Pubdate: Tue, 25 Nov 2003 Source: Medical Post, The (CN ON) Copyright: 2003 The Medical Post Contact: http://www.medicalpost.com/ Author: Michael Smith Bookmark: http://www.mapinc.org/mmjcn.htm (Cannabis - Medicinal - Canada) MEDICAL POT USED BY NEARLY ONE-THIRD OF ONT. HIV PATIENTS Rate is double that of British Columbia TORONTO - Almost one in three HIV patients in Ontario is using marijuana for medical reasons, according to a study presented at the 2003 Ontario HIV Treatment Network research conference. Of HIV-positive Ontarians, 29% use marijuana medically - almost double the 14% rate found in a British Columbia study published in 2001, said study presenter Michelle Furler, a PhD student in pharmaceutical science at the University of Toronto. But the rate is consistent with research on medical marijuana use among HIV-positive people in the U.S., she said. The difference may arise, Furler suggested, because the B.C. survey was conducted through that province's drug access program. Patients may have been wary of being truthful. By contrast, the Ontario survey was based on in-depth interviews on complementary and alternative medicines with 104 people (55 of them men) across the province between 1999 and 2001, as well as on chart reviews using the HIV Ontario Observational Database. Questions about marijuana came late in the interview, when the subjects were comfortable with the process, she said. The result is also consistent with a questionnaire-based anonymous survey carried out in Toronto, Ottawa and Montreal by researchers preparing for a randomized controlled trial of marijuana in HIV-positive people, said Sergio Rueda, a PhD student at the University of Toronto, who was one of the authors of the three-city study. That survey showed about 37% of HIV-positive patients were smoking the drug, he said. The response rate, however, (40%) was "very, very low." In the Ontario study, 43% reported they had smoked the drug for any reason during the year before their interview, but 29% - about two-thirds of the smokers - said they had used it for medical reasons. The main goals were to gain weight or increase appetite, aid sleep, and alleviate nausea and vomiting. Significantly more women than men (45% versus 5%) used the drug for pain management. Furler said she and her colleagues found clear differences between those who used the drug for therapeutic purposes and those who used it for fun. Strikingly, medical users were 10 times more likely to be poor - with a family income of less than $20,000 a year - and three times more likely to be unemployed. Furler said the cause of the link between poverty, unemployment and medical marijuana use is hard to tease out. "We can't say why it happens, we can just say it happens," she said. But, she added, it is possible poorer health is linked to inability to work, which might lead to a greater need for medical marijuana. On the other hand, the study showed no statistical differences in the usual markers of ill-health in HV patients - CD4 cell count and viral loads. As well, she said, medical users smoked the drug more often - 40% reported daily use, compared to 13% of the non-medical users. For the physician treating HIV patients, the study raises a red flag: 73% of the medical users thought their doctor was aware of their drug use, but only 23% of their medical charts reflected that fact. By contrast, Furler said, 27% of those who used the drug for recreation said their doctor knew about it and 20% of the charts recorded the marijuana use. - --- MAP posted-by: Josh