humulene and Acquired-Immunodeficiency-Syndrome

Palliative care aims to improve the quality of life in patients with incurable illness. Medicinal cannabis (MC) has been used in the palliative care setting to address multiple symptoms in patients.. To evaluate the full scope of available literature investigating the effects and potential harms of MC on symptom management and quality of life in palliative care.. PubMed, Embase, The Cochrane Library and clinicaltrials.gov were searched for eligible articles, published between 1960 and September 9, 2021. Quality of the evidence was assessed in accordance with Grading of Recommendations, Assessment, Development and Evaluations. Risk of bias was assessed using the RoB 2 tool for randomised controlled trials and the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool for non-randomized trials.. Fifty-two studies (20 randomised; 32 non-randomised) with 4786 participants diagnosed with cancer (n = 4491), dementia (n = 43), AIDS (n = 235), spasticity (n = 16), NORSE syndrome (n = 1) were included. The quality of evidence was 'very low' or 'low' for all studies, and low for only two randomised controlled trials. Positive treatment effects (statistical significance with P < 0.05) were seen for some MC products in pain, nausea and vomiting, appetite, sleep, fatigue, chemosensory perception and paraneoplastic night sweats in patients with cancer, appetite and agitation in patients with dementia and appetite, nausea and vomiting in patients with AIDS. Meta-analysis was unable to be performed due to the wide range of cannabis products used and the heterogeneity of the study outcomes.. While positive treatment effects have been reported for some MC products in the palliative care setting, further high quality evidence is needed to support recommendations for its use in clinical practice.

Topics: Acquired Immunodeficiency Syndrome; Analgesics; Cannabis; Dementia; Humans; Medical Marijuana; Nausea; Neoplasms; Palliative Care; Quality of Life; Vomiting

The use of cannabis (marijuana) or of its psychoactive ingredient delta-9-tetrahydrocannabinol (THC) as a medicine has been highly contested in many settings.There have been claims that smoked or ingested cannabis, either in its natural form or artificial form (pharmaceutically manufactured drug such as dronabinol), improves the appetites of people with AIDS, results in weight gain and lifts mood, thus improving the quality of life.. The objectives of this review were to assess whether cannabis (in its natural or artificially produced form), either smoked or ingested, decreases the morbidity or mortality of patients infected with HIV.. The search strategy was conducted to July 2012 and was based on that of the Cochrane HIV/AIDS Review Group. We searched the following databases: CENTRAL/CCTR, MEDLINE and EMBASE. In addition, searching was performed where necessary of journals, reference lists of articles, and conference proceedings.. The review included randomised controlled trials (RCTs) of any cannabis intervention, in any form, and administered by any route, in adults with HIV or AIDS, compared with placebo or with a known effective treatment, and conducted in a hospital, outpatient clinic, or home care setting. Quasi-randomised studies using any form of cannabis as an intervention in patients with HIV or AIDS were also included.. Data from the eligible studies were extracted and coded independently by two researchers, using a standardised data extraction form. Data were then analysed using RevMan 5.0. No meta-analyses were performed.. A total of seven relevant studies were included in the review, reported in eight publications. All were randomised controlled studies, with four utilising a parallel group design, two a within-subject randomisation and two a cross-over design. All of the studies were of a fairly short duration, ranging from 21 days to 84 days. In only four papers (in effect, three studies) were sequence generation and allocation concealment judged to be adequate. The use of cannabis and rapidly acting cannabinoids posed considerable challenges for blinding, as the psychoactive effects are expected to be quickly discernible to study participants, particularly those who have been previous users of such products. Dronabinol was expected to be more easily blinded. The outcomes measured were variable, including change in weight, change in body fat (measured as a percentage of total body weight), change in appetite (measured on a visual analogue scale), change in caloric intake (measured in kcals/kg/24hr), change in nausea and vomiting (measured on a visual analogue scale), change in performance (measured by Karnofsky performance score or specific tests for memory and dexterity) and change in mood (measured on a visual analogue scale).The evidence for substantial effects on morbidity and mortality is currently limited. Data from only one relatively small study (n=139, of which only 88 were evaluable), conducted in the period before access to highly-active antiretroviral therapy (HAART), showed that patients administered dronabinol were twice as likely to gain 2kg or more in body weight (RR 2.09), but the confidence interval for this measure (95% CI 0.72 - 6.06) included unity. The mean weight gain in the dronabinol group was only 0.1kg, compared with a loss of 0.4kg in the placebo group. However, the quality of sequence generation and allocation concealment in this study, in which participants were randomised by centre, could not be assessed.. Despite dronabinol being registered by at least some medicines regulatory authorities for the treatment of AIDS-associated anorexia, and some jurisdictions making allowances for the "medical" use of marijuana by patients with HIV/AIDS, evidence for the efficacy and safety of cannabis and cannabinoids in this setting is lacking. Such studies as have been performed have been of short duration, in small numbers of patients, and have focused on short-term measures of efficacy. Long-term data, showing a sustained effect on AIDS-related morbidity and mortality and safety in patients on effective antiretroviral therapy, has yet to be presented. Whether the available evidence is sufficient to justify a wide-ranging revisiting of medicines regulatory practice remains unclear.

