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MARIJUANA AS MEDICINE?: The Science Beyond the Controversy
nausea and vomiting brought on by AIDS medications remains to be determined in the clinic. Research on marijuana's antinausea properties has focused on chemotherapy-induced emesis (vomiting) in cancer patients and is discussed in depth in the next chapter. Several different types of antiemetic drugs (including substituted benazamides, serotonin receptor antagonists, and corticosteroids) have been used successfully by both AIDS patients and cancer patients, so there is reason to believe that cannabinoids could help both groups. On the other hand, clinical studies indicate that marijuana and THC do not control nausea and vomiting as effectively as do other medications.
Since a wide variety of factors influence emesis and each person responds to them differently, it is possible that certain patients would get better relief from marijuana-based medicines than from conventional treatments. That this is the case remains to be substantiated by controlled studies. In the meantime, some people with AIDS who take THC in the form of dronabinol (Marinol) to combat weight loss may also find that it reduces their feelings of nausea. AIDS patients who took the drug in a four-week clinical study showed a trend toward decreased nausea compared with those who took a placebo, as well as a significant increase in appetite.1
AIDS WASTING SYNDROME
While both nausea and appetite loss play a role in wasting, the latter is the primary reason AIDS patients take Marinol. Weight loss is one of two indications for which the U.S. Food and Drug Administration has approved the drug for sale (the other is nausea and vomiting associated with cancer chemotherapy). For people with HIV, loss of as little as 5 percent of their body weight appears to be life threatening. Death from wasting generally occurs when patients drop to more than one-third below their ideal weight.
The Centers for Disease Control and Prevention defines AIDS wasting syndrome as the involuntary loss of more than 10 percent of body weight, accompanied by diarrhea or fever that lasts more than 30 days and is not attributable to another illness. Wasting occurs through a combination of two different physiological