December 29th, 2010
The medical marijuana debate is still raging and I have little doubt that it will be around for at least a decade to come. In the mean time, there is little doubt that marijuana, and more specifically its most active ingredient THC, are useful for individuals suffering from a number of medical conditions (see medical uses of marijuana). One of those conditions is HIV, where THC is particularly useful for helping patients fight the anorexia that often goes along with the infection and treatment. While a number of states (15 and the District of Columbia at last count) allow for medical marijuana prescriptions, most others require that patients get their THC in a synthetic form known as dronabinol.
Synthetic THC in a capsule
I’m not getting into the discussion of whether putting THC in a synthetic form is the American government’s way of directing money towards the pharmaceutical industry. The bottom line is that smoking marijuana, like smoking cigarettes, causes pulmonary (as in lung) problems including an increased risk of cancer as well as a host of other diseases like emphysema and such. New(ish) devices like vaporizers may help reduce that risk, but until more data comes in, I doubt those are going to cause any movement in terms of legislation. And since smoking marijuana is still illegal in most states, patients are pretty much left with the dronabinol pill.
The only problem is that something like 30% of HIV patients report smoking marijuana any way for relief of disease-associated symptoms and no one ever assessed the effectiveness of dronabinol on these patients until now. In this recent study, researchers assessed the efficacy of a very high dose of dronabinol (10mg – twice the recommended daily dose and half of the allowed daily maximum dose) on HIV/AIDS patients who smoke marijuana recreationally. Not surprisingly these patients showed a reduced response to the drug and even this high dose was only effective for the first half (eight days – during which they consumed 350 more calories a day and slept better) of the experimental period, after which it was no more effective than placebo at improving caloric intake and sleep.
The researchers’ conclusion in this article is that is seems higher doses are necessary for these patients, although I wonder about the rates of lying about regular marijuana use by patients given its legal status in most states. The patients in this study all smoked marijuana but while some smoked sporadically (2 days a week), others were daily or near daily smokers. I would assume that those two groups reacted differently to the dronabinol, but this paper didn’t address any such differences.
So… Do you have to smoke weed to get the medical benefit of THC?
Overall this study, like a few others before it, shows that synthetic THC is effective in treating a number of the effects of HIV/AIDS infection and treatment. Nevertheless, there is little doubt that HIV patients who use marijuana require different dosing than patients who don’t smoke weed, an effect that was probably predictable. Given the high prevalence of marijuana smoking among HIV/AIDS patients, it seems that more research should be carried out in order to fully develop a recommended dose range for such patients.
For HIV/AIDS patients who live in states where medical marijuana use is legal, it is likely easier and more cost effective to get their THC from marijuana leaves, though given their increased risk of infection and the lung effects of inhaling smoke, they should likely play it safe and use a vaporizer rather using more traditional methods (as in joint, bowl, or bong). The last thing HIV patients need to do is to put their body at any increased risk of any sort of medical complication. However, since dosing can be an issue this way, and since not everyone objects to the notion of taking pills instead of smoking weed, dronabinol might be a good options for those who are simply looking to counteract their infection complications and not to light up.
Gillinder Bedi, Richard W. Foltin, Erik W. Gunderson, Judith Rabkin, Carl L. Hart, Sandra D. Comer, Suzanne K. Vosburg & Margaret Haney (2010). Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study. Psychopharmacology, 212, 675-686.
Arno Hazekamp, Renee Ruhaak1, Lineke Zuurman, Joop van Gerven, Rob Verpoorte (2006). Evaluation of a vaporizing device (Volcano®) for the pulmonary administration of tetrahydrocannabinol. Journal of Pharmaceutical Sciences, 95, 1308-1317.
|Posted in: Education
Tags: aids patients, dronabinol, high dose, high dose dronabinol, HIV, hiv aids, hiv aids patients, hiv patients, increased rish, marijuana, marijuana smoking, medical, medical marijuana, patients, smoking cigarettes, smoking marijuana, THC, thc synthetic form
July 5th, 2010
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Drug use & Crime
Huffington Post: Over 5,000 lives were taken in drug related crimes in Mexico in the past year. Drug trade related violence is linked directly to the rising levels of drug use worldwide.
Bloomberg Businessweek: For the first time since 2002, the number of Americans smoking marijuana rose . Around 12.5% (39 million people) between the ages of 15 and 64, smoked marijuana in 2008, up from 12.3 percent the year before. Medical Marijuana anyone?
Drinking alcohol, and smoking cigarettes
Science Daily: Drunkenness increases the risk for violent behavior, but only for individuals with a strong inclination to suppress anger. Seems similar to my thesis findings.
Health Day: American teenage girls seem more receptive to drinking alcohol and taking other drugs than in earlier years. Teenage girls reach more than ever for drugs and booze to help them emotionally.
Health Day: There seems to be a connection between parents who smoke and children who weigh more or misbehave more than other children. This speaks to the environmental, as well as genetic, influences on behavior and health.
Cesar Fax: The percentage of high school students who for the first time tried alcohol or cigarettes before the age of 13 has decreased over the last ten years. In 1999, around one-third of high school students had reported drinking alcohol and one-fourth reported smoking a cigarette for the first time before age 13.
Health Day: Smoking may cause certain genetic mutations in older women, and therefore boost the risk of colon cancer in that population. In the general population, there is not much of connection between smoking and a higher risk of colorectal cancer.
Cravings and Brain function in addiction
Science Daily: Recovering addicts who avoid coping with stress succumb easily to substance use cravings, making them more likely to relapse during recovery.
Science Daily: Becoming addicted could result from a persistent impairment of synaptic plasticity in the brain. There exists a correlation between synaptic plasticity and the transition to addiction.
|Posted in: Alcohol, Drugs, Education, Links, Marijuana
Tags: Alcohol, anger, Brain, cigarettes, craving, crime, drinking alcohol, Drugs, drunk, health, high school students, marijuana, medical marijuana, mental health, smoking, teen alcoholism, teens, violence