September #166 : Considering Cannabis - by John-Manuel Andriote

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Table of Contents

Thou Shalt Fear AIDS

Lest We Forget

When to START Drugs?

You Said It

Burn that Belly

In Sync with ZInc

No Butts About It


HIV a Best Seller?

Considering Cannabis

The Importance of Remembering Ryan White

Insult to Injury

World Cup Wrap Up

Back-to-School Books

Angels Redux

Crying Uncle

Fear & Loathing in Illinois

Editor's Letter


Keeping Track

GMHC Treatment Issues- September 2010

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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September 2010

Considering Cannabis

by John-Manuel Andriote

In states where it is legal, medical marijuana helps some HIV-positive people cope with living their lives.

 In the states of California and Washington, since 1996 and 1998, respectively, medical marijuana has been legally available for people with HIV, cancer and other serious health challenges. Heading west this past spring from my home in Connecticut, I set out to learn about the states’ medi-pot programs. Okay, I admit it. I also hoped to score a bit of medicine, too.

Nationally, 14 states plus the District of Columbia allow medical marijuana use. Most of these consider anyone with HIV/AIDS eligible for medical pot. Many HIV-positive people use marijuana to treat nausea, appetite loss, the pain of neuropathy, chronic bowel problems and even anxiety. “When appropriately prescribed and monitored,” the American Academy of HIV Medicine stated in 2007, “marijuana/cannabis can provide immeasurable benefits for the health and well-being of our patients.”

So it is not surprising that some people with HIV use marijuana for medical purposes, whether it’s legal or not. And a whopping 89 percent of the men participating in the long-term Multicenter AIDS Cohort Study (MACS) acknowledged using pot, though they weren’t asked whether it was legally obtained.

In Seattle, I interviewed Robert Wood, MD, recently retired AIDS chief for the Seattle/King County public health department. Based on his experience, which dates to the early 1980s, Wood said pot helps many positive people in the aforementioned ways. And while it seems to help some people sleep, he noted, it can have the opposite effect for others.

John Moore, a San Francisco man living with HIV since 2004, told me his doctor recommended pot to treat lipoatrophy. “Weed does not help lipoatrophy [a condition that results in loss of body fat], OK?” he said, fairly winking. But it can alleviate the emotional impact of lipo and other HIV side effects.

“It provides a sense of well-being and allows me to get away temporarily from anxieties,” Moore said. “Some would say it’s an illusion, but so what? I think we should be looking at it like any other medicinal substance.”

Indeed, the placebo effect can be useful. As Josiah Rich, MD, professor of medicine and community health at Brown Medical School at Providence, Rhode Island, said: “Whether the benefit is from marijuana or from the belief that it is helping, it has a real effect for some people suffering from symptoms related to HIV or HIV meds.”  

The road to legalization has been long. In 1999, the Institute of Medicine, which advises the federal government on scientific matters, asserted “the potential therapeutic value for cannabinoid drugs.” But it took until last year for the American Medical Association to sign on.

Moreover, federal law still outlaws marijuana. But in 2009, the justice department directed prosecutors to lay off people using medical cannabis in states where it’s legal. In San Francisco, the city instructed the police department not to arrest people for having medical marijuana. Apparently, the directive worked. “I get on the bus in the morning,” Moore said, “and the whole thing reeks of weed because so many people are carrying it.”

Unfortunately for me, California, like all the other medical pot states, limits the use of legal marijuana to state residents. Only a few states offer reciprocity for visitors from other legal-marijuana states who run out of medicine.

Obtaining medical pot is a pretty standard process for residents of the states offering it. First, you need a doctor’s medical recommendation (not a prescription). If having HIV isn’t enough, your doctor will want to know what specific ailments you are trying to address.

The referral—and a fee, ranging from $100 in Michigan to $150 in Nevada—will get you a one-year, state-issued ID card, usually from the state health department. Some states have dedicated medical pot offices, such as Vermont’s Marijuana Registry. The ID card allows you to avoid arrest and—important for people with compromised immune systems—avoid low-quality marijuana, possibly mixed with mystery compounds.

You might pick up your new medicine in a state-licensed dispensary or “compassion center,” as Rhode Island calls them. In most states, a license also entitles you to grow a limited amount of pot. (See sidebar for further details.)