Topics: Acquired Immunodeficiency Syndrome; Adult; Cannabinoids; Cannabis; Dronabinol; HIV Infections; Humans; Morbidity; Phytotherapy; Randomized Controlled Trials as Topic; Weight Gain

Among the immunosuppressive effects of marijuana, impairment of natural killer cell activity is significant. HIV also inhibits these cells. Friend leukemia virus complex and its helper component Rowson-Parr virus induce early immunosuppression in mice resembling human AIDS, and late leukemia, providing a small animal AIDS model. Leukemia susceptible BALB/c and resistant C57BL/6 mice were infected with these viruses. At different time points, their natural killer cells separated from spleens were treated with 0 to 10 micrograms/ml tetrahydrocannabinol, subsequently mixed with Yac-1 target cells for 4 and 18 h. The natural killer cell activity in both mouse strains infected by either virus complex or helper virus weakened on days 2 to 4 postinfection, normalized by day 8 and enhanced on days 11 to 14. Natural killer cell activity upon the effect of low concentration (1.0 to 2.5 micrograms/ml) of tetrahydrocannabinol slightly increased in BALB/c, was unaffected in C57BL/6, especially in 18 h assays. In the combined effects of marijuana and retrovirus, damages by marijuana dominated over those of retroviruses. Inhibition or reactive enhancement of natural killer cell activity on the effect of viruses are similar to those of infected but marijuana-free counterparts, but on the level of uninfected cells treated with marijuana. The effects of marijuana and retrovirus are additive resulting in anergy of natural killer cells.

Topics: Acquired Immunodeficiency Syndrome; Animals; Cannabis; Disease Models, Animal; Humans; Immunosuppression Therapy; Killer Cells, Natural; Mice; Retroviridae

Topics: Acquired Immunodeficiency Syndrome; Biomedical Research; California; Canada; Cannabinoids; Cannabis; Clinical Trials as Topic; Crohn Disease; Drug and Narcotic Control; Female; Humans; Inflammation; Leadership; Male; Medical Marijuana; Multiple Sclerosis; Pain; Policy Making; Research Personnel; Seizures; Stress Disorders, Post-Traumatic

Topics: Acquired Immunodeficiency Syndrome; California; Cannabis; Humans; Phytotherapy

Topics: Acquired Immunodeficiency Syndrome; California; Cannabis; Government Agencies; Hospices; Humans; Phytotherapy

Topics: Acquired Immunodeficiency Syndrome; Biomedical Research; Cannabinoids; Cannabis; Clinical Trials as Topic; Humans; Nausea; Nebulizers and Vaporizers; Pain; Phytotherapy; Time Factors; United States Government Agencies

Significant attention has been given to the debate regarding allowances for medical marijuana use since the 1996 California and Arizona ballot initiatives. State medical marijuana allowances, however, have existed since the mid-1970s. Much of the current debate stems from confusion about the various ways states approach the issue. In this paper, we present original legal research on current state medical marijuana laws identifying four different ways states statutorily enable the medical use of marijuana. We discuss the tension these approaches have with federal law as well as their implications regarding real access for patients. In addition, we present information on how a small number of states are trying to deal with the issue of access within the context of their medical marijuana laws, and discuss the implication of various supply approaches on the enforcement of other state marijuana laws.

