Thoughts from the void: Cannabis and HIV

- UNAIDS.ORG

- United Nations Office on Drugs and Crime, World Drug Report 2020

- LANCET

World wide, as per the WHO, 'AIDS - HIV continues to be a major global public health issue, having claimed more than 32 million lives so far. Due to gaps in HIV services, 770 000 people died from HIV-related causes in 2018 and 1.7 million people were newly infected. - https://www.who.int/news-room/fact-sheets/detail/hiv-aids'. Many are in poor Asian and African nations with limited access to expensive HIV medication.

One of the great harms of cannabis prohibition has been an increase in the number of persons who inject drugs (PWID), primarily through the extensive use of opioids, including heroin and methamphetamine. As a result of this, PWID account for a significant percentage of persons infected with HIV. The United Nations Office on Drugs and Crime World Drug Report 2020 states that - 'Injecting drug use is estimated to account for approximately 10 per cent of HIV infections worldwide and 30 per cent of all HIV cases outside Africa, while in the eastern countries of the WHO European Region more than 80 per cent of all HIV infections occur among PWID [persons who inject drugs]. PWID are estimated to be 22 times more likely than people in the general population to be living with HIV.'

Needle sharing is rampant in poor communities where drug taking is prevalent. In addition to the direct exposure to HIV through reused needles, there is also frequent same sex and heterosexual contact within these populations and with outsiders, often in exchange for money or more inject-able drugs. This vicious cycle has led to problems in controlling HIV in spite of growing efforts at needle exchange programs, education and distribution of contraceptives. The United Nations Office on Drugs and Crime, in its World Drug Report 2020, reports that - 'Harmful patterns deriving from drug shortages include an increase in injecting drug use and the sharing of injecting equipment and other drug paraphernalia, all of which carry the risk of spreading blood-borne diseases, such as HIV/AIDS and hepatitis C, as well as COVID-19. Risks resulting from drug overdose may also increase among people who inject drugs and who are infected with COVID-19.'

Once a person has contracted HIV, the situation changes drastically for the individual. Often shunned by society, susceptible to many diseases (any of which could prove fatal), with low levels of nourishment, and the constant effort to fuel addictions that may exist, these individuals are regularly driven to despair and deep depression. Many of them stay under the radar, making it nearly impossible to estimate accurate numbers of persons who are infected or vulnerable. United Nations Office on Drugs and Crime, World Drug Report 2020, says 'Owing to the criminalization of drug use, punitive laws, stigma and discrimination against people who use or inject drugs in many parts of the world, conventional survey methods have been found to underestimate the actual population size because of the hidden nature of PWID [persons who inject drugs]; therefore, only indirect methods have been shown to reflect the situation of PWID with greater accuracy. Overall, new or updated estimates of PWID were available for 40 countries in 2018.' Persons who are able to access pharmaceutical medication for HIV often through social service organizations are not very much better off. The medications are known to be powerful with their own harmful side effects and are expensive in addition to being moderately effective. Most of these medications are not even accessible in many parts of the world where it is much easier to access inject-able opioids, cocaine and methamphetamine.

The countries that have the most stringent anti-cannabis laws, such as China, Russia, Iran, Afghanistan, and Pakistan, appear to be among the most affected by HIV through injecting drugs. United Nations Office on Drugs and Crime, World Drug Report 2020, states that - 'The largest number of PWID [persons who inject drugs] living with HIV reside in Eastern Europe, East and South-East Asia and South-West Asia, which together account for 67 per cent of the global total. Although the prevalence of HIV among PWID (9.3 per cent) is below the global average, a fifth of the global number of PWID living with HIV reside in East and South-East Asia. A small number of countries continue to account for a large proportion of the total global number of PWID living with HIV. In 2018, for example, PWID living with HIV in China, Pakistan and the Russian Federation accounted for almost half of the global total (49 per cent), while PWID in those three countries comprise only a third of all PWID worldwide.' Iran and Afghanistan, traditional producers of opium and cannabis, have seen alarming shifts in recent times towards methamphetamine.

Whether cannabis consumption boosts the immune system or not in the fight against HIV is something that probably needs more study. THC does not reduce immunity says a study. But what is indisputable are the indirect, but most significant, ways in which cannabis can help fight and reduce HIV. Many of these way are more preventive than reactive.

