Pubdate: Thu, 26 Dec 2002
Source: Cape Gazette (DE)
Contact:  2002, Cape Gazette
Website: http://www.capegazette.com/
Details: http://www.mapinc.org/media/2722
Author: Jeanne Doe
Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal)
Bookmark: http://www.mapinc.org/opinion.htm (Opinion)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

CONTROVERSY ENVELOPES HIV PATIENTS USING MARIJUANA

This past September, I was in southern California to attend the U.S. 
Conference on AIDS, held in Anaheim, Calif. While watching the news one 
morning, a headline caught my attention about activists for the 
distribution of medical marijuana. The activists at San Diego City Hall 
were that very moment passing out small bags of marijuana to patients who 
had a medical need for the substance and who had a physician's note to 
obtain it.

Advocates for the use of medical marijuana say cannabis can assist in 
reducing symptoms for patients who have cancer, AIDS and other chronic 
ailments. In fact, the city was working on guidelines to provide 
identification cards to medical users in case authorities ever confronted them.

Proposition 215, also known as the Compassionate Use Act of 1996, allows 
Californians who are seriously ill to obtain and use marijuana for medical 
purposes if recommended by a physician. A similar bill is on the books in 
the states of Alaska, Colorado, Hawaii, Maine, Nevada, Oregon and Washington.

Marijuana, which is classified as a cannabinoid - known on the street as 
"dope," "grass," "pot" and "weed" - continues to be controversial. Although 
little is known about its direct interaction with human immunodeficiency 
virus (HIV) medications or its effect on the progression of HIV, research 
has shown there are plenty of negative effects associated with its use in 
general.

Whether swallowed or smoked, marijuana can cause euphoria, slowed thinking 
and reaction time, confusion, impaired balance and coordination, cough and 
respiratory infections, impaired learning, and increased risk of heart 
disease, anxiety, panic attacks and addiction. Among the more than 400 
chemicals, marijuana also contains tetrahydrocannabimnol (THC), a drug that 
alters the mind and body.

Marijuana has been classified in the most restrictive category of 
controlled substances since 1970. Nationally, it is not accepted for 
medical use; therefore, it is not a regulated drug and can be laced with 
other dangerous drugs. Abuse is a high risk for people who use it. In 
addition, impaired judgment and memory induced by the use of marijuana 
could lead to unsafe sexual practices leading to exposure to sexually 
transmitted diseases. For individuals already infected with HIV, smoking 
dope could lead to the spread of HIV to their partners or lead to 
reinfection. The bottom line is both the short- and long-term risks should 
be considered as well as alternative options to its medical use.

Against medical use Claims marijuana use is effective in treating wasting 
syndrome, pain of neuropathy - aneurological disorder often effecting the 
limbs - and nausea associated with HIV are largely noted through personal 
experience and not medical research; therefore, it is critical to assess 
the usefulness of marijuana for medical use.

Medical options are available to treat side effects experienced from HIV 
and HIV-related illnesses. There are several medications already available 
to treat pain and nausea.

A common medication known to the HIV community is dronabinol (Marinol), a 
synthetic form of THC. The U.S. Food and Drug Administration approved 
Marinol in 1994 for its use in treating wasting syndrome. It is available 
by prescription to act as an appetite stimulant and to reduce nausea.

One of the largest concerns of marijuana use for individuals living with 
HIV is the effect that it has on the immune system. THC has been suggested 
to negatively affect many of the immune functions causing the user to be 
more susceptible to certain infections. Bacterial, viral, and fungal 
infections may result in an increased viral load - the level of virus in blood.

Third, lung complications similar to those associated with tobacco smoke 
can be harmful increasing the risk of lung cancer, heart disease and 
asthma. Aspergillus, a fungus sometimes found in marijuana, has been found 
in individuals with advanced HIV disease and can cause lung infections. 
Smoking marijuana may inhibit the ability of cells to fight bacteria in the 
lungs and increase the risk of lung complications.

Neurologically, marijuana is commonly known to affect the ability to think, 
judge and perform tasks. The user will determine whether those short-term 
effects are negative or positive. Individuals taking the highly active 
antiretroviral therapy (HAART) have noted using marijuana impairs their 
memory, leading to the hindrance of adhering to their treatment regimen. 
Adherence is imperative to prevent drug resistance and to the success of 
the treatment. To someone infected with HIV, that is crucial to living a 
longer healthy life.

