Researchers at the the University of Florida received a $3.2 million grant from the National Institute on Drug Abuse (NIDA) to study people with HIV and AIDS and how cannabis affects their health and cognitive abilities.
With one of the highest rates of new HIV infections in the country, Florida is an ideal target for the study. The problem has reached such a crisis state that in 2016 the Centers for Disease Control (CDC) released an alarming forecast of rates of infection if the current trend in Florida continues. It predicted that 50 percent of black men who have sex with men and 25 percent of Latino men who have sex with men could eventually be infected.
Dr. Robert L Cook, a Univerity of Florida professor of epidemiology and the director of the Southern HIV and Alcohol Research Consortium, is painfully aware of the need to address this issue, He is curious about how people living with HIV are using cannabis and how it may be affecting them.
“We want to learn from people using marijuana about which specific patterns, modes of consumption, or types of marijuana they think are most beneficial for specific types of symptoms,” Dr. Cook said. “We also want to see whether different patterns of use, or presence of CBD, is associated with decreases in systemic inflammation as measured by blood tests and biomarkers of inflammation. We also want to see what happens when people change, from using whatever they can get in their community to a prescription product that they make take on a more prescribed basis.”
People living with HIV are often prescribed antiretroviral drugs to fight the infection. The drugs can take a great toll with side effects such as pain, lack of appetite and sleep problems. Patients report that it helps with appetite, nausea, sleep and pain. Previous research has shown that patients who use cannabis were over three times more likely to continue taking their prescription meds. This supports the reasoning of Florida and other states that list HIV and AIDS as qualifying conditions for state-licensed medical marijuana.
The University of Florida study will follow 400 patients who are already receiving medical care from specialists. As Dr. Cook pointed out to us, this research does not take place in a lab environment.
“Our current study will recruit primarily from HIV care settings. It is observational so we will only be asking people what they do, asking if they are acquiring from a dispensary (or not), and doing a urine test to see if they have different cannabinoids,” Dr. Cook said. “We are not dispensing any marijuana. Now that a much broader range of marijuana is available in Florida and HIV is a qualifying medical condition, we may see a lot of HIV+ persons switch over to the dispensary products.”
The great variety of products available in the medical marijuana market and lack of more sophisticated ability to homogenize ingredients and measure dosing make this type of scientific venture a challenge. Dr. Cook hopes that an additional benefit of their study will help narrow down the scope of products to a few that could later be examined and compared more closely.
“Given the huge range of potential products that people may use, one of the goals of our project is to try to narrow down the options that could be tested in future randomized clinical trials,” he said. “Ultimately, I hope we can conduct some clinical trials of ‘product A vs. product B’ to better inform patients, providers and policymakers.”
This will also provide an opportunity to monitor use patterns, possible misuse and any resulting changes “related to planning and motivation, to see whether these aspects of cognitive function change over time with increasing or decreasing marijuana use.”
Science sometimes answers a question with a better question. Although we will have to wait for answers on this one, results should shed further light on how cannabis may already be helping many Floridians with HIV and guide us to ask better questions for the next round of inquiry.