Having a wholesome, healthy, medicinal, tried and tested natural plant such as cannabis available would prevent many persons from taking up inject-able drugs such as heroin, morphine, etc. Not only is cannabis not addictive, it has not been known to cause any deaths from overdose unlike opioids. Many are the persons who have been pushed to the toxic inject-able synthetic drugs by a society that has banned the natural cannabis. There are numerous instances where what started as prescribed medicine by medical professionals has ended up being so addictive that the patient has deteriorated moving from one drug to another of increasing potency and toxicity just in order to be functional.

Cannabis is a supreme harm reduction mechanism, whereby individuals use cannabis to wean themselves out of a hard drug injection habit, thus reducing the risk of needle sharing on the one hand, and kicking the injection habit on the other. A change in the nature of recreational drug consumed, and its method of delivery, could reduce one of the main pathways of the spread of HIV.

Cannabis can be grown by anybody, anywhere, making it accessible and affordable, unlike the hard drugs responsible for the spread of HIV through infected needles and other shared drug paraphernalia, as well as the current medications being pursued for the treatment of the disease. It can be consumed in a number of ways, and none of this involves the use of a needle. Not only does the user not have to sell everything, beg, borrow and steal to feed the habit or pay for the treatment, all the user needs is some rolling paper to smoke the herb. Many people just chew the herb. It can be grown in the remotest places, among the poorest communities and safely administered to all ages.

In addition to reducing the consumption of harmful synthetic drugs, and cutting down the likely spread of HIV through needle sharing, cannabis is a known mood regulator and can help the infected individual to deal with stress, anxiety and depression. Cannabis helps build appetite, enabling the individual to eat better and more nourishing food, thus building up immunity. It enables an individual to sleep better.

Cannabis is also known, in some studies, to work well with HIV medication, such as anti-retroviral therapy (ART), assisting in its increased absorption in a patient's body. Cannabis's pain management properties are widely evident, and it can be a healthy substitute for opioid based painkillers which are themselves highly addictive and one of the primary paths to inject-able opioid addiction.

Cannabis is prohibited world wide. Legalizing cannabis, so that individuals with HIV can grow the plant at home, and access this plant medicine will be hugely beneficial, and go a long way in tackling the trauma of HIV. More importantly, the legalization of cannabis reduces the likelihood of an individual seeking inject-able and highly addictive drugs, such as heroin and methamphetamine, in the first place, thus reducing the amount of needle sharing that happens among addicts. The WHO and UN need to focus on this, as do all the nations, and public and private health entities involved in the fight against HIV. Every nation needs to acknowledge the suffering of their poorest populations and legalize the plant. The world needs to break the shackles of injected drugs, opioid and methamphetamine trade - both legal and illegal - and the system that keeps pharmaceutical based inject-able drugs within easy public access while banning natural cannabis. The cannabis plant needs no elaborate, expensive international aid programs and NGO funding. Just a change in laws will enable each person who needs it to personally grow and access it. It is a simple solution, one which persons and organizations sincerely looking to handle the disease should be able to recognize. Of course it will mean a change in the way things work, the flow of funds and the profits to be made. It will essentially empower each individual to fight the battle against HIV independently and sustainably. Does society have the will to make the change is always the question.

Listed below are articles taken from various media related to the above subject. Words in italics are the thoughts of your truly at the time of reading the article

'Timely introduction and full-scale implementation of accessible harm reduction programmes can prevent HIV infections, as well as many cases of viral hepatitis B and C, tuberculosis and drug overdose. The United Nations system is united in promoting harm reduction services and decriminalization of personal possession of drugs, based on the evidence that harm reduction and decriminalization provide substantial public and personal health benefits and do not increase the number of people with drug dependency. Despite this position, reflected in the United Nations system common position supporting the implementation of the international drug control policy through effective inter-agency collaboration, in reality less than 1% of people who inject drugs live in countries with the United Nations-recommended levels of coverage of needles, syringes and opioid substitution therapy, and the funding gap for harm reduction in low- and middle-income countries sits at a dismal 95%.

