Marijuana as therapy for people living with HIV/AIDS:

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Fogarty A, Rawstorne P, Prestage G, Crawford J, Grierson J, Kippax S
Marijuana as therapy for people living with HIV/AIDS: Social and health aspects. [Journal Article]
AIDS Care 2007 Feb; 19(2):295-301.



Therapeutic use of marijuana has emerged as an important issue for people living with cancer, HIV/AIDS and multiple sclerosis.

This paper examines therapeutic use of marijuana in the Positive Health cohort study, a longitudinal cohort study of men and women living with HIV/AIDS in NSW and Victoria, Australia.
Factors that distinguish therapeutic use of marijuana from recreational use were assessed by comparisons on a range of social and health-related variables.

The results show that among 408 participants, 59.8% reported some use of marijuana in the past six months. Of those participants (n=244), 55.7% reported recreational use only of marijuana and 44.3% report mixed use of marijuana for therapeutic and recreational purposes. Multivariate logistic regression analysis showed that participants who used marijuana for therapeutic purposes were significantly more likely than recreational-only users to have used other complementary or alternative therapies, experienced HIV/AIDS-related illness or other illnesses in the past 12 months, had higher CD4/T-cell counts, had lower incomes, be younger in age and less likely to have had a casual partner in the six months prior to interview.

These results show that a substantial proportion of people living with HIV/AIDS (PLWHA) use marijuana for therapeutic purposes, despite considerable legal barriers, suggesting marijuana represents another option in their health management.

See the rest of this article: http://www.unboundmedicine.com/medline/ebm/record/17364413/abstract/Marijuana_as_therapy_for_people_living_with_HIV/AIDS:_Social_and_health_aspects

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HIV / AIDS

Marijuana Use Does Not Accelerate HIV Infection
http://paktribune.com/news/print.php?id=139255 (http://paktribune.com/news/print.php?id=139255)

THC improves appetite and reverses weight loss in AIDS patients
http://www.cannabis-med.org/studies/...w.php?s_id=189 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=189)

Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep.
http://www.cannabis-med.org/studies/...w.php?s_id=190 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=190)

Cannabis in painful HIV-associated sensory neuropathy
http://www.cannabis-med.org/studies/...w.php?s_id=199 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=199)

Smoked cannabis therapy for HIV-related painful peripheral neuropathy
http://www.cannabis-med.org/studies/...w.php?s_id=172 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=172)

Short-term effects of cannabinoids in patients with HIV-1 infection
http://www.cannabis-med.org/studies/...ow.php?s_id=62 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=62)

Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS.
http://www.cannabis-med.org/studies/...ow.php?s_id=21 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=21)

Effect of dronabinol on nutritional status in HIV infection.
http://www.cannabis-med.org/studies/...w.php?s_id=150 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=150)

Dronabinol stimulates appetite and causes weight gain in HIV patients.
http://www.cannabis-med.org/studies/...ow.php?s_id=20 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=20)

Dronabinol effects on weight in patients with HIV infection.
http://www.cannabis-med.org/studies/...ow.php?s_id=45 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=45)

Recent clinical experience with dronabinol.
http://www.cannabis-med.org/studies/...ow.php?s_id=90 (http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=90)

Marijuana as therapy for people living with HIV/AIDS: Social and health aspects
http://www.unboundmedicine.com/medli...health_aspects (http://www.unboundmedicine.com/medline/ebm/record/17364413/abstract/Marijuana_as_therapy_for_people_living_with_HIV/AIDS:_Social_and_health_aspects)

Marijuana and AIDS: A Four-Year Study
http://ccrmg.org/journal/05spr/aids.html (http://ccrmg.org/journal/05spr/aids.html)