It is common knowledge individuals who smoke marijuana often get the 
"munchies"; therefore, marijuana has been suggested to aid in reducing the 
side effects of wasting syndrome. However, in many cases, the food consumed 
during these moments are high in fat and often snack foods that cause 
weight gain to consist of fat rather than muscle gain. Weight gain is also 
contributed to marijuana leads people to sleep more and participate in less 
physical activities.

The University of California at San Francisco is conducting a study on the 
effects of marijuana use and its effects on Crixivan, an anti-HIV medication.

In addition, it will be studying the effects of Marinol and marijuana on 
weight gain and loss, appetite, the immune system and hormone levels. 
Advocates against marijuana for medical use hope the research data support 
their stand that marijuana is harmful to people living with HIV.

For medical use Advocates for the medical use of marijuana claim it reduces 
chronic pain, spasms, nausea and depression, and it decreases the 
progression of wasting syndrome - the weight loss associated with HIV - 
without having negative effects on the progression of HIV. Data from the 
Multicenter AIDS Cohort Study found marijuana was not linked to a higher 
rate of HIV progression or loss of CD4 cells. A short-term study conducted 
by the University of California at San Francisco concluded marijuana did 
not have a harmful effect on HIV levels - the viral load.

Although Marinol has been shown to increase appetite for as long as five 
months, reports show it can be absorbed erratically, making managing its 
psychological side effects, like euphoria and disorientation, difficult for 
some people. Individuals who have used both marijuana and Marinol in pill 
form report smoking marijuana allows them more control in how "stoned" they 
get. In addition, the cost of a needed prescription for Marinol can be up 
to $30,000 a year, making it financially unavailable to many and a 
deterrent to others.

New studies show that marijuana may have antiinflammatory effects as it 
reduces pain experienced by individuals with neuropathy. Clients with HIV 
find smoking marijuana the only relief they receive from their daily 
discomfort. Research and personal experiences have shown marijuana also 
reduces nausea for people using the antiviral therapies. Many cancer 
survivors credit marijuana for their survival. Taking marijuana during 
chemotherapy allowed them to withstand the overwhelming nausea, which was 
the cause for ending therapy for many others.

After California voted yes to the medical use of marijuana, physicians 
noted positive outcomes relative to their HIV-positive patients' weight 
gain and quality of their life. In addition, if medical marijuana is 
combined with an extensive nutritional, weight maintenance and exercise 
program, lean muscle gain can be increased.

Although indications that marijuana can help people experiencing nausea, 
pain and wasting due to HIV, the political concerns and ramifications have 
not provided researchers with much incentive to continue conducting studies 
on HIV and marijuana use. There is a lack of studies suggesting marijuana 
use has a negative long-term effect on HIV disease. More research could 
benefit many people and may provide an alternative to existing treatments.

In summary, the medical use of marijuana for individuals infected with HIV 
has had an enormous effect in the political arena and not such an enormous 
effect in the research arena. Advocates for and against its use for 
medicinal purposes each have examples of why it should or should not be 
permitted, unfortunately with little concrete scientific data to support 
their positions.

The idea that an individual could be healthier and more functional by using 
another potentially dangerous drug has been proven true with the use of 
methadone. However, the understanding is methadone is not necessarily a 
permanent treatment but is rather a step toward abstinence, whereas medical 
marijuana is intended as a permanent treatment for those suffering from 
chronic or terminal illnesses.

Some HIV-positive individuals use marijuana to reduce nausea, reduce pain, 
aid sleeping and increase appetites or gain weight. Many are aware of the 
controversy and legality surrounding medical marijuana, but they are less 
likely to be aware of the potential dangers to their bodies from prolonged use.

Others who are aware of the dangers overlook them, because they feel the 
immediate relief they receive from using marijuana outweighs the possible 
long-term effects from the drug. Yet others feel they will not be living by 
the time the long-term effects catch up to them.

Sussex County residents have mixed feelings about the passing a law for 
marijuana medical use. Recently, WGMD, a local talk radio station, prompted 
a discussion led by host Sharon Kennedy. Callers who favored medical 
marijuana stated: "I would vote in a heartbeat to legalize it", "I only 
don't smoke it now because of drug testing at work" and "same will get high 
legal or illegal - I believe in total legalization." Callers who opposed 
stated: "a pot head is a pot head" and "it's just an excuse to get high."

For information relating to marijuana for medical use, drug and alcohol 
use, support groups, or 12-step programs, call the SCAC Resource Center at 
644-1094. As one recovering SCAC client stated: "I moved toward sobriety 
because I realized HIV was not killing me; the drugs were. Now I realize 
that HIV lives with me. I don't live with it."
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MAP posted-by: Jackl