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IN THE WORLD of community-based clinical trials, one of the goals is evaluating commonly used treatments, regardless of whether they're prescribed by physicians. Among those with HIV infection in San Francisco's Community Consortium, one such therapy is marijuana.
For the past 2 years, Donald Abrams, MD, the consortium's chairman, has been trying to devise a trial to compare the efficacy of inhaled marijuana with dronabinol (Marinol, Roxane Laboratories Inc, Columbus, Ohio) as an appetite stimulant for patients with HIV wasting syndrome. Designing such a study to yield meaningful data is a trial in itself. Ushering it through a regulatory maze because it uses a schedule I controlled substance adds to the complexities.
"It's difficult," says Abrams, also a professor of clinical medicine at the University of California-San Francisco. "If the science survives the politics, we'll be ready. But there are a lot of politics around this field. I want to
Voelker R. Medical Marijuana: A Trial of Science and Politics. JAMA. 1994;271(21):1645-1648. doi:10.1001/jama.1994.03510450017007