Topics: Acquired Immunodeficiency Syndrome; California; Cannabis; Drug and Narcotic Control; Drug Prescriptions; Federal Government; Glaucoma; Humans; Legislation, Medical; Neoplasms; Pain; Palliative Care; State Government; Therapeutic Human Experimentation; United States

As previously reported in this publication, in January 2002 the Ontario Court of Appeal denied Jim Wakeford's claim that Canada's laws prohibiting marijuana possession and cultivation infringe his constitutional rights to liberty and security of the person. On 22 November 2002 the Supreme Court of Canada announced that it would not hear his appeal from that decision.

Topics: Acquired Immunodeficiency Syndrome; Canada; Cannabis; Humans; Illicit Drugs; Phytotherapy

Topics: Acquired Immunodeficiency Syndrome; Cannabis; District of Columbia; Drug and Narcotic Control; Humans; Lobbying; Palliative Care; Patient Advocacy; Phytotherapy; Politics

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Crime; Drug and Narcotic Control; Epilepsy; Evidence-Based Medicine; Humans; Marijuana Abuse; Multiple Sclerosis; Neoplasms; Ontario; Patient Advocacy

Topics: Acquired Immunodeficiency Syndrome; California; Cannabis; Drug and Narcotic Control; Government Agencies; Humans; Interinstitutional Relations; National Institutes of Health (U.S.); Public Health Administration; United States

Topics: Acquired Immunodeficiency Syndrome; Canada; Cannabis; Humans; Phytotherapy; United States

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Drug and Narcotic Control; Drug Industry; Evidence-Based Medicine; Humans; Neoplasms; Palliative Care; United States

The Institute of Medicine (IOM) released its conclusions and recommendations regarding the medical use of marijuana based on a study it conducted. The Institute found that cannabinoids (a class of chemicals found in marijuana) have important symptom-management uses for many patients, but marijuana smoke is harmful like tobacco smoke. IOM made six recommendations: more research into physiological effects of cannabinoids; development of safer delivery systems; more studies of psychological effects of such drugs; studies of the health risks associated with smoking marijuana; controlled trials of marijuana for medical purposes; and use of the drug for patients with debilitating symptoms under certain conditions. Excerpts from the prepublication copy of the report are included.

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Humans; Internet; Marijuana Smoking; National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; Palliative Care; Phytotherapy

Topics: Acquired Immunodeficiency Syndrome; Anti-Anxiety Agents; Cannabis; Hiccup; Humans; Male; Marijuana Smoking; Midazolam; Phytotherapy

Topics: Acquired Immunodeficiency Syndrome; Cannabinoids; Cannabis; Humans; Legislation, Drug; Risk Assessment; Societies, Medical; United Kingdom

AIDS funding for fiscal year 1999 saw large increases in Congress, according to the AIDS Action Council. Increases included funds to fight the epidemic in the African-American community, ADAP funding increases, overall funding for research programs, and substance abuse treatment and prevention programs. AIDS Action Council attributes the increases to a heavily distracted Congress and a budget surplus, and is forecasting that this increase is not a trend that will continue for the next fiscal year. Congress also passed a resolution requiring the FDA to report on the possibility of marijuana being approved as a prescription drug. This report has to be compiled in 90 days. There is concern that the FDA will be unable to meet this time requirement.

