Published 5:27 p.m., Tuesday, September 18, 2012
The therapeutic uses of cannabis have long been a focus of research for Dr. Donald Abrams, UCSF professor and chief of the hematology-oncology division at San Francisco General Hospital. Abrams wrote a study last year on the combination of cannabinoids - the main ingredient in cannabis or medical marijuana - and pain drugs. Abrams talks about the preclinical work by the California Pacific Medical Center Research Institute and other research on cancer and cannabis, 16 years after California became the first state to legalize medical marijuana.
Q: Is it difficult, due to stigma or the political climate, to do research on the therapeutic benefits of cannabis?
A: The only way you can get cannabis to do research in this county is through the National Institute on Drug Abuse, or NIDA, and it's clear the congressional mandate is to study the substance for abuse rather than for treatment. It started in 1997 in HIV research when we studied whether it was safe to inhale cannabis while on protease inhibitors. The next study was through the UC Center for Medicinal Cannabis Research in 1999, when the state budget surplus allowed the state to devote $3 million for three years of studies to demonstrate whether cannabis had medical use. The funding enabled a number of studies and NIDA supplied the cannabis, but that money ran out.
If this plant were discovered in the Amazon today, scientists would be falling all over each other to be the first to bring it to market. But it has a stigma, and it's being attacked by our government as part of the war on drugs.
Q: What kind of research are you doing now?
A: We did a study in patients with HIV who had damage to their nerves. We showed inhaling cannabis was better than inhaling a cannabis placebo for relieving those symptoms and that vaporization of cannabis was equivalent to smoking. The last study we did, which was again funded by NIDA, was looking to see if it was safe to combine cannabis with opiates - sustained-release morphine and sustained-release oxycodone. It was a small study ... but we did note patients had increased relief of pain when cannabinoids were added to the opiates.
Q: What do you think of the research being done on triple-negative breast cancer cells at the California Pacific Medical Center Research Institute?
A: The data is promising and it's elegant, but the true test is now really going to be to do some clinical trials in the patient population that (the researchers) think is correct to study at this time, which is patients with triple negative breast cancer. But at this time I would not tell my triple-negative patients to go out and look at taking high cannabidiol-containing cannabis products. We need to do the research. What happens in the test tube or even in animal models does not necessarily predict what happens in people. People are much more complex.
Q: What do you think about the University of Southern California study released last week that found a link between the recreational use of marijuana among young men and testicular cancer?
A: Young men use cannabis and get cancer. If they looked at video games and riding bicycles, that might also be associated. Is there an epidemic of testicular cancer in Jamaica where Rastafarians use cannabis religiously? I think that's all a trick of numbers, personally.
Michael A. Komorn
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