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Marijuana and AIDS: A Four-Year Study
Patients reported reduced levels of pain, nausea and insomnia--and increased appetite.
by David Jay Brown, Kenneth Michael Smuland, and Valerie Corral
The Wo/Men’s Alliance for Medical Marijuana (WAMM) is a cultivation collective in Northern California with approximately 150-175 patient-members, who suffer from a range of debilitating illnesses, including cancer, AIDS, epilepsy, multiple sclerosis, and glaucoma. In 1993 the authors undertook to assess the medical effectiveness of marijuana on WAMM’s AIDS patients.
Previous studies have demonstrated marijuana’s usefulness in reducing nausea and vomiting1 , stimulating appetite and promoting weight gain2 and diminishing intra-ocular pressure from glaucoma3 . There is also evidence that marijuana reduces muscle spasticity from spinal cord injuries4 and multiple sclerosis5, and diminishes tremors in multiple sclerosis6.
WAMM developed an assessment form —known as an analog— for the symptoms that marijuana is reputed to alleviate. Weekly reports were collected from members. All of the patients studied had AIDS. The symptoms assessed were pain, nausea, insomnia, and lack of appetite.
Method
This study ran from June 1993 through December 1997. Data were collected by means of analogs given by WAMM to each of its patient-members with their weekly supply of medical marijuana. Our analog was adapted from one used in Charles Grob’s MDMA studies with pancreatic cancer patients7, revised by AIDS patients to incorporate their symptoms. The patients were asked to mark on the analogs how they felt before and after they smoked marijuana with respect to each of the applicable symptoms.
The scale on the analogs ranged from zero to 10, with 10 being the highest intensity level of symptom or physical-emotional state (pain, nausea, insomnia, and appetite.)
Results
There were a total of 264 subjects with AIDS in the study—44 women and 220 men—however not all of the symptoms measured on the analogs applied to all of the subjects.
For 29 women the medium average level of pain reported prior to using marijuana was 6.5. After using the medication the medium average level of pain dropped to 3.2. The result of the two-tailed t-test P(T<=t) was 1.45E-08.
For 37 women the medium average level of nausea reported prior to using marijuana was 5.2. After using the medication the medium average level of nausea dropped to 3.1. The result of the two-tailed t-test P(T<=t) was 0.003.
For 44 women the medium average appetite level reported prior to using marijuana was 2.3. After using the medication the medium average appetite level rose to 6.3. The result of the two-tailed t-test P(T<=t) was 8.33E-15.
For 29 women the medium average level of insomnia reported prior to using marijuana was 7.2. After using the medication the medium average level dropped to 3.4. The result of the two-tailed t-test P(T<=t) was 8.33E-15.
For 175 men the medium average level of pain reported prior to using marijuana was 5.9. After using the medication the medium average pain level dropped to 2.4. The result of the two-tailed t-test P(T<=t) was 4.3E-30.
For 203 men the medium average level of nausea reported prior to using marijuana was 5.4. After using the medication the medium average level of nausea dropped to 2.8, The result of the two-tailed t-test P(T<=t) was 3.25E-25.
For 220 men the medium average appetite level reported prior to using marijuana was 3.3. After using the medication the medium average appetite level rose to 6.2. The result of the two-tailed t-test P(T<=t) was 1.72E-33. (continued below graphics)

MORE....
http://ccrmg.org/journal/05spr/aids.html

[Sequoiacrone]

Fogarty A, Rawstorne P, Prestage G, Crawford J, Grierson J, Kippax S
Marijuana as therapy for people living with HIV/AIDS: Social and health aspects. [Journal Article]
AIDS Care 2007 Feb; 19(2):295-301.



Therapeutic use of marijuana has emerged as an important issue for people living with cancer, HIV/AIDS and multiple sclerosis. This paper examines therapeutic use of marijuana in the Positive Health cohort study, a longitudinal cohort study of men and women living with HIV/AIDS in NSW and Victoria, Australia. Factors that distinguish therapeutic use of marijuana from recreational use were assessed by comparisons on a range of social and health-related variables. The results show that among 408 participants, 59.8% reported some use of marijuana in the past six months. Of those participants (n=244), 55.7% reported recreational use only of marijuana and 44.3% report mixed use of marijuana for therapeutic and recreational purposes. Multivariate logistic regression analysis showed that participants who used marijuana for therapeutic purposes were significantly more likely than recreational-only users to have used other complementary or alternative therapies, experienced HIV/AIDS-related illness or other illnesses in the past 12 months, had higher CD4/T-cell counts, had lower incomes, be younger in age and less likely to have had a casual partner in the six months prior to interview. These results show that a substantial proportion of people living with HIV/AIDS (PLWHA) use marijuana for therapeutic purposes, despite considerable legal barriers, suggesting marijuana represents another option in their health management. Rather than solely using marijuana in response to illness, the experience of illness may influence a person's understanding of their marijuana use, so that they come to understand it as therapeutic. Further research might consider possible interactions between cannabinoids and antiretroviral treatments, potential use of oral THC and the difficulties faced by clinicians and PLWHA in discussing marijuana in the current legal context.


