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Medical Marijuana and HIV: Can It Help?

Medically reviewed by Barry S. Zingman, M.D.
Written by Simi Burn, PharmD
Posted on April 4, 2023

If you’re living with HIV, you may wonder about the risks and benefits of using marijuana or cannabis. This is a common topic on myHIVteam, where members often ask questions and share their experiences.

“How do I know which kind of cannabis to buy?” one member asked. Another said, “I have to use cannabis for my pain, and it helps me a lot.”

Some people living with HIV say marijuana helps with their symptoms, medication side effects, and quality of life. A survey of 523 people with HIV found that up to one-third said they smoked marijuana or used it in other forms, for many reasons including nerve pain relief, appetite stimulation, stress relief, and sleep.

Although some studies show that marijuana may have benefits for HIV-related symptoms, it’s not for everyone and there are risks to consider. Talk to your health care provider about your needs.

What Is Cannabis?

Cannabis is short for the plant Cannabis sativa, a natural product with many varieties. Cannabis has been used in traditional medicine for thousands of years for the treatment of many conditions such as pain, nausea, and epilepsy. Some people smoke cannabis flowers from the plant, but they can also be processed to make different types of products such as edible products, beverages, concentrated oils, tinctures, vaporized products for inhalation, or topical products.

The endocannabinoid system is a physiological system that helps your body stay balanced. Your body naturally produces endocannabinoids, which are chemicals that act on receptors of the endocannabinoid system in different ways. The endocannabinoid system regulates many functions of your body, like pain, stress, the immune system, and sleep. Cannabis plants naturally contain hundreds of compounds called cannabinoids, terpenes, and flavonoids that act on the endocannabinoid system receptors.

What Is Marijuana?

The term “marijuana” refers to a product made from the Cannabis sativa plant that contains significant amounts of the substance tetrahydrocannabinol (THC), which is the mind-altering component of cannabis that gives people a “high” feeling. THC is also responsible for cannabis side effects like anxiety and a racing heart.

While some studies have reviewed the impact of using marijuana for HIV, others have investigated the use of cannabis for the condition.

What Is CBD?

Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (delta-9-THC) are two of the cannabinoids found in cannabis plants and products. CBD does not have intoxicating effects and is legal to buy in most states.

Legal Status of Cannabis

Although many states have passed laws that allow medical use or adult use (recreational) of cannabis consumption, products that contain more than 0.3 percent THC are illegal at the federal level. If you are considering trying cannabis, check the laws in your state to find out what is legal where you live.

Potential Benefits of Marijuana

Marijuana may provide multiple uses for people living with HIV. Research has found that it may help improve quality of life in several ways and may help with:

  • Nerve pain
  • Nausea and appetite stimulation
  • Sleep
  • Anxiety and depression

Nerve Pain

Nerve pain, also called neuropathy or neuropathic pain, is an HIV symptom that is caused by damage to the nerves. Symptoms of nerve pain can include tingling, loss of sensation, or pins and needles. Nerve pain affects between 13 percent and 50 percent of people living with HIV.

A study of 50 people with HIV-related nerve pain found that smoking cannabis reduced their pain by 34 percent. Another study of 34 people evaluated whether smoking cannabis helped with HIV-related nerve pain that wasn’t relieved by other pain medications. For nearly half of the study participants, cannabis reduced the amount of HIV-associated nerve pain they felt by 30 percent or more.

Many HIV experts say medical cannabis is an option for the treatment of HIV-related nerve pain in some people, but they also warn that its use should be balanced against any potential risks.

Nausea and Appetite Stimulation

Many people find that marijuana increases their appetite — this is referred to as “the munchies.” One myHIVteam member shared, “I smoke marijuana to help with my appetite so I can eat.”

People living with HIV may experience a loss of appetite or unexplained weight loss, and nausea can be a side effect of some HIV treatments. If you are living with HIV and experiencing these symptoms, you might be wondering if marijuana can help you manage nausea or boost your appetite.

Some studies show that cannabinoids, including CBD and THC, work on endocannabinoid system receptors in the body that may help reduce nausea. Dronabinol (Marinol) is a prescription medication that is a synthetic form of THC. Dronabinol is approved by the U.S. Food and Drug Administration (FDA) as a treatment for appetite and weight loss associated with AIDS. It’s also approved for treating nausea in people with cancer who are receiving chemotherapy.

Clinical trials in people with HIV have found that dronabinol stimulates the appetite. One study from the Journal of Acquired Immune Deficiency Syndromes evaluated the effects of dronabinol in 10 people living with HIV who normally smoked marijuana. The study authors found that both dronabinol and smoked cannabis were well tolerated and increased how much food the participants ate. However, there are no scientific studies that are well designed and thorough enough to show how different types of marijuana affect people compared to the synthetic THC in dronabinol.