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Financing, Government; Humans; Medical Assistance; Needle-Exchange Programs; Phytotherapy; Politics; Research Support as Topic; Substance-Related Disorders; United States

Topics: Abortion, Induced; Acquired Immunodeficiency Syndrome; Animals; Bioethical Issues; Bioethics; Cannabis; Cloning, Organism; Disabled Persons; Employment; Fetus; Genetic Testing; HIV Seropositivity; Human Experimentation; Humans; Jurisprudence; Managed Care Programs; Motivation; Organ Transplantation; Physicians; Pregnancy; Pregnant Women; Privacy; Psychotropic Drugs; Refusal to Treat; Suicide, Assisted; Terminally Ill; Transplantation, Heterologous; Treatment Refusal; United States

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Dronabinol; Humans; Neoplasms

Topics: Acquired Immunodeficiency Syndrome; California; Cannabis; Communication; Disclosure; Federal Government; Government Regulation; Humans; Jurisprudence; Legislation, Drug; Nausea; Physician-Patient Relations; Risk Assessment; United States

Topics: Acquired Immunodeficiency Syndrome; Antineoplastic Agents; Cannabis; Dronabinol; Humans; Nausea; Neoplasms; Phytotherapy; Vomiting

Topics: Acquired Immunodeficiency Syndrome; Adult; Cannabis; Empathy; Humans; Male; Phytotherapy

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Chemotherapy, Adjuvant; Drug Approval; Humans; Marijuana Smoking; Muscle Spasticity; Nausea; United States

U.S. District Judge David Sam of Utah ruled that [name removed]'s estate could not proceed with an Americans with Disabilities Act (ADA) lawsuit brought against [name removed]. Prior to his death, [name removed] sued his employer, [name removed], for back pay, damages for intentional infliction of emotional distress, and a court order enjoining the company from violating the ADA. The suit dates back to 1993, when [name removed] was required to undergo random drug screening under the company's drug-free workplace policy. At that time it was determined that [name removed] was taking Marinol to combat AIDS-related symptoms of nausea and appetite loss. The company dismissed [name removed] and refused to let him return to work unless his medical records could be scrutinized. As [name removed]'s condition deteriorated in 1996, his attorneys pressed for accelerated discovery proceedings; [name removed] died before these proceedings could be completed. Judge Sam ruled that in the State of Utah, an ADA lawsuit does not survive a plaintiff's death.

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Death; Disabled Persons; Employment; Humans; Male; Prejudice; Utah

Topics: Abortion, Induced; Acquired Immunodeficiency Syndrome; Adolescent; AIDS Serodiagnosis; Bioethical Issues; Bioethics; Cannabis; Cloning, Organism; Disabled Persons; Disclosure; Electroconvulsive Therapy; Embryo Research; Euthanasia; Federal Government; Genetic Privacy; Government; Health Maintenance Organizations; Health Personnel; HIV Seropositivity; Human Experimentation; Humans; Iatrogenic Disease; Informed Consent; Insurance, Life; Jurisprudence; Minors; Occupational Exposure; Parents; Patient Advocacy; Pedigree; Posthumous Conception; Privacy; Professional Misconduct; Psychotropic Drugs; Religion; Reproduction; Reproductive Techniques, Assisted; Research; Resuscitation Orders; Social Change; State Government; Suicide, Assisted; Third-Party Consent; Treatment Refusal; United States; Wrongful Life

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Humans; Illicit Drugs; San Francisco

Manhattan Criminal Court Judge Robert M. Stolz has refused to dismiss charges of marijuana possession and distribution against [name removed] was arrested for selling marijuana to a man with AIDS in a New York City park. [Name removed] claims that he sold marijuana at cost to HIV/AIDS patients with wasting syndrome. [Name removed]'s argument that his actions are justifiable on humanitarian grounds will be decided by a jury. Judge Stolz noted that the therapeutic administration of marijuana demands medical supervision and that [name removed]'s actions were indistinguishable from those of illegal drug dealers.

Topics: Acquired Immunodeficiency Syndrome; Cachexia; Cannabis; Drug and Narcotic Control; Humans; Illicit Drugs; Male; Nausea

The Clinton Administration is continuing to block the research efforts of Dr. Donald Abrams, University of California, San Francisco, to study the safety and effectiveness of marijuana in stimulating the appetites and reducing nausea of people with AIDS wasting syndrome. Dr. Abrams does not require money for the study, but he does need a supply of the marijuana. Since the National Institute on Drug Abuse (NIDA) is the Federal agency responsible for the supply of marijuana for clinical research, NIDA informed Dr. Abrams that he must submit a grant application to an NIH peer-review panel that will determine whether the research protocol has scientific merit. After submitting a grant proposal, the National Institute of Allergy and Infectious Diseases (NIAID) rejected Dr. Abrams' application. The Marijuana Policy Project contends that the peer-review approval is a ploy to block research, or delay it until after the presidential election. They continue to work to persuade Congress to require NIDA to provide marijuana to all FDA-approved medicinal marijuana studies, as it did in the late 1970s and early 1980s. A sample letter-to-the-editor advocating the use of marijuana as a useful medicine for the treatment of AIDS and other diseases is also included.

