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Winter/Spring 2005
O'Shaughnessy's
Journal of the California Cannabis Research Medical Group

Marijuana and AIDS: A Four-Year Study

Patients reported reduced levels of pain, nausea and insomnia--and increased appetite.

by David Jay Brown, Kenneth Michael Smuland, and Valerie Corral
The Wo/Men’s Alliance for Medical Marijuana (WAMM) is a cultivation collective in Northern California with approximately 150-175 patient-members, who suffer from a range of debilitating illnesses, including cancer, AIDS, epilepsy, multiple sclerosis, and glaucoma. In 1993 the authors undertook to assess the medical effectiveness of marijuana on WAMM’s AIDS patients.
Previous studies have demonstrated marijuana’s usefulness in reducing nausea and vomiting1 , stimulating appetite and promoting weight gain2 and diminishing intra-ocular pressure from glaucoma3 . There is also evidence that marijuana reduces muscle spasticity from spinal cord injuries4 and multiple sclerosis5, and diminishes tremors in multiple sclerosis6.
WAMM developed an assessment form —known as an analog— for the symptoms that marijuana is reputed to alleviate. Weekly reports were collected from members. All of the patients studied had AIDS. The symptoms assessed were pain, nausea, insomnia, and lack of appetite.

Method
This study ran from June 1993 through December 1997. Data were collected by means of analogs given by WAMM to each of its patient-members with their weekly supply of medical marijuana. Our analog was adapted from one used in Charles Grob’s MDMA studies with pancreatic cancer patients7, revised by AIDS patients to incorporate their symptoms. The patients were asked to mark on the analogs how they felt before and after they smoked marijuana with respect to each of the applicable symptoms.
The scale on the analogs ranged from zero to 10, with 10 being the highest intensity level of symptom or physical-emotional state (pain, nausea, insomnia, and appetite.)

Results
There were a total of 264 subjects with AIDS in the study—44 women and 220 men—however not all of the symptoms measured on the analogs applied to all of the subjects.
For 29 women the medium average level of pain reported prior to using marijuana was 6.5. After using the medication the medium average level of pain dropped to 3.2. The result of the two-tailed t-test P(T<=t) was 1.45E-08.
For 37 women the medium average level of nausea reported prior to using marijuana was 5.2. After using the medication the medium average level of nausea dropped to 3.1. The result of the two-tailed t-test P(T<=t) was 0.003.
For 44 women the medium average appetite level reported prior to using marijuana was 2.3. After using the medication the medium average appetite level rose to 6.3. The result of the two-tailed t-test P(T<=t) was 8.33E-15.
For 29 women the medium average level of insomnia reported prior to using marijuana was 7.2. After using the medication the medium average level dropped to 3.4. The result of the two-tailed t-test P(T<=t) was 8.33E-15.
For 175 men the medium average level of pain reported prior to using marijuana was 5.9. After using the medication the medium average pain level dropped to 2.4. The result of the two-tailed t-test P(T<=t) was 4.3E-30.
For 203 men the medium average level of nausea reported prior to using marijuana was 5.4. After using the medication the medium average level of nausea dropped to 2.8, The result of the two-tailed t-test P(T<=t) was 3.25E-25.
For 220 men the medium average appetite level reported prior to using marijuana was 3.3. After using the medication the medium average appetite level rose to 6.2. The result of the two-tailed t-test P(T<=t) was 1.72E-33. (continued below graphics)

AIDS Patient' Perceived Level of pain, nausea, insomnia, and lack of appetite before and after smoking marijuana was reported on a scale of 1-10. Forty-four women and 220 men participated in the four-year study. Not all subjects reported with respect to all symptoms.

Discussion
This study indicates that these AIDS patients believed that they experienced significantly less pain, nausea, and insomnia, and had much greater appetites after using marijuana (See Tables I & 2 and Graphs I & 2).
In this study we were testing the null hypothesis that AIDS patients would not experience any significant difference in their symptoms before and after using marijuana. In every case our results indicated a rejection of the null hypothesis with a statistical significance greater than 0.01. This is consistent with previous studies and claims, which suggest that marijuana can help reduce pain and nausea, improve appetites, and help people sleep better.

