from neuropathic pain, a burning sensation of the skin that occurs spontaneously or is triggered by even the most gentle touch.

While some AIDS patients report that smoking marijuana relieves neuropathic pain, that claim has not been confirmed by a clinical study. As discussed in the previous chapter, researchers have found THC to be moderately effective in treating cancer pain, which includes neuropathy. These results suggest that THC might also provide relief for AIDS-related pain.

EFFECTS ON MOOD

AIDS exacts a toll not only on the body but also on the emotions. Even patients whose disease is effectively controlled must deal with the side effects of medications and cope with having a chronic illness for the rest of their lives. Few escape feeling bereft or anxious from time to time, feelings that often coincide with depression. But some people with AIDS say that, when they use marijuana to relieve their pain or stimulate their appetite, they also improve their mood.

Distinguishing between the medical use of marijuana to treat anxiety or depressed mood and the recreational pursuit of a “high” is not a simple matter, and some would say no such distinction exists. This is an especially thorny issue among AIDS patients, many of whom discover the drug's medical benefits through recreational experience. But there are also patients who, although they began using marijuana to relieve physical symptoms, have come to appreciate the psychological lift it provides.

How often such appreciation of marijuana's psychological effects leads to dependence or abuse remains to be determined. THC, in the form of Marinol, has been found to produce psychological (as well as physiological) dependence in healthy people. But a recent study concluded that for AIDS and cancer patients euphoria was a “desirable side effect” of treatment with Marinol. The study, conducted at San Francisco 's Haight Ashbury Clinic, also found that Marinol has a low potential for abuse by patients and that the drug is rarely, if ever, diverted to the black market.6

Not everyone, though, reacts positively to marijuana and its active ingredients. Some—typically those who have never used



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