Cannabis therapeutics in HIV/AIDS

233 Pages·2001·2.28 MB·English

by  Ethan Russo

Cannabis Therapeutics
in HIV/AIDS
Cannabis Therapeutics in HIV/AIDS has been co-published
simultaneously asJournal of Cannabis Therapeutics, Volume 1,
Numbers 3/4 2001.
9780789016997
Cannabis Therapuetics in HIV/AIDS
Size: 212 x 152 Spine size: 13 mm Color pages: Binding: Paperback
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Cannabis Therapeutics in HIV/AIDS,edited by Ethan Russo, MD (Vol. 1, No. 3/4, 2001).Explores
delivery methods, clinical studies, and the history of cannabis therapy with HIV/AIDS patients.
Cannabis Therapuetics
in HIV/AIDS
Ethan Russo, MD
Editor
Cannabis Therapeutics in HIV/AIDS has been co-published
simultaneously asJournal of Cannabis Therapeutics, Volume 1,
Numbers 3/4 2001.
FirstPublished by
TheHaworthIntegrativeHealingPressisanimprintofTheHaworthPress,Inc.,10AliceStreet,
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CannabisTherapeuticsinHIV/AIDShasbeenco-publishedsimulta-
neously as Journal of Cannabis Therapeutics, Volume 1, Numbers
3/4 2001.
©2001byTheHaworthPress,Inc.Allrightsreserved.Nopartofthisworkmaybereproducedoruti-
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Cover design by Marylouise E. Doyle
Photograph of Cannabis courtesy of GW Pharmaceuticals Ltd.
Library of Congress Cataloging-in-Publication Data
Cannabis therapeutics in HIV/AIDS/Ethan Russo, editor.
p. ; cm.–(Journal of cannabis therapeutics; v. 1, no. 3/4)
Includes bibliographical references and index.
ISBN 0-7890-1698-2 (hard: alk. paper)–ISBN 0-7890-1699-0 (pbk.: alk. paper)
1. AIDS (Disease)–Complications–Treatment. 2. Marijuana–Therapeutic use. 3. Cannabis–
Therapeutic use. I. Russo, Ethan. II. Series.
[DNLM: 1. HIV Infections–drug therapy. 2. Acquired Immunodeficiency Syndrome–drug
therapy. 3. Cannabinoids–administration & dosage. 4. Cannabis. WC 503.2 C224 2001]
RC606.6.C36 2001
616.97(cid:1)92061–dc21 2001051488
Cannabis Therapeutics in HIV/AIDS
CONTENTS
Introduction: Cannabis Therapeutics in HIV/AIDS,
Plus, a Modest Proposal 1
Ethan Russo
Therapeutic Cannabis (Marijuana) as an Antiemetic
and Appetite Stimulant in Persons with Acquired
Immunodeficiency Syndrome (AIDS) 5
Richard E. Bayer
Medical Marijuana and the AIDS Crisis 17
Clinton A. Werner
Marijuana Use in HIV-Positive and AIDS Patients:
Results of an Anonymous Mail Survey 35
Stephen Sidney
Differential Effects of Medical Marijuana Based on Strain
and Route of Administration: A Three-Year Observational
Study 43
Valerie Leveroni Corral
Marijuana and Cannabinoids: Effects on Infections, Immunity,
and AIDS 61
Guy A. Cabral
Effects of Smoked Marijuana on the Lung and Its Immune
Defenses: Implications for Medicinal Use in HIV-Infected
Patients 87
Donald P. Tashkin
Cannabis and Cannabis Extracts: GreaterThanthe Sum
of Their Parts? 103
John M. McPartland
Ethan B. Russo
Harm Reduction Associated with Inhalation and Oral
Administration of Cannabis and THC 133
Franjo Grotenhermen
Cannabis “Vaporization”: A Promising Strategy for Smoke
Harm Reduction 153
Dale H. Gieringer
AnalgesicandReinforcingPropertiesof∆9-THC-Hemisuccinate
in Adjuvant-Arthritic Rats 171
Susan L. Broom
Kenneth J. Sufka
Mahmoud A. ElSohly
Samir A. Ross
Prospects for New Cannabis-Based Prescription Medicines 183
Brian A. Whittle
Geoffrey W. Guy
Philip Robson
Index 207
ABOUT THE EDITOR
Ethan Russo, MD, is a neurologist with Montana Neurobehavioral
SpecialistsinMissoula.Heisboardcertifiedinneurologywithaspecial
qualificationinchildneurology.Inaddition,Dr.RussoisClinicalAssis-
tantProfessorattheDepartmentofMedicineattheUniversityofWash-
ingtonandAdjunctAssociateProfessorofPharmacyattheUniversity
ofMontana.Hefrequentlylecturestoundergraduateandgraduatestu-
dentsinthefieldsofpharmacy,psychology,sportsmedicine,interper-
sonalcommunications,andphysicaltherapy,amongothers.Dr.Russo
has written numerous peer-reviewed articles on ethnobotany, herbal
medicine,andcannabis,andhaslecturedinternationallyonthesetopics.
He is also the author of the Handbook of Psychotropic Herbs (The
HaworthPress,Inc.).Currently,Dr.Russoisactivelyengagedinbench
researchontheserotoninreceptoractivityofnaturalproducts,especially
as it applies to migraine headaches.
Introduction:
Cannabis Therapeutics in HIV/AIDS,
Plus, a Modest Proposal
TheJournalofCannabisTherapeutics:StudiesinEndogenous,Herbaland
SyntheticCannabinoidsispleasedtopresentitsfirstspecialissue,onthesub-
jectofCannabisTherapeuticsinHIV/AIDS.Certainly,withrespecttothera-
peuticcannabis,HIV/AIDSsufferersareitsmostcommonconsumers,andthis
