allow people with AIDS and other chronic conditions to benefit from marijuana's active ingredients.

Both anecdotal evidence and scientific research suggest that cannabinoids could soothe a variety of symptoms suffered by AIDS patients: nausea, appetite loss, pain, and anxiety. Although more effective medicines than marijuana already exist to treat these conditions, they are not equally effective for all patients, nor do they offer the broad spectrum of relief that might be obtained from cannabinoid drugs. These will only become available, however, if there is sufficient financial incentive for pharmaceutical companies to produce marijuana-based medicines or if public funding supports similar research and development. The perils and possibilities of these alternatives are explored in Chapter 10.

But what about the immediate needs of AIDS patients who have not found relief except by smoking marijuana? The IOM team suggested that people suffering from chronic conditions, including AIDS wasting, could be treated as participants in single-patient clinical trials, carefully monitored and conducted with institutional approval. Once admitted to such trials, patients would be permitted to smoke marijuana under medical supervision but only after being fully informed of their status as experimental subjects and of the harms inherent in using smoking as a delivery system. Each patient's condition would be closely monitored and carefully documented as long as he or she continued to use marijuana. In this way not only would AIDS patients be assured of receiving the best possible treatment, but their experiences would further medical knowledge of marijuana's risks and benefits.

NOTES

1. Beal JE, Olson RLL, Morales JO, Bellman P, Yangco B, Lefkowitz L, Plasse TF, Shepard KV. 1995. “Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS.” Journal of Pain and Symptom Management 10:89-97.

2. Timpone JG, Wright DJ, Li N, Egorin MJ, Enama ME, Mayers J, Galetto G. 1997. “The safety and pharmacokinetics of single-agent and combination therapy with megestrol acetate and dronabinol for the treatment of HIV wasting syndrome.” The DATRI 004 Study Group. AIDS Research and Human Retroviruses 13:305-315.



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