Time-Tested Treatment

State medical cannabis programs could not exist without the long list of AIDS activists who helped pioneer the first medical cannabis dispensaries in America. During the deadly AIDS crisis, patients consumed cannabis to battle wasting syndrome and the effects of the virus, but no one understood the mechanisms behind cannabis’ healing powers at the time. Today, research on cannabis and HIV is reaching an entirely new level, with federally-funded studies underway. The University of Florida recently received $3.2 million grant from the National Institute on Drug Abuse (NIDA) to study the relationship between cannabis and HIV.

“I was diagnosed with HIV in 2011, and I’m forced to take a three-drug pill daily. Medical cannabis makes my daily regimen of medication bearable.”

I was diagnosed with HIV in 2011, and I’m forced to take a three-drug pill daily. Medical cannabis makes my daily regimen of medication bearable. The liver-damaging drug Atripla, for instance, was the first mandatory pill I was prescribed and caused visual hallucinations about every three days. Currently, less toxic pills are available, but cannabis can be extremely effective as an adjunct therapy. Multiple studies on both tetrahydrocannabinol (THC) and cannabidiol (CBD) have suggested cannabis’ many benefits on HIV patients, including slowing the progression of the virus.

The Background

Robert C. Randall was the first person in America to win the right to legally consume medical cannabis in 1976. He would later die from AIDS in 2001. Randall originally suffered from glaucoma and claimed that only cannabis kept him from going blind. A judge ruled in 1976 that the Food and Drug Administration (FDA) must provide Randall with cannabis. Thanks to Randall’s efforts, the federal government created the Compassionate Investigational New Drug program and allowed Randall and a handful other patients to have access to cannabis provided by the government.

Without effective medicine, and sometimes with medicine that ironically accelerated the progression of AIDS (like AZT), patients resorted to holistic medicines. Soon “buyers clubs” sprouted in major cities offering herbal medicines. And the patients clearly didn’t have enough time to wait for FDA approvals—by then, they’d be dead. It didn’t take long until they were experimenting and offering medical cannabis.

Dennis Peron, co-author of Proposition 215, America’s first statewide medical cannabis law, opened the Cannabis Buyers Club in San Francisco, years before any medical cannabis dispensary laws had been written. He was inspired to open up a cannabis club after police raided his home in 1990, taking away four ounces of cannabis and charging Peron with intent to distribute. The cannabis actually belonged to Peron’s boyfriend, Jonathan West, who was dying of AIDS. West died later that year.

Peron took control of an underground dispensary at 194 Church Street in San Francisco after its founder Thomas O’Malley died of AIDS in 1992. By that time—over 23,000 AIDS deaths were confirmed and 30 people were dying—per week. A whole network of underground HIV buyers clubs were secretly helping AIDS and cancer patients. Proposition 215 co-author “Brownie Mary” Jane Rathbun made it her own personal mission to distribute brownies to AIDS victims.

Peron specifically cited West’s death as the driving force behind his efforts to author Proposition 215, shortly after the groundbreaking bill passed in 1996.

The New Research

Last August, the University of Florida received a $3.2 million grant from the NIDA. With around 400 HIV-positive and 100 HIV-negative participants, it will be the largest clinical study on medical cannabis and HIV ever conducted. On Oct.24, 2017, it was announced that the study was being launched and would span over five years. CULTURE spoke to the study’s lead investigator Dr. Robert L. Cook M.D. M.P.H.

“One of the goals is to really provide better guidelines for treatment for people with HIV, including HIV itself and other comorbidities, Cook explained. “[Currently] the treatment guidelines don’t have any guidance on what kind of marijuana might be the most beneficial or what kind might be the most harmful.” Cook and his team hope to distinguish and compare the relative benefits of products with THC alone, CBD and THC combined, products that are consumed orally and products that are smoked or vaped.

Cook said the study will be focused on self-reported experiences. “Our study—we won’t really be able to control [medications and sources]. All we can do is ask people what they’ve experienced. So we hope to learn from people that have been using marijuana or about to start using marijuana and to teach us what they’ve learned in their own experiences, such as managing pain and what type of marijuana is most helpful.” Dr. Cook and his team are currently in the final stage of drafting the questionnaire.

Cook said particularly CBD could show promise as an anti-inflammatory. “People living with HIV are living near-normal life spans, but they are still seeing cardiovascular diseases four or five years earlier [than HIV-negative people], and we are seeing neurocognitive deficits potentially earlier. A lot of people think this could be related to chronic inflammation—the stress it puts on the body in those who are constantly battling the virus. If marijuana, especially CBD, has some anti-inflammatory properties, that could help prevent the rapid aging that we see in people living with HIV, in theory.”

The Future of HIV and Cannabis

Florida’s Amendment 2 was approved in January 2017, allowing access to medical cannabis. But the University of Florida researchers still have limited options to conduct conventional clinical studies, thanks to cannabis’ federal status.

People living with HIV, and with access to medicine, are living near-normal life spans, however aging with HIV is another story. “Today, people are surviving,” Cook explained. “For example in Florida this year we’ve just hit it—50 percent of people living with HIV in Florida are over 50 years old. With HIV, a lot of these patients—one, have symptoms related to pain or maybe some nausea—but those are symptoms that are normal in people that are aging. Marijuana could have benefits on chronic inflammation.”

People living with HIV now face new challenges including battling inflammation, chronic pain and digestive problems that increase with aging. Cannabis can help in so many ways.