For too long, conducting legitimate research on the medical benefits of marijuana was all but impossible. Kept out of the hands of doctors and scientists by an overzealous DEA, pot is still classified by the federal government as a Schedule I drug under the Controlled Substances Act—the strictest category available. This makes funding and access to research-grade, federally legal cannabis hard to come by; even in states where marijuana is legal, studies on the drug are still subject to approval by multiple boards, and samples must be procured from the only lab in the country approved to dispense research-grade marijuana.
Robert L Cook, professor of epidemiology at the University of Florida, recently announced he is leading a 400 person study to scrutinize marijuana’s effects on people living with HIV. The five year, $3.2 million study is believed to be the largest of its kind, and will look not only at marijuana’s impact on the brains of HIV patients, but also whether the drug is able to help suppress the virus. Cook will also account for the specific amount of marijuana consumed or inhaled by participants, as well as the amount of THC and cannabinoids in those doses—something he said other researchers haven’t been able to do.
Cook spoke with VICE about how marijuana works on a cellular level, why Florida is an interesting place to do pot research, and what it’s like to research the plant in the midst of the DEA’s effort to block two dozen other medical marijuana proposals.
VICE: How did you first become interested in the effect of marijuana on people living with HIV?
Robert L Cook: I’m a primary care physician and I see patients with HIV all the time. I was looking to see what type of marijuana I should recommend—should my patients inhale it, ingest it, or should I recommend a specific type? There was no data on why a certain type might have a better health outcome for someone with HIV than another, and that’s why I wrote this grant.In the study, we can compare those who use it daily to those who use it occasionally. We’re going to do urine toxicology screens to try to differentiate what’s in the marijuana, because most people told us they were getting, like, a dime bag a couple times a month, so they probably don’t really know what they are getting.
Ideally, by the end of the study, we can say “Wow, it looks like most people who are using it are using it for pain are using it in a certain pattern.” Or that most people who are using it to help them with their stress are using it in a certain kind of pattern.
At the same time, you’re also interested in the effects of THC on the virus and its symptoms, right?
I’ve seen some very interesting data that looked at just how much of the virus is in people’s blood before they were treated with antiretrovirals. The research showed that those who used marijuana had a lower amount of the virus in their blood compared to those who didn’t use marijuana. That’s a good thing if there is a lower amount of the virus. But I haven’t seen any clinical trials looking at the direct effects of THC on the virus. We also don’t have a lot research comparing THC alone versus THC and CBD on people with HIV.
We’re also measuring the inflammatory response to marijuana in a much more carefully controlled way than in previous studies.
Measuring adherence to medications is also important. One of the reasons why marijuana might affect HIV is behavioral; the stereotypical scenario is that someone who uses marijuana becomes less motivated—they sit on the couch, watch TV and don’t take their medications on time. I’m not sure that’s true, but we will be looking into it.
credit:vice.com