durabinol which had been just approved for that indication. And that began a bit of a sort of struggle with our government to be able to conduct a clinical trial. But ultimately after a number of years we did get a million dollars and 1400 government cannabis cigarettes to do a clinical trial. It wasn’t any more in patients with the AIDS wasting syndrome, because by this time we had effective anti-retroviral drugs and that syndrome had disappeared. And with the national institute on drug abuse they have actually a congressional mandate that they can only study substances of abuse as substances of abuse.
So they were never going to allow me or to give me marijuana to study as a possible therapeutic agent. The study I ultimately got funded for was to study whether or not it was safe. For patients with HIV on the new potent anti-retroviral regimes to use cannabis. Because there had been a report in the literature of a patient using ecstasy or MDMA and dying from an overdose of ecstasy when taken with these antiviral drugs. So the question I posed and the government allowed me investigate, was is it safe for patients on the anti-retroviral drugs to smoke cannabis or to take the cannabis pill while they were taking the protease inhibitors.