Lone Patient Quits Marijuana Study
By Nicole Achs Freeling
Half Moon Bay Review
October 13, 2001

One evening last week, AIDS activist Phillip Alden unpacked some groceries in the kitchen of his stylishly appointed Redwood Shores condominium and prepared for his daily pre-dinner ritual.

Alden, a long-time AIDS survivor, pulled a tightly rolled joint of marijuana from a plastic medicine jar, noted it on an index card, and then settled back into his recliner and took a long drag.

Seeds in the cigarette sparked and popped.

"I know after I take a few hits that within 10 minutes I'm going to be hungry and my nausea is going to go away," said Alden, who suffers from chronic persistent wasting syndrome, a condition that inhibits the body's ability to absorb nutrients.

He says the drug gives him the appetite to keep the pounds on.

Last Thursday, however, in a development that could be a serious setback to San Mateo County's groundbreaking study on the medicinal use of pot, Alden's participation came to an abrupt end.

A sudden throat inflammation, which he blamed on the poor quality of the pot, left Alden unable to eat and gulping for air,

Alden said the marijuana was not as good as the pot he was used to getting from Bay Area cannabis clubs.

"The pot was stale and it was full of seeds. When marijuana seeds burn, they smell and taste really bad."

Apparently, the two joints a day that he was required to smoke through the study had aggravated a throat condition. The doctor issued an edict - no more smoking.

"I feel really bad about the whole thing," Alden added. "I'm a big proponent of medical marijuana and I'm very much in support of the study."

For the last several months he has been the sole patient in the novel clinical trial in the use of medical marijuana to treat AIDS-related symptoms.

The study, being conducted by San Mateo County Health Center, is the first to be done with the aid and support of the federal government.

The study, which has involved cautious cooperation among county government officials, health care professionals and federal policy makers, has been off to a slow start.

It was launched to great media fanfare in April, but so far the only confirmed participants are Alden, who has been in the study since early July, and another patient who joined in the past two weeks.

The trials have stringent participation requirements that bar many potential participants. Subjects must have used marijuana before, but cannot be active recreational drug users.

"It is a long, tedious process," said Jonathan Messinger, an assistant to program director Dr. Dennis Israelski. "We just have to let the research run its course."

The marijuana is grown in a federal government laboratory at the University of Mississippi, and then shipped to the San Mateo County Hospital, where it is kept under lock and key. It arrives dried and frozen and is rehydrated the night before it is dispensed to patients.

"In terms of the quality of the marijuana, we have to go by what the patients say since we're not trying it ourselves," Messinger said. "We know the level of THC is lower in this federal-provided marijuana, but unfortunately we don't have any control over that. We have to use whatever we're given by the federal government for this study."

The joints are rolled in tobacco-company cigarette paper, rather than traditional rolling papers. Alden said that besides the poor quality of the pot he believed the cigarette paper was harsher on his throat.

Messinger said he was hopeful other subjects would fare better with the treatment.

"It's built into any study that you'll have people that don't complete the study," he said

"We're optimistic that most people who enter will be able to complete it. We realize that isn't going to be the case with everyone, however."

Doctors have said that they hope to recruit 60 participants over the next two years and to have some results of their research next fall.

Messinger said he believed the study was still on track to meet those estimates. "We've been fine-tuning our recruiting process," he said.

A clean-cut man who opposes recreational drug use and rarely finishes a glass of wine, Alden is an unusual spokesman for medical marijuana. But he credits the drug with enabling him to live with his disease.

"I think a lot of people, even those who support medical marijuana, think it's a party scene.

"In the (pot) clubs, what I see are very sick people. These are people with canes and with limps. They have multiple sclerosis or cancer or advanced AIDS. It's not a bunch of hippies trying to get stoned."

For him, marijuana has been particularly effective in alleviating peripheral neuropathy, a condition that causes stabbing pains in the hands and feet.

"All of a sudden, it'll feel like someone stuck a knife through my foot," he said.

That pain was severe during the control arm of the study, when Alden was prohibited from smoking.

"When I left the control arm of the study and started smoking again, I had no neuropathy pain at all. It worked really, really well."

Alden also says marijuana controls the anxiety attacks he has suffered from for years and the nausea and stomach pains that are chronic side effects of AIDS medication.

When he started taking one particular protease inhibitor, "I couldn't work for a month. I literally did not leave the house," he said.

"Medical marijuana was a godsend for me."

Such results motivated Alden to take part in the study, which requires a demanding schedule from its participants.

Subjects fill out daily logs, go for weekly blood tests and check-ups and follow strict protocols for consuming the joints.

They are given three containers: one for new joints, one for those in progress and a third for the butts, or "roaches," which must be logged in at the pharmacy when they receive a new supply.

Patients get less than a week's supply at a time and must log all their consumption.

During the study, Alden would smoke a marijuana cigarette in the evening before dinner to stimulate his appetite and another before bed to calm his stomach.

Once his throat condition clears, Alden says he will go back to treating himself at the cannabis clubs.

"It works. I have no doubt about that," he said.

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