isatopicmostworthyofcloserexamination.Ourcurrentofferingincludesnu-
merous articles pertinent to the issue, which will be supplemented by subse-
quent entries in future volumes.
The survey commences with a broad medical overview of the subject by
Dr. RichardBayer.Thisablyservesasapointofdepartureinitspresentation
of the pertinent topics of interest with respect to AIDS and its treatment.
Next,ClintWerneroffersadistinctviewpoint,moreofan“insider’sview”
onthetwenty-yearhistoryofthisaffliction,anditsinterfacewithcannabisand
the medical marijuana political movement.
Subsequently, we present two survey studies of clinical cannabis usage
fromdifferentpopulationsinCalifornia.Bothconfirmtheassertionabovethat
HIV/AIDS sufferers frequently turn to cannabis in attempts to treat their
symptoms.ThefirstisfromDr.StephenSidney,aphysicianandepidemiolo-
gistworkingforKaiserPermanente,thestate’slargestHMO(HealthMainte-
nance Organization). The second is from Valerie Corral, a clinical cannabis
patientherself.Despitethefactthatsheisnotfromaprofessionalbackground,
herlong-termstudyprovidesmuchusefulinformationontherangeofcondi-
tions, symptoms and results obtained with medical marijuana.
Dr.GuyCabralprovidesuswithastate-of-the-artreviewofimmunological
issuesincannabisusage.Thepictureisacautionaryone,butalsoonethatpro-
[Haworthco-indexingentrynote]:“Introduction:CannabisTherapeuticsinHIV/AIDS,Plus,aModest
Proposal.”Russo,Ethan.Co-publishedsimultaneouslyinJournalofCannabisTherapeutics(TheHaworth
IntegrativeHealingPress,animprintofTheHaworthPress,Inc.)Vol.1,No.3/4,2001,pp.1-4;and:Cannabis
TherapeuticsinHIV/AIDS(ed:EthanRusso)TheHaworthIntegrativeHealingPress,animprintofThe
HaworthPress,Inc.,2001,pp.1-4.SingleormultiplecopiesofthisarticleareavailableforafeefromThe
Haworth Document Delivery Service [1-800-342-9678, 9:00 a.m. - 5:00 p.m. (EST). E-mail address:
[email protected]].
©2001 by TheHaworthPress, Inc. All rights reserved. 1
2 CANNABIS THERAPEUTICS IN HIV/AIDS
videsnoblanketsupportorindictmentoftherapeuticcannabiswithrespectto
immuneeffects.Asalways,moreresearchisneededtoascertainallthemedi-
cal implications inherent in this treatment modality.
DonaldTashkinprovidesanotherthoroughreview,thistimeofpulmonaryis-
sueswithsmokedcannabisthatisofparticularimporttoHIV-positivepatients.
EarlyissuesofJCANThavealludedtopossiblesynergisticeffectsofcanna-
biscomponentsbeyondTHC.ThefollowingarticlebyMcPartlandandRusso
examinesthose“otherplayers”ingreaterdetailinanefforttoelucidatetheissue.
Movingintotheareaofharmreduction,Dr.FranjoGrotenhermenprovides
a clinician’s interpretation of cannabis consumption issues, and a number of
practical recommendations for patients and their doctors.
Dr. Dale Gieringer provides some of the first experimental data on the
method of cannabis vaporization that portends to provide the same clinical
benefitsassmoking,butwithmarkedlyfewerhealthsequelae.Thisisatech-
nologyunderintensescrutinyamongclinicalcannabispatientsandadvocates,
butonehardlymentionedbytherecentInstituteofMedicineReport(Joy,Wat-
son, and Benson 1999).
AresearchgroupfromtheUniversityofMississippiwithleadauthorSusan
Broomprovidesanexperimentalstudyexamininganotheralternativecanna-
binoid delivery system, that of rectal suppositories containing THC-semi-
succinate.
Rounding out the original articles, Drs. Brian Whittle, Geoffrey Guy and
Philip Robson of GW Pharmaceuticals provide a glimpse of innovative re-
search in the UK focusing on standardized sublingual whole-cannabis ex-
tracts, and aerosol preparations that many believe represent the future of
standardized pharmaceutical cannabis delivery.
AIDS IN THE THIRD WORLD: A MODEST PROPOSAL
Since its discovery a mere two decades ago, acquired immune deficiency
syndrome (AIDS) has quickly become one of the world’s most challenging
publichealthissues.InitialcasesintheUSAandEuropemostlyaffectedho-
mosexual males and intravenous drug abusers, making it easy for those in
some quarters to relegate AIDS to some expression of heavenly revenge for
immoral behavior. This introduced a noteworthy roadblock into funding for
research(seeWerner’sarticleinthisissue).When“innocentvictims”suchas
transfusion recipients and babies with congenitally acquired infections ap-
pearedonthescene,publicsentimentsbegantochange.Soonenough,thedis-
easeprovedtobeapandemic,andnonewasimmunetoitsreach.Itnowaffects
36 million people worldwide (Piot et al. 2001).
ThecurrentspreadofAIDSisgreatestintheThirdWorld,with60%oftotal
cases in Africa, affecting an estimated 8% of the adult population (Thomas