Moore described the San Francisco dispensary he uses as a trailer-type building—like a teashop, but with bulletproof glass. “Behind [that] glass,” he explains, “is a woman sitting with a cash register. A white board on the wall lists what they have. Then there are big jars with different types [of cannabis]”—bearing names such as Purple Haze and White Widow.

“Everything is priced by an eighth of an ounce,” Moore said. Prices are as high as $60 for high-quality grass, to a mere $20 for what’s commonly called “shake,” the stems and seeds that can be added to melted butter to make a spread. Insurance companies and third-party payers won’t (yet?) pay for medical marijuana, so it’s all out of pocket.

I didn’t see the dispensary, but Moore did take me into a smoke shop on 18th Street, half a block from the intersection of Castro, and pointed out the shelf of vaporizers. Instead of smoking, he uses one of these.

“You put the weed in this little mesh chamber at the end of a short hose,” he said. “And you attach that above a heating element that heats but does not burn the herb, then inhale from the other end.“

Smoking pot can harm the lungs, the Institute of Medicine first warned in 1999. In contrast, vaporizers produce “little or no exposure” to the unhealthy chemicals smoking generates, including carbon monoxide and benzene, according to University of California at San Francisco researchers, led by longtime HIV and cancer doctor Donald Abrams, MD. What’s more, they found that a vaporizer produced higher plasma levels of THC (tetrahydrocannabinol, marijuana’s ?active ingredient) than smoking.

Back in Providence, in his HIV clinic, Josiah Rich recommends a vaporizer to avoid lung damage. “But,” he adds, “smoking small amounts is not unreasonable.” In the name of research, I tried a vaporizer. As promised, the device eliminates the coughing and irritation associated with smoking weed.

Beyond the known risks of smoking, there’s been at least a squeak of a warning about cannabis for people with HIV—from a “humanized” mouse.

Researchers at UCLA infected a specially engineered mouse with an HIV-like virus, then gave it THC. They concluded the cellular damage they observed could mean that THC might slightly speed up the progress of untreated HIV.

But Abrams found that neither smoked nor synthetic THC—dronabinol, in prescription Marinol tablets—affects viral load or interacts with HIV meds. In fact, he said, the research shows that marijuana “actually improved immune function after 21 days of smoking three times a day.” And so far, no other research has confirmed those mousy data.

All medications have side effects and trade-offs. For example, the side effects of the HIV meds I take are diarrhea, headache, nausea, stomach pain or upset, tiredness, vomiting and weakness. By contrast, marijuana, whose most common side effect is “euphoric mood,” stacks up amazingly well.

Who among us wouldn’t put up with a bit of a buzz to be able to eat, move or sleep normally? And it only makes sense that eating, exercising and sleeping better will improve our chances of surviving HIV.  

States of Grass
Where medical marijuana is legal, where you can grow it and where you can find more details:

 Alaska  6 plants
 California 18 plants
 Colorado  6 plants
 District of Columbia
 not permitted (search “D.C. medical marijuana”)
 Hawaii  7 plants (search “medical marijuana”)
 Maine  6 plants

 Michigan  12 plants (search “medical marijuana”)
 Montana  6 plants
 Nevada  7 plants
New Jersey
 New Mexico
 16 plants
 Oregon  24 plants
 Rhode Island
 12 plants
 Vermont 9 plants

 Washington  15 plants

Other useful websites:
National Organization for the Reform of Marijuana Laws (
Marijuana Policy Project (
ProCon.Org (

Search: Cannabis, medical marijuana, medi-pot, lipoatrophy, legalization, American Medical Association, weed, vaporizer, carbon monoxide, benzene, THC, euphoric mood

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  comments 1 - 15 (of 18 total)     next > >>

Greg, Detroit, 2011-02-17 15:46:00
Here in Michigan a Compassion Club out of Lansing delivers medical marijuana to HIV and Cancer patients in the Metro Detroit area at a discount. It's $300 oz for card holders. They have 9 strains. It's been a godsend for me. Sweet Relief Compassion Club 877-900-0374 Ask for Hancock and the Cancer discount

Frederick Wright, Tampa, 2010-09-29 11:21:58
I agree with MP in LA about pot makes a person more sexual and hungry too. The point she makes about drugs is fascinating for as an HIV person my Docotor writes a lot of Drugs with more scienctific evdance of harm then pot. I live in Florida where People United for Medical Marijuana are pushing for legalisation. Enough with putting people in prison over a plant,enough in stopping alternative medical treatment, enough with the brain washing of the public concerning the war on drugs. Fair Trade.