Even where harm reduction services are available, they are not necessarily accessible. Punitive drug control laws, policies and law enforcement practices have been shown to be among the largest obstacles to health care in many countries. Criminalization of drug use and harsh punishments (such as incarceration, high fines or removal of children from their parents) discourage the uptake of HIV services, drive people underground and lead to unsafe injecting practices, and increase the risk of overdose. Women who use drugs face higher rates of conviction and incarceration than men who use drugs, contributing to the increased levels of stigma and discrimination they face in health-care settings. In effect, criminalization of drug use and possession for personal use significantly and negatively impact the realization of the right to health.'

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2021/november/20211101_international-drug-users-day

'Conclusions:
Current daily cannabis use was associated with lower levels of pro-inflammatory chemokines implicated in HIV pathogenesis and these chemokines were linked to the cognitive domain of learning which is commonly impaired in PWH. Cannabinoid-related reductions of MCP-1 and IP-10, if confirmed, suggest a role for medicinal cannabis in the mitigation of persistent inflammation and cognitive impacts of HIV.'

https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/abs/daily-cannabis-use-is-associated-with-lower-cns-inflammation-in-people-with-hiv/9A2960B21749A35F7490C06958B9A2B6

'In 2019, as shown in the new UNAIDS report Global Commitments, Local Action, 10% of new infections worldwide were in those who inject drugs. Many of these infections could have been prevented if the war on drugs had not contributed to an environment hostile (both politically and socially) to injection drug users. Some regions are hit harder than others: in eastern and central Asia 48% of new HIV infections are linked to injection drug use. A Feature in this issue of The Lancet HIV from Ed Holt explores the role softening drug laws in this region could have on HIV. A linked Profile highlights the work of Positive Movement, a Belarusian organisation, in providing advocacy, support, and treatment to people living with HIV who inject drugs in Belarus.'

https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(21)00130-2/fulltext

'The available preclinical results suggest that targeting the ECS for prevention and treatment of HIV-NP is a plausible therapeutic option. Clinical evidence shows that smoked cannabis alleviates HIV-NP. Further research is needed to find out if non-psychoactive drugs that target the ECS and are delivered by other routes than smoking could be useful as treatment options for HIV-NP.'

https://www.sciencedirect.com/science/article/pii/S2667242121000051?via%3Dihub

'People living with HIV infection (PWH) disclose that cannabis is an effective strategy for alleviating symptoms associated with HIV disease. However, some medical providers feel ill-informed to engage in evidence-based conversations. HIV leads to alterations in the gut microbiome, gut–brain axis signaling, and chronic inflammation. The endocannabinoid system regulates homeostasis of multiple organ systems. When deficient, dysregulation of the gut–brain axis can result in chronic inflammation and neuroinflammation. Cannabis along with the naturally occurring endocannabinoids has antioxidant and anti-inflammatory properties that can support healing and restoration as an adjunctive therapy. The purpose of this literature review is to report the physiologic mechanisms that occur in the pathology of HIV and discuss potential benefits of cannabinoids in supporting health and reducing the negative effects of comorbidities in PWH.'

https://www.liebertpub.com/doi/10.1089/can.2020.0037

'Ten preclinical studies found that the endocannabinoids (2-AG and AEA), synthetic mixed CB1R/CB2R agonist WIN 55,212-2, a CB2R-selective phytocannabinoid ß-caryophyllene, synthetic CB2R-selective agonists (AM1710, JWH015, JWH133 and Gp1a, but not HU308); FAAH inhibitors (palmitoylallylamide, URB597 and PF-3845) and a drug combination of indomethacin plus minocycline, which produces its effects in a CBR-dependent manner, either prevented the development of and/or attenuated established HIV-NP. Two clinical trials demonstrated greater efficacy of smoked cannabis over placebo in alleviating HIV-NP, whereas another clinical trial demonstrated that cannabidivarin, a cannabinoid that does not activate CBRs, did not reduce HIV-NP. The available preclinical results suggest that targeting the ECS for prevention and treatment of HIV-NP is a plausible therapeutic option. Clinical evidence shows that smoked cannabis alleviates HIV-NP. Further research is needed to find out if non-psychoactive drugs that target the ECS and are delivered by other routes than smoking could be useful as treatment options for HIV-NP.'

