HIV Clinical Practice Guidelines Include Medical Cannabis, Discourage Opioids
The Infectious Diseases Society of America (IDSA) released new guidelines designed to address the treatment of chronic pain in HIV/AIDS. The IDSA recommend that patients choose yoga, physical therapy or medical cannabis over opioids. This reaffirms why HIV patients were among the first to discover the medical properties of cannabis in America.
Douglas Bruce, MD is chief of medicine at Cornell Scott-Hill Health Center and associate clinical professor of medicine at Yale University. “Opioids are never first-line,” Bruce told the Pain News Network.
In the study, medical cannabis is recommended for chronic pain in HIV patients in the instances that cognitive therapy, yoga, physical therapy and hypnosis do not prove to be effective enough. Opioid-based medications, the doctors warned, should only be used as a second- or third-line defensive therapy if and only if gabapentin, pregabalin, anti-depressants and medical cannabis have first been considered as a treatment route.
The guidelines mention cannabis specifically as an option for managing chronic pain. “Medical cannabis may be an effective treatment for chronic neuropathic pain in appropriate patients,” researchers wrote. “A growing body of literature suggests that cannabinoids have a role in the modulation of pain.”
Peripheral neuropathy is nerve damage that affects about 30 percent of all HIV-infected individuals. It is manifested as a shooting pain or a pins-and-needles sensation that begins in the feet and slowly works its way up the body. It is caused by a compromised immune system in HIV patients, and it is the same numbing and pain sensation that is the most common complication of diabetes. It is a strange beast; typical painkillers and pain relievers sometimes have no effect.
HIV clinicians specialize in HIV, therefore they don’t always know what the best route is for managing pain. Peripheral neuropathy is only one of the ways medical cannabis can help those infected with HIV. Medical cannabis also can help with HIV-related inflammation and the spread of HIV cells in the digestive system.