MP, Los Angeles, CA, 2010-09-28 11:34:09
I am also HIV+ and I do not need Marijuana to cope with my decease. There are plenty of ways of coping with HIV without being a pothead. Medical Marijuana is the perfect excuse for a lot of teenagers that want to use pot and for a lot of people that are drug-addicts. If you are in a terminal stage and you have only a few months to live by all means use it; otherwise please stay away from drugs (specially before having sex since it seriously impairs your judgment when comes to using protection).

Adam, NYC, 2010-09-27 10:09:45
I have hepititisC and HIV. A docter told me marijuana is hard on the liver..Is this true. I think she's more concern with me being a member of a 12 step program and stretching the facts out of concern of me using any mind and mood alterating substance, which i appreciate but I'd like tp know the facts.

Mark, , 2010-09-17 18:02:36
BTW-MJ may be consumed in cookies, butter, peanut butter, brownies, hard candy and even in tincture form can help. Of course it must be prepared correctly.

Damel, Lusaka, 2010-09-15 10:19:53
Hope this can be made legal worldwide. Eating the untreated mj once a week gives out gradual energy, however it burns the gullet lining making it difficult to swallow meds and fibrous food. Not worth the price if your diet gets affected.

Art Riley Mullen, lexington,ky, 2010-09-03 17:54:30
please help get med marijuana in ky

raggamuffin, Seattle, 2010-09-03 10:23:46
I am highly pro-cannibis but rather I have no desire to use it myself (I like my coffee and redbulls instead). However my new meds and health concerns make me wonder if I should give it a try. My dr is a pioneer in legalizing the med mj in our state but not once has he recommended it for my care. I wish there were more substantial evidence on HIV and the new meds before I ask to get a rx. Anyone have a credible website link? Btw, legalize it for everyone!

Mark, NJ, 2010-09-02 09:01:59
In addition to vaporizers which I learned from this story, there are other more healthy ways to consume pot. I had it in a lollipop in CA and it was effective and good. Here in NJ it is legal but the new governor is dragging his feet. He was the state prosecutor. So it is legal but were are held up. We are between the drug dealers and the cops.

Devon, Denver, 2010-09-01 17:50:19
I would love to know what the effects (if any) smoking has on HIV medication. This is, as of yet, not studied and I think people might be surprised by the findings!

Joe, Chicago, 2010-08-31 17:28:42
Why medical marijuana isn't legal in all states is beyond my comprehension. It is not legal in Illinois, but I still have to have it, and it absolutely helps me eat and sleep and cope with the never-ending HIV challenges, as well as the challenges life seems to dole out in big doses anymore. If it was legal, it wouldn't cost so darmn much to buy it.

Patrick Faith, Fairfield, CA, 2010-08-31 15:49:55
I have found that it's been a great help to me for the years that I used it. It keeps my apitite up and helps with the ill side effects from my HIV meds. But California is making a big business out of it and the trouble I face now is being on disability I can't afford to get the card to use it and then can't afford the medicine itself. It has become so expensive. I hope the just make it leagle soon so it's available to all the benifit from it.

Paterson Pete, Paterson, nj, 2010-08-31 15:42:01
It is ludicrous that in NJ, a simple weed which would give people that have been traumatized (plwha's) a lot of satisfaction to grow may not be grown, (that is illegal here), which by the Nazi's in power in NJ, instead, you have to go to the state run facility to buy their brand at their price. Sieg Heil!

Thomas, Seattle, 2010-08-31 13:19:36
I lived in Seattle Housing Authority Building (Harvard Court)for 11 years. I was Stalked by residents of the building for using med. pot, they had the FBI going thru my apartment on a regular basis. They were lead by several mentally ill Christian Women. These Christian Women enlisted the help of Christian Seattle Cops, they followed me to Doctors appointments, The Grocery Store at Broadway (QFC) the Library, everywhere I went I had a Cop or one of the people from SHA Harvard Court Stalk me.

Mighty Mouse, San Francisco, 2010-08-31 09:56:49
Marijuana saved my life many years ago when I couldn't keep any food down. It continues to enhance it by reducing the pain of neuropathy, relieving stress, eliminating minor depressions and other minor ailments. I believe it is a natural high and a gift from a higher power to make our experience here a little more pleasant.

comments 1 - 15 (of 18 total)     next > >>

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