Sleep

Insomnia and trouble sleeping are common among people living with HIV, and some individuals use marijuana to help with this issue. As one myHIVteam member shared, “Medical marijuana has been helping me to sleep and better deal with anxiety and stress.” Another member said, “I’ve had trouble sleeping each of the three nights while I am traveling. I believe this is because I have no marijuana with me.”

Surveys of those who use cannabis show that many people say it helps them sleep, but the scientific research is mixed. It may depend on the type and amount of cannabis used and whether products have more THC or CBD. Some early research shows that cannabis products containing THC may help shorten the time it takes to fall asleep after you lie down.

Anxiety or pain can create a vicious cycle that makes it difficult to get a good night’s sleep. Marijuana may help some people sleep by working on the underlying reasons for their insomnia.

For example, mental health conditions like anxiety and depression can interfere with sleep, but a lack of sleep can increase the risk of anxiety and depression. Some research shows that CBD may help reduce anxiety and promote sleep.

If chronic pain keeps you awake night after night, the lack of sleep can make the pain worse. Some cannabis products may promote sleep by reducing pain, with the added side effect of sleepiness.

Risks of Marijuana and Cannabis

Marijuana and cannabis are often marketed as treatments for many ailments, but they aren’t necessarily proven by well-designed and thorough studies. If you are considering using marijuana or cannabis, there could be serious risks such as side effects or interactions with your other medications.

Risks depend on the type of cannabis product you use. Possible adverse effects may include:

  • Altered senses or hallucinations
  • Anxiety or paranoia
  • Changes in mood
  • Impaired memory
  • Lung damage or breathing problems from smoking cannabis
  • Severe vomiting, which could be a sign of a serious health emergency called cannabinoid hyperemesis syndrome
  • Cannabis addiction, when a person needs to continue using cannabis regularly to avoid withdrawal symptoms, or is unable to stop using cannabis although it is negatively affecting their health or quality of life
  • Worsening symptoms in people living with schizophrenia

Ask your health care provider to help you decide whether marijuana and cannabis products are safe for you. The FDA has found that many CBD products on the market do not contain the amount of CBD they claim on the label. Many cannabis products have also been shown to contain potentially harmful substances, such as toxic chemicals or high amounts of mercury or other dangerous minerals, due to poor processing and quality control. Protect your safety by purchasing products from a legal and reputable source that has independent lab testing for quality and safety.

Connect With Others Who Understand

Are you or a loved one living with HIV? Consider joining myHIVteam today. Here, more than 36,000 people come together to connect with others who understand life with HIV. You can share your story, join ongoing conversations, and find a team made up of people from around the world who will support you through your journey.

Have you tried using marijuana to ease HIV symptoms? Did it help you? Share your questions or thoughts in the comments below or by posting on myHIVteam.

References
  1. Cannabis Use in HIV for Pain and Other Medical Symptoms — Journal of Pain and Symptom Management
  2. History of Cannabis and the Endocannabinoid System — Dialogues in Clinical Neuroscience
  3. An Introduction to the Endogenous Cannabinoid System — Biological Psychiatry
  4. Cannabis Sativa: The Plant of the Thousand and One Molecules — Frontiers in Plant Science
  5. Cannabis (Marijuana) and Cannabinoids: What You Need To Know — National Center for Complementary and Integrative Health
  6. The Effects of Cannabidiol, a Non-Intoxicating Compound of Cannabis, on the Cardiovascular System in Health and Disease — International Journal of Molecular Sciences
  7. Cannabinoids: Therapeutic Use in Clinical Practice — International Journal of Molecular Sciences
  8. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD) — U.S. Food and Drug Administration
  9. HIV-Related Neuropathy: Pathophysiology, Treatment and Challenges — Journal of Neurology and Experimental Neuroscience
  10. Cannabis in Painful HIV-Associated Sensory Neuropathy: A Randomized Placebo-Controlled Trial — Neurology
  11. Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial — Neuropsychopharmacology
  12. 2017 HIVMA of IDSA Clinical Practice Guideline for the Management of Chronic Pain in Patients Living With HIV — Clinical Infectious Diseases
  13. Exploring the Munchies: An Online Survey of Users’ Experiences of Cannabis Effects on Appetite and the Development of a Cannabinoid Eating Experience Questionnaire — Journal of Psychopharmacology
  14. Regulation of Nausea and Vomiting by Cannabinoids — British Journal of Pharmacology
  15. Label: Dronabinol Capsule — DailyMed
  16. Clinical Utility of Dronabinol in the Treatment of