More from this journal
AIDS care (http://www.unboundmedicine.com/medline/ebm/record/17364413/abstract/Marijuana_as_therapy_for_people_living_with_HIV/ebm/journal/AIDS_care) [AIDS Care] (http://www.unboundmedicine.com/medline/ebm/record/17364413/abstract/Marijuana_as_therapy_for_people_living_with_HIV/ebm/journal/AIDS_Care)

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Public release date: 6-Aug-2008


Contact: Debra Kain
ddkain@ucsd.edu (ddkain@ucsd.edu)
619-543-6163
University of California - San Diego (http://www.ucsd.edu/)

Medicinal marijuana effective for neuropathic pain in HIV



In a double-blind, placebo-controlled clinical trial to assess the impact of smoked medical cannabis, or marijuana, on the neuropathic pain associated with HIV, researchers at the University of California, San Diego School of Medicine found that reported pain relief was greater with cannabis than with a placebo. The study, sponsored by the University of California Center for Medical Cannabis Research (CMCR) based at UC San Diego, will be published on line, August 6 in the journal Neuropsychopharmacology.
Led by Ronald J. Ellis, M.D., Ph.D., associate professor of neurosciences at UCSD School of Medicine, the study looked at 28 HIV patients with neuropathic pain not adequately controlled by other pain-relievers, including opiates. They took part in the controlled study as outpatients at the UCSD Medical Center. The proportion of subjects achieving pain reduction of 30 percent or more was greater for those smoking cannabis than those smoking the placebo.
"Neuropathy is a chronic and significant problem in HIV patients as there are few existing treatments that offer adequate pain management to sufferers," Ellis said. "We found that smoked cannabis was generally well-tolerated and effective when added to the patient's existing pain medication, resulting in increased pain relief."
Each trial participant participated in five study phases over seven weeks. During two five-day phases, randomly selected participants smoked either cannabis or placebo cigarettes made from whole plant material with cannabinoids (the psychoactive compound found in marijuana) removed, both provided by the National Institute on Drug Abuse. Outcome was tested by standardized tests measuring analgesia (lessened pain sensation), improvement in function and relief of pain-associated emotional distress.
Using verbal descriptors of pain magnitude, cannabis was associated with an average reduction of pain intensity from 'strong' 'to mild-to-moderate' in cannabis smokers, according to Ellis. Also, cannabis was associated with a sizeable (46% versus 18% for placebo) proportion of patients reporting clinically meaningful pain relief.
The study's findings are consistent with and extend other recent research supporting the short-term efficacy of cannabis for neuropathic pain, also sponsored by the CMCR.
"This study adds to a growing body of evidence that indicates that cannabis is effective, in the short-term at least, in the management of neuropathic pain," commented Igor Grant, M.D., professor of psychiatry and director of the CMCR.

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The CMCR coordinates and supports cannabis research throughout the state of California. Research focuses on the potential medicinal benefits of cannabis for diseases and conditions as specified by the National Academy of Sciences, Institute of Medicine Report (1999) and by the Workshop on the Medical Utility of Marijuana, National Institutes of Health (1997).
Grant noted that this is the fourth CMCR sponsored study to provide convergent evidence that cannabis can help in relieving these types of pain. The previous studies were conducted with CMCR support by Donald I. Abrams, M.D., Professor of Clinical Medicine at UCSF, who reported efficacy in short-term treatment of HIV neuropathy (Neurology, 2007, 68:515-521); by Mark Wallace, M.D., Program Director for the UCSD Center for Pain Medicine, who found that normal volunteers subjected to chemically induced pain which mimics neuropathy also responded to medium doses of cannabis (Anesthesiology, 2007, 107(5):785-796); and by Barth Wilsey, M.D., Director of the UC Davis Analgesic Research Center, who also reported benefit from smoked cannabis in a group of patients with neuropathy of multiple origins (Journal of Pain, 2008 Jun;9(6):506-21).
Additional contributors to the study, all from the UCSD School of Medicine, include Will Toperoff, RN, FNP, Department of Neurosciences; Florin Vaida, Ph.D., Family and Preventive Medicine; Geoff van den Brande, RN, Medicine; J. Gonzales, Pharm.D., Pharmacy; Ben Gouaux, Heather Bentley, CCRA, and J. Hampton Atkinson, M.D., Psychiatry.

source public announcement: http://www.eurekalert.org/pub_releases/2008-08/uoc--mme073008.php