https://www.sciencedirect.com/science/article/pii/S2667242121000051

'One-way ANCOVAs were conducted to examine effects of a past cannabis use disorder (CUD+) on tests of attention/working memory, processing speed, executive functioning, verbal fluency, learning, memory, and motor ability. Compared to the past CUD- group, the past CUD+ group performed significantly better on tests of processing speed, visual learning and memory, and motor ability (p’s?<?.05). Findings suggest PLWH with past cannabis use have similar or better neurocognition across domains compared to PLWH without past use.'

https://www.tandfonline.com/doi/abs/10.1080/09540121.2020.1822504?journalCode=caic20

'In this pilot study, seventeen (11 HIV+, 6 HIV-) adults aged 50–70 who consumed cannabis completed four daily smartphone-based surveys for 14 days, in which they reported their cannabis use (yes/no) since the last survey. Participants also wore actigraphy watches during the 14-day period to objectively assess sleep quality (i.e., efficiency, total sleep time, and sleep fragmentation). In linear mixed-effects models, cannabis use was significantly associated with greater subsequent total sleep time (ß = 0.56; p = 0.046). Cannabis use was not related to a change in sleep efficiency (ß = 1.50; p = 0.46) nor sleep fragmentation (ß = 0.846, p = 0.756) on days with cannabis use versus days without cannabis use. These preliminary results indicate cannabis use may have a positive effect on sleep duration in middle-aged and older adults'

https://publications.sciences.ucf.edu/cannabis/index.php/Cannabis/article/view/59

'Results. Between 2005 and 2018, at-least-daily cannabis use was associated with swifter rates of injection cessation (adjusted hazard ratio [AHR]=1.16; 95% confidence interval [CI]=1.03, 1.30). A subanalysis revealed that this association was only significant for opioid injection cessation (AHR=1.26; 95% CI=1.12, 1.41). At-least-daily cannabis use was not significantly associated with injection relapse (AHR=1.08; 95% CI=0.95, 1.23).

Conclusions. We observed that at-least-daily cannabis use was associated with a 16% increase in the hazard rate of injection cessation, and this effect was restricted to the cessation of injection opioids. This finding is encouraging given the uncertainty surrounding the impact of cannabis policies on PWID during the ongoing opioid overdose crisis in many settings in the United States and Canada.'

https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2020.305825

'The study’s authors concluded: “These observations are encouraging given the uncertainty surrounding the impact of cannabis legalization policies during the ongoing opioid overdose crisis in many settings in the United States and Canada, particularly among PWID [people who inject drugs] who are at increased risk for drug-related harm. The accumulating evidence from preclinical and epidemiological studies linking cannabis use to opioid use behaviors further supports the evaluation of the therapeutic benefits of cannabis and specific cannabinoids (e.g., CBD and THC) for people living with opioid use disorder.”'

https://norml.org/news/2020/08/27/study-cannabis-associated-with-increased-cessation-of-iv-opioid-use

'Disparities remain in HIV viral load (VL) suppression between people living with HIV (PLWH) who use cocaine and those who do not. It is not known how cannabis use affects VL suppression in PLWH who use cocaine. We evaluated the relationship between cannabis use and VL suppression among PLWH who use cocaine. We conducted a secondary data analysis of 119 baseline interviews from a randomized controlled trial in the Bronx, NY (6/2012 to 1/2017). Participants were adult PLWH prescribed antiretrovirals for =16 weeks, who endorsed imperfect antiretroviral adherence and used cocaine in the past 30-days. In bivariate and multivariable regression analyses, we examined how cannabis use, is associated with VL suppression among PLWH who use cocaine. Participants were a mean age of 50 years; most were male (64%) and non-Hispanic black (55%). Participants with VL suppression used cocaine less frequently than those with no VL suppression (p<0.01); cannabis use was not significantly different. In regression analysis, compared with no use, daily/near-daily cannabis use was associated with VL suppression (aOR=4.2, 95% CI: 1.1–16.6, p<0.05). Less-frequent cannabis use was not associated with VL suppression. Further investigation is needed to understand how cannabis use impacts HIV outcomes among PLWH who use cocaine.'