Topics: Acquired Immunodeficiency Syndrome; Cachexia; Cannabis; Humans

Police raided the Cannabis Buyers' Club and confiscated the club's supply of pure marijuana and drug-laced baked goods. Although the club's purpose was to supply people with AIDS and cancer with marijuana, the California Attorney General's office says healthy people were being supplied as well. Many see the raid as a way to derail Proposition 215, which would give individuals the right to grow marijuana for personal medicinal purposes. Interested parties who wish to help or make financial contributions to the organization should call Californians for Compassionate Use.

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Humans; Neoplasms; Police; San Francisco

Recent raids on buyers' clubs in San Francisco have focused attention on medicinal uses of marijuana. The Clinton administration's policy is that there is no scientific evidence that smoked marijuana is useful in treating pain and nausea in AIDS and cancer patients. However, mainstream medical literature has supported the use of cannabis in managing symptoms of diseases such as glaucoma and multiple sclerosis. Well designed, controlled studies of marijuana are needed to determine the effective medical uses of the drug and break the political stalemate on this issue.

Topics: Acquired Immunodeficiency Syndrome; Cannabinoids; Cannabis; Government; Health Policy; Humans; Neoplasms; Pain; Palliative Care; Politics; United States

Many people living with HIV use marijuana to manage agitation, spasms, chronic pain, depression, nausea arising from chemotherapy, and loss of appetite. Concerns over the use of marijuana or dronabinol (a pharmaceutical version of tetrahydrocannabinol or THC) include potential contamination from pesticides or other chemicals used in the growing process, and the potential of increasing the likelihood of lung infections. Use of THC is associated with reduced levels of testosterone and may have similar effects on other hormones in women. THC can also interact with other mood-altering medications such as Valium, librium, Xanax, seconal, Nembutal, or phenobarbital, by exaggerating their effect.

Topics: Acquired Immunodeficiency Syndrome; Appetite Stimulants; Cannabis; Dronabinol; Humans

Voters in California and Arizona decided that the medical use of marijuana should be legal and available to treat people with terminal illnesses, such as AIDS. These initiatives were opposed by both President Clinton and his challenger Bob Dole, and three former presidents warn that these measures will undermine drug prevention efforts. Law enforcement officials in both States campaigned against these initiatives. The measures do not change Federal laws, leaving physicians with a legal dilemma. If physicians prescribe marijuana, the Drug Enforcement Administration could investigate them and revoke their licenses to dispense prescriptions.

Topics: Acquired Immunodeficiency Syndrome; Arizona; California; Cannabis; Humans; Legislation, Drug; Politics

Topics: Acquired Immunodeficiency Syndrome; Altruism; American Medical Association; Beneficence; Cannabis; Codes of Ethics; Ethics, Professional; Federal Government; Freedom; Government; Government Regulation; Humans; Jurisprudence; Palliative Care; Patients; Personal Autonomy; Physician-Patient Relations; Physicians; Psychotropic Drugs; Social Control, Formal; Societies; Terminally Ill; United States

Topics: Acquired Immunodeficiency Syndrome; Cachexia; Cannabis; Clinical Protocols; Drug and Narcotic Control; Health Policy; Humans; Marijuana Smoking; United States; United States Food and Drug Administration

Topics: Acquired Immunodeficiency Syndrome; Cachexia; Cannabis; Humans; Legislation, Drug; Research Support as Topic; United States

Topics: Acquired Immunodeficiency Syndrome; Appetite; Cachexia; Cannabis; Drug Approval; Humans; United States

The Gay and Lesbian Medical Association (GLMA) issued a statement on May 19, 1995, announcing its support of clinical trials of the therapeutic uses of marijuana. The U.S. Department of Health and Human Services has continued to resist permitting clinical trials of marijuana despite evidence that it can relieve symptoms of cancer, multiple sclerosis, and glaucoma. According to Dr. Alvin Novick, head of GLMA's AIDS Task Force, the Clinton Administration is being asked to not let its political fears blind it to the positive and legitimate scientific research designed to alleviate the suffering of thousands of AIDS patients.

