Does Cannabis Improve Symptoms of HIV/AIDS? – A Doctor’s Case Study
You may not know this but HIV positive patients and those with AIDS constitute the largest single group of medical marijuana users to date.
There have been several trials using smoked marijuana, orally ingested THC products and prescription drugs like Dronabinol which are used to treat various aspects of this debilitating disease.
Since many of these patients will most likely use cannabis and/or its associates for their entire lives, we should know which methods are preferred and which are the most successful. Below, I included some well-designed, positive studies that clearly demonstrate how cannabinoids can help patients suffering from HIV/AIDS. I also provide one article that may raise some red flags for AIDS patients.
CD4/CD8 CELL COUNTS, VIRAL TITERS, PROTEASE INHIBITOR LEVELS
A trial was completed by the San Francisco Bay Area’s well known cannabis doctor Donald Abrams. He’s the cancer doctor who presumably refers some of his worst cases to a cannabis facility in the Bay Area where allegedly they have been inducing remissions in stage 4 cancers. However, very little proof is available for such claims.
Donald Abrams, MD, Professor of Clinical Medicine at the University of California, San Francisco, et al., wrote in 2003 the following conclusions which clearly showed an improvement in immune status and positive weight gain:
Smoked and oral cannabinoids did not seem to be unsafe in people with HIV infection with respect to HIV RNA levels, CD4 and CD8 cell counts, or protease inhibitor levels over a 21-day treatment.
Patients receiving cannabinoids had improved immune function compared with those receiving placebo. They also gained about 4 pounds more on average than those patients receiving placebo.
A second trial also had a positive effect. This time it was using cannabis to treat the painful condition of peripheral neuropathy that often develops in AIDS patients.
Donald Abrams, MD, wrote in his Feb. 13, 2007 article:
Objective: To determine the effect of smoked cannabis on the neuropathic pain of HIV-associated sensory neuropathy, and an experimental pain model…
Patients were randomly assigned to smoke either cannabis (3.56% THC) or identical placebo cigarettes with the cannabinoids extracted three times daily for 5 days…
Conclusion: Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy. The findings are comparable to oral drugs used for chronic neuropathic pain.
Another team noted a good response in treating peripheral neuropathy. Ronald J. Ellis, MD, PhD, Professor, Department of Neuroscience at the University of California at San Diego, et al., published their findings on Aug. 2008.
This was a double-blind, randomized, clinical trial (considered the gold standard of studies) of the short-term adjunctive treatment of neuropathic pain in HIV-associated sensory polyneuropathy.
What they found was that cannabis significantly outperformed the placebo arm of the study by a wide margin. Here they state the amazing difference between the two:
The proportion of subjects achieving at least 30% pain relief was again significantly greater with cannabis (46%) compared to placebo (18%). It was concluded that smoked cannabis was generally well-tolerated and effective when added to concomitant analgesic therapy in patients with medically refractory pain due to HIV-associated neuropathy.
A RANGE OF BEHAVIORS
In yet another study by a different team of researchers, they compared the efficacy of smoked marijuana and oral dronabinol maintenance in HIV-positive marijuana smokers. This placebo-controlled within-subjects study, evaluated marijuana and dronabinol across a range of behaviors: eating, mood, cognitive performance, physiologic measures, and sleep.
Here’s their conclusions on the comparison:
These data suggest that for HIV-positive marijuana smokers, both dronabinol (at doses 8 times current recommendations) and marijuana were well tolerated and produced substantial and comparable increases in food intake.
Other parameters were not significantly affected.
An inconclusive study by Diane Prentiss et al found some beneficial effects which needed to be researched in greater depth. Here’s what they found:
Reported benefits included relief of anxiety and/or depression (57%), improved appetite (53%), increased pleasure (33%), and relief of pain (28%).
PULMONARY FUNCTION/IMMUNE FUNCTION
Donald P. Tashkin, MD, is the Director of the Pulmonary Function Laboratories at UCLA. He was the physician who recently published a landmark study demonstrating that cannabis smoking in healthy subjects did not increase the risk for COPD or lung cancer. Dr. Tashkin found that smoking marijuana in AIDS patients may increase risk for pneumonia and overall decreases in immune function. Here’s what he said in the conclusion section of the study:
Frequent marijuana use can cause airway injury, lung inflammation and impaired pulmonary defense against infection. The major potential pulmonary consequences of habitual marijuana use of particular relevance to patients with AIDS is superimposed pulmonary infection, which could be life threatening in the seriously immunocompromized patient.
In view of the immunosuppressive effect of THC, the possibility that regular marijuana use could enhance progression of HIV infection itself needs to be considered, although this possibility remains unexplored to date.
To avoid pulmonary complications, use oral THC medicinals and steer clear of smoking anything including cannabis. Dr. Tashkin also comments on the immunosuppressive effects of THC (oral or smoked). This is an area that needs further exploration.
As you can see from the above sample of clinical trials it appears that marijuana can be a useful adjunct to existing medical therapies in a range of disparate indications from weight gain and immune status to improvements in pain scores, appetite and improved sleep.
However positive these studies appear, we must also use caution as Dr Tashkin notes above. In time we’ll understand the role of cannabinoids in treating AIDS and AIDS related diseases better.
But for now the overall evidence suggests that cannabis can improve a remarkable constellation of associated disorders in HIV/AIDS patients.
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