https://www.tandfonline.com/doi/abs/10.1080/09540121.2020.1799922?journalCode=caic20

'Some 11.3 million people are estimated to have injected drugs in 2018, a practice that accounts for roughly 10 per cent of HIV infections worldwide. More than 1 million people who inject drugs are living with HIV and 5.5 million are living with hepatitis C. Of the roughly 585,000 deaths attributed to drug use in 2017, half were due to liver diseases caused by hepatitis C, which continues to mostly go untreated among people who inject drugs. Opioid shortages caused by COVID-19 restrictions could lead to users substituting with more readily available substances such as alcohol or benzodiazepines, or to mixing with synthetic drugs. More harmful patterns of use may emerge as some users switch to injecting, or to more frequent injecting' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_BOOKLET_1.pdf

'Harmful patterns deriving from drug shortages include an increase in injecting drug use and the sharing of injecting equipment and other drug paraphernalia, all of which carry the risk of spreading blood-borne diseases, such as HIV/AIDS and hepatitis C, as well as COVID-19. Risks resulting from drug overdose may also increase among people who inject drugs and who are infected with COVID-19.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_BOOKLET_1.pdf

'The health consequences of drug use can include a range of negative outcomes such as drug use disorders, mental health disorders, HIV infection, hepatitis-related liver cancer and cirrhosis, overdose and premature death. The greatest harms to health are those associated with the use of opioids and with injecting drug use, owing to the risk of acquiring HIV or hepatitis C through unsafe injecting practices.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'Injecting drug use is a significant public health concern and causes morbidity and mortality owing to the risk of overdose and blood-borne infections (mainly HIV and hepatitis B and C), transmitted through the sharing of contaminated needles and syringes and other drug paraphernalia or risky sexual behaviour in some groups and subsequent severe immunosuppression, cirrhosis, neoplastic disease and inflammation sequelae. Social and physical effects can further aggravate potential underlying mental health conditions.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'Owing to the criminalization of drug use, punitive laws, stigma and discrimination against people who use or inject drugs in many parts of the world, conventional survey methods have been found to underestimate the actual population size because of the hidden nature of PWID [persons who inject drugs]; therefore, only indirect methods have been shown to reflect the situation of PWID with greater accuracy. Overall, new or updated estimates of PWID were available for 40 countries in 2018.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'The prevalence of PWID [persons who inject drugs] aged 15–64 in 2018 continues to be the highest in Eastern Europe (1.26 per cent) and Central Asia and Transcaucasia (0.63 per cent). Those percentages are, respectively, 5.5 and 2.8 times higher than the global average. More than a quarter of all PWID reside in East and South-East Asia, although the prevalence itself is relatively low (0.19 per cent). The three subregions with the largest numbers of PWID (East and South-East Asia, North America and Eastern Europe) together account for over half (58 per cent) of the global number of PWID. It is noteworthy that, as in previous years, while three countries – China, the Russian Federation and the United States – account for just 27 per cent of the global population aged 15–64, they are home to almost half (43 per cent) of all PWID.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'Injecting drug use is estimated to account for approximately 10 per cent of HIV infections worldwide and 30 per cent of all HIV cases outside Africa, while in the eastern countries of the WHO European Region more than 80 per cent of all HIV infections occur among PWID [persons who inject drugs]. PWID are estimated to be 22 times more likely than people in the general population to be living with HIV.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'The largest number of PWID [persons who inject drugs] living with HIV reside in Eastern Europe, East and South-East Asia and South-West Asia, which together account for 67 per cent of the global total. Although the prevalence of HIV among PWID (9.3 per cent) is below the global average, a fifth of the global number of PWID living with HIV reside in East and South-East Asia. A small number of countries continue to account for a large proportion of the total global number of PWID living with HIV. In 2018, for example, PWID living with HIV in China, Pakistan and the Russian Federation accounted for almost half of the global total (49 per cent), while PWID in those three countries comprise only a third of all PWID worldwide.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'UNODC, WHO, UNAIDS and the World Bank jointly estimated the prevalence of hepatitis C among PWID [persons who inject drugs] worldwide in 2018 to be 48.5 per cent, or 5.5 million (range: 4 million to 7.8 million) people aged 15–64. This estimate is based on estimates in 108 countries, covering 94 per cent of the estimated global number of PWID.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'Although data coverage was low in the Caribbean, the highest prevalence of hepatitis C among PWID [persons who inject drugs] was found in that subregion, at 76 per cent, followed by East and South-East Asia, Western and Central Europe, North America, and Central Asia and Transcaucasia, where it ranged between 61 and 54 per cent. In North Africa, a hepatitis C prevalence of 25 per cent was found among PWID, compared with a combined prevalence in the general population (>15 years) in North Africa and the Middle East estimated at 3.1 per cent. In Central Asia, a hepatitis C prevalence of 54 per cent was found among PWID, compared with a range of 0.5 to 13.1 per cent among the general population' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_Booklet_2.pdf

