Bob Cook, a professor of epidemiology at the University of Florida, is leading a study on marijuana’s medicinal effects on HIV patients.
As a schedule 1 drug, marijuana isn’t as often or easily researched as less restricted drugs. Schedule 1 drugs, according to the U.S. Drug Enforcement Administration, have a high potential for abuse and no accepted medical treatment.
Medical marijuana became legal in Florida as the state’s Amendment 2 took effect in January, allowing those with serious illnesses access to the drug if ordered by an approved doctor.
Bob Cook, UF professor of epidemiology, is researching whether marijuana has a medicinal effect on individuals with HIV. The study, which will take five years to complete and include surveys from more than 500 people, received a $3.2 million grant from the National Institute on Drug Abuse.
Cook spoke with The Gainesville Sun about how to study a federally illegal drug.
This interview has been edited for length and clarity.
Q: What are you hoping to find with these studies of marijuana’s effects medically on HIV patients?
A: We’re trying to find out if there are certain either strains or strains of different types of marijuana or certain ways that people consume marijuana that are most helpful in terms of helping people with HIV. Similarly, are there certain strains or patterns that are potentially harmful in the same population?
Q: Is this different from the current uses of medical marijuana in pain management?
A: The definition of medical versus recreational marijuana is difficult.
The last couple of years, we did a survey of over 900 people with HIV in Florida. We asked them, “Are you using any marijuana?” Of those who said yes, we asked them what were some of the reasons. Over 80 percent gave some reason that was other than just to get high. Most of them said they were self-managing symptoms of pain, anxiety, sleep, nausea, medication side effects.
These are not people getting medical marijuana from a dispensary or that is prescribed to them. They’re people using marijuana that they’ve gotten off the street or that they’ve gotten somehow, but they’re self-managing symptoms. In some ways, we do think of them as medical users.
Most of the people that I’m interviewing in this grant are going to be using marijuana that’s not from the dispensaries. It’s just much harder to research because it’s harder to know exactly what they’re using.
Q: Are there legal repercussions for participating in this study?
A: There are legal implications for using marijuana, so we are asking people about an illegal behavior. We as the researchers need to do everything we can to ensure that the identity of our participants is kept confidential.
In this study, we’re not giving anybody marijuana, and it’s not illegal to ask people questions.
Q: Has researching marijuana ever been taboo in medical research fields?
A: I don’t think it’s ever officially been taboo, and certainly for the last decade the National Institutes of Health have produced a crop of marijuana that can be used for medical research.
But it is the National Institute of Drug Abuse, and in the past they have focused more on the harms. Our study, which has health effects in the title, and another study that was recently funded by NIDA, are looking at whether people could use less pain medication if they start using medical marijuana.
I do think the proportion of grants focusing on potential health effects has definitely increased over the last decade. Internationally, I think in Israel and some other places, they’ve been a little bit ahead of the U.S. in terms of doing research with marijuana. It’s just been really, really hard as a researcher to, other than just asking people questions, do any research with marijuana because it is a Schedule 1 drug.
Q: You don’t ask participants to use marijuana. Is it research based on survey questions?
A: We are asking them to tell us what they currently use, why they currently use it, how they know if it’s helping them and if they’ve experienced side effects and harm. We are going to do a urine drug test that will be sent to a toxicology lab here at UF … to see if we can learn about some of the components of marijuana that that individual was exposed to.
If you go to a marijuana physician in Gainesville or anywhere else, that clinician will recommend that you use a product that’s THC (tetrahydrocannabinol) alone or that’s got THC plus CBD (cannabidiol) — these are both components of marijuana. There’s very little hard evidence on which product really has a true effect, especially in my area for different conditions, like post-traumatic stress disorder, pain or HIV infection.
Q: Is there anything that you’re hoping to see in this research?
A: I’m going into this with a very neutral mindset. I’m certainly not trying to find anything. But I do believe the evidence suggests that marijuana can have some health effects, and I think if we can demonstrate evidence that would potentially ease it off as a Schedule 1 drug. Only drugs that have no known medical benefit are supposed to be Schedule 1. It’s very difficult to research those.