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Clinical Trials as Topic; Glaucoma; Humans; Multiple Sclerosis; Neoplasms; Organizations, Nonprofit; United States

A Pierce County judge has ruled that physicians can prescribe marijuana for medical purposes. Judge Rosanne Buckner decided that lawyer [name removed], who is undergoing treatment for bone cancer, can use marijuana to ease the pain associated with chemotherapy. Buckner ruled that the patient's interest in using marijuana as a medicine outweighs Washington's interest in outlawing prescriptions for it. Assistant Attorney General Melissa Burke-Cain plans to appeal this decision.

Topics: Acquired Immunodeficiency Syndrome; Bone Neoplasms; Cannabis; Humans; Marijuana Smoking; Minnesota; Pain; Washington

Topics: Acquired Immunodeficiency Syndrome; Antiemetics; Antineoplastic Agents; Cannabis; Glaucoma; Humans; Nausea; Nutrition Disorders; United States; United States Public Health Service

In a cohort of 249 male sexual contacts of men with acquired immunodeficiency syndrome (AIDS) or an AIDS-related condition in Toronto, Ontario, Canada, 143 cohort members were seropositive on enrollment and 16 seroconverted between initial recruitment in July 1984 to July 1985 and December 1988. Data on age, smoking and drinking status, recreational drug use, and history of sexually transmitted diseases and other diseases were obtained from interviews at induction and during follow-up on the cohort members every 3 months. Cox relative risk regression models, in which time was calculated from estimated date of human immunodeficiency virus (HIV) infection for seroprevalent cohort members and from 90 days prior to the first positive test for seroconverters, examined the potential effect of use of a variety of recreational drugs and the occurrence of selected infections on the risk of development of AIDS. Thirty-five cohort members developed AIDS while under study. No significant association with risk of progression to AIDS was noted for use of various recreational drugs (singly or in combination), history of specific infections, age at enrollment, or smoking and drinking status at enrollment. Only estimated duration of HIV infection appeared to be associated with increasing risk of development of AIDS.

Topics: Acquired Immunodeficiency Syndrome; Amphetamines; Barbiturates; Cannabis; Cocaine; Cohort Studies; Follow-Up Studies; HIV Seropositivity; Humans; Lysergic Acid Diethylamide; Male; Risk Factors; Sexual Partners; Substance-Related Disorders; Time Factors

Topics: Acquired Immunodeficiency Syndrome; Cannabis; Humans; Risk

Embryonal cell carcinoma of the testis was seen in 2 homosexuals with peripheral lymphadenopathy of the head and neck, and abnormal cellular immunity measured by reduced T helper cells and increased T suppressor cells. One patient had no history of venereal disease but had taken marijuana, nitrites and methyl-dextroamphetamines regularly. The other patient had a history of syphilis, gonorrhea, hepatitis and venereal warts but rarely used inhalant recreational drugs. Both patients had smoked cigarettes. Neither patient had any known risk factors that predisposed to testicular cancer. Biopsy of a supraclavicular lymph node in 1 patient showed histological features of reactive follicular hyperplasia similar to those described previously in the acquired immune deficiency syndrome. These cases of testicular cancer increase the spectrum of rare cancers developing in young male homosexuals with acquired cellular immune abnormalities.

Topics: Acquired Immunodeficiency Syndrome; Adult; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cannabis; Cisplatin; Gonorrhea; Hepatitis; Homosexuality; Humans; Immunity, Cellular; Male; Nitrites; Substance-Related Disorders; Syphilis; T-Lymphocytes, Helper-Inducer; T-Lymphocytes, Regulatory; Teratoma; Testicular Neoplasms; Vincristine