'The question is frequently asked: Why does a man become a drug addict?

The answer is that he usually does not intend to become an addict. You don't wake up one morning and decide to become a drug addict. It takes at least three months' shooting twice a day to get any habit at all. And you don't really know what junk sickness is until you have had several habits. It took me almost six months to get my first habit, and then the withdrawal symptoms were mild. I think it is no exaggeration to say it takes about a year and several hundred injections to make an addict' - Prologue, Junky, William S Burroughs, 1977, originally published in 1953

'The question, of course, could be asked: Why did you ever try narcotics? Why did you continue using it long enough to become an addict? You become a narcotics addict because you do not have strong motivations in any other direction. Junk wins by default. I tried it as a matter of curiosity. I drifted along taking shots when I could score. I ended up hooked. Most addicts I have talked to report a similar experience. They did not start using drugs for any reason they can remember. They just drifted along until they got hooked. If you have never been addicted, you can have no clear idea what it means to need junk with the addict's special need. You don't decide to be an addict. One morning you wake up sick and you're an addict.' - Prologue, Junky, William S Burroughs, 1977, originally published in 1953

'I have never regretted my experience with drugs. I think I am at better health now as a result of using junk at intervals than I would be if I had never been an addict. When you stop growing you start dying. An addict never stops growing. Most users periodically kick the habit, which involves shrinking of the organism and replacement of the junk-dependent cells. A user is in continual state of shrinking and growing in his daily cycle of shot-need for shot completed.' - Prologue, Junky, William S Burroughs, 1977, originally published in 1953

'In 1937, weed was placed under the Harrison Narcotics Act. Narcotics authorities claim it is a habit-forming drug, that its use is injurious to mind and body, and that it causes the people who use it to commit crimes. Here are the facts: Weed is positively not habit forming. You can smoke weed for years and you will experience no discomfort if your supply is cut off. I have seen tea heads in jail and none of them showed withdrawal symptoms. I have smoked weed myself off and on for fifteen years, and never missed it when I ran out. There is less habit to weed than there is to tobacco. Weed does not harm the general health. In fact. most users claim it gives you an appetite and acts as a tonic to the system. I do not know of any other agent that gives as definite a boot to the appetite. I can smoke a stick of tea and enjoy a glass of California sherry and a hash house meal.' - Junky, William S Burroughs, 1977, originally published in 1953

'I once kicked a junk habit with weed. The second day off junk I sat down and ate a full meal. Ordinarily, I can't eat for eight days after kicking a habit.' - Junky, William S Burroughs, 1977, originally published in 1953

'It has also been submitted that while enacting the NDPS Act, the government failed to consider the medicinal benefits of the drug, including its effect as an analgesic, its role in fighting cancer, reducing nausea, and increasing appetite in HIV patients.'
https://swarajyamag.com/insta/delhi-high-court-seeks-centres-take-on-use-of-cannabis-after-a-petition-challenges-ndps-act

'Cannabis may have a beneficial impact on HIV-associated BBB [blood-brain barrier] injury. Since BBB disruption may permit increased entry of toxins such as microbial antigens and inflammatory mediators, with consequent CNS injury, these results support a potential therapeutic role of cannabis among PWH [persons with HIV] and may have important treatment implications for ART effectiveness and toxicity.'
https://academic.oup.com/cid/article-abstract/doi/10.1093/cid/ciaa437/5820626

'Voters approved a constitutional amendment in November allowing medical marijuana in Missouri.