Improving the quality of an AIDS patient’s life increases the probability that person will stick with other lifesaving medical procedures

For someone with AIDS—a condition that requires a lifetime of chemotherapy—these improvements can mean the difference between life and death. Improving the quality of an AIDS patient’s life increases the probability that that person will stick with other lifesaving medical procedures, some of which have extremely uncomfortable side-effects. In addition to reducing the side-effects from other types of medication, marijuana can serve as a powerful appetite-stimulant for those suffering from the AIDS Wasting Syndrome.

The subjective nature of analog responses inherently raises questions of reliability. In this study a possible source of bias may stem from a tendency for marijuana users to exaggerate how much better they felt after using the medication. This seems unlikely, however, as they would have little motivation for doing so.
Although it is beyond our current ability to know with any certainty how much bias influenced our data, it is evident that many AIDS patients report significant benefits from using marijuana. Because of this, and the lack of any serious side-effects, marijuana appears to be a powerful medical tool for dealing with the serious consequences of AIDS.

WAMM is conducting ongoing research into the effects of marijuana on patients with AIDS and other illnesses, including cancer, epilepsy, multiple sclerosis, and glaucoma. Research is required to determine the effects exerted by different strains of the marijuana plant, and the efficacy of various delivery systems (vaporizing, eating, tinctures, etc.)

Acknowledgments
The authors wish to thank all those who took part in this study.
WAMM is a collective run entirely by patients and caregivers. It relies on tax-deductible donations to continue its operation, and the valuable research its doing. For reprint requests and correspondence contact:
WAMM
309 Cedar ST # 39
Santa Cruz, California 95060
(831) 425-0580


References
1, Chang, A.E. et al., “Delta-Nine-Tetrahydrocannabinol as an Antiemetic in Cancer Patients Receiving High-Dose Methotrexate: A Prospective Randomized Evaluation,” Annals of Internal Medicine 91: 819-24 (1979).
Orr, L.E. et al., “Antiemetic Effect of Tetrahydrocannabinol Compared with Placebo and Prochlorperazine in Chemotherapy-Associated Nausea and Emesis,” Archives of Internal Medicine 140: 1431-33 (1980).
Vinciguerra, V. et al., “Inhalation of Marijuana as an Antiemetic for Cancer Chemotherapy,” New York State Journal of Medicine 85: 525-27 (1988).
2. Foltin, R.W. et al., “Effects of Smoked Marijuana on Food Intake and Body Weight of Humans Living in Residential Laboratory,” Appetite 11: 1-14 (1988).
Plasse, T.F. et al., “Recent Clinical Experience with Dronabinol,” Pharmacology Biochemistry and Behavior 40: 695-700 (1991).
Gorter, R. et al., “Dronabinol Effects on Weight in Patients with HIV Infection,” AIDS 6: 127-38 (1992).
3. Crawford, W.J. and Merritt, J.C., “Effects of Tetrahydrocannabinol on Arterial and Intraocular Hypertension,” International Journal of Clinical Pharmacology and Biopharmaceutics 17: 191-96 (1979).
Merritt, J.C. et al., “Effects of Marijuana on Intraocular and Blood Pressure in Glaucoma,” Ophthalmology 87:222-28 (1980).
4. Malec, J. et al., “Cannabis Effect on Spasticity in Spinal Cord Injury,” Archives of Physical and Medical Rehabilitation 63: 116-18 (1982).
Hanigan, W.C. et al., “The Effect of Delta-9-THC on Human Spasticity,” Clinical Pharmacology and Therapeutics 39: 198 (1986).
5. Ungerleider, J.T. et al., “Delta-9 THC in the Treatment of Spasticity Associated with Multiple Sclerosis,” Advances in Alcohol and Substance Abuse 7: 39-50 (1987).
Meinck, H.M. et al., “Effects of Cannabinoids on Spasticity and Ataxia in Multiple Sclerosis,” Journal of Neurology 236: 120-22 (1989).
6. Clifford, D.B., “Tetrahydrocannabinol for Tremor in Multiple Sclerosis,” Annals of Neurology 13: 669-71 (1983).
7. Grob, C. et al., “Analgesic safety and efficacy of MDMA in modification of pain and distress of end-stage cancer,” unpublished (2004).

 

 

O'Shaughnessy's
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