The measure allows patients with cancer, HIV, epilepsy and other conditions access to marijuana. It also permits use by veterans suffering from post-traumatic stress disorder.'
https://mjbizdaily.com/missouri-to-start-taking-medical-marijuana-business-application-fees-jan-5/

The 21 qualifying conditions for medical marijuana in Ohio includes AIDS and HIV-positive status

'The Enquirer set out to determine how many Ohioans could be eligible for medical marijuana under the 21 qualifying conditions from the Ohio Department of Health, the U.S. Centers for Disease Control and Prevention and private nonprofits that raise money for medical research. For many diseases, the numbers of patients are estimates, since the government does not track patient counts for every ailment. The conclusion: About 3.5 million Ohioans deal with at least one of the qualifying conditions. Ohio's population is 11.66 million'
https://www.cincinnati.com/story/news/2018/07/18/3-10-ohioans-eligible-medical-marijuana-card/784017002/

Minnesota's list of qualifying conditions for medical marijuana includes HIV/AIDS

Pennsylvania's list of medical conditions qualifying for medical marijuana includes HIV/AIDS

' In particular, I would really love to see anxiety, depression and ADHD added,” Spaar said. '
https://triblive.com/state/pennsylvania/14367032-74/pennsylvania-to-consider-more-conditions-that-should-qualify-for-medical-marijuana

“These include patients on chemotherapy with nausea and vomiting, glaucoma, asthma, anorexia and weight loss in AIDS, cancers, anorexia nervosa, chronic and neuropathic pain, multiple sclerosis, sleep disorders and some neuropsychiatric disorders” she outlined.'
https://jis.gov.jm/health-ministry-supports-conditional-use-of-cannabis-for-research-and-meidicinal-purposes/

'When we reviewed its medical uses in 1993 after examining many patients and case histories, we were able to list the following: nausea and vomiting in cancer chemotherapy, the weight loss syndrome of AIDS, glaucoma, epilepsy, muscle spasms and chronic pain in multiple sclerosis, quadriplegia and other spastic disorders, migraine, severe pruritus, depression, and other mood disorders. Since then we have identified more than a dozen others, including asthma, insomnia, dystonia, scleroderma, Crohn’s disease, diabetic gastroparesis, and terminal illness. The list is not exhaustive.'
http://rxmarijuana.com/old_medicine.htm

'Results
After adjusting for demographic and HIV-related covariates, THC-positive patients had significantly higher CD4+ and CD8+ counts than their THC-negative counterparts.

Conclusion
These results extend previous HIV-related immunity findings in an underrepresented group, and suggest that THC use does not reduce immune function as measured by CD count. Further research is warranted on the overall effects of THC on immune function in HIV positive patients.'
https://www.sciencedirect.com/science/article/pii/S0376871618308287?via%3Dihub

'Where data are available, they show a steady decline in the use of NPS in Europe, but such substances have established themselves in some marginalized groups in society, such as the homeless or people in prison, among whom the smoking of synthetic cannabinoids has been identified as a problem. In Europe, the use of NPS in prisons was reported by 22 countries, with synthetic cannabinoids identified as posing the main challenge and health risks (16 countries), whereas the use of synthetic cathinones in prisons was reported by 10 countries, NPS with opioid effects by six, and new benzodiazepines by four countries. In Latvia, the use of synthetic opioids in prisons has also been linked to an increase in overdose cases and in injecting drugs and sharing needles among prisoners who use drugs.' - United Nations Office on Drugs and Crime, World Drug Report 2020, https://wdr.unodc.org/wdr2020/field/WDR20_BOOKLET_4.pdf

Cannabis and Nausea
https://ravingkoshy.blogspot.com/2020/11/cannabis-and-nausea.html

Cannabis and the Digestive System
https://ravingkoshy.blogspot.com/2020/03/cannabis-and-digestive-system.html

Cannabis and Cocaine
https://ravingkoshy.blogspot.com/2020/11/cannabis-and-cocaine.html

Cannabis and Benzodiazepines
https://ravingkoshy.blogspot.com/2020/11/cannabis-and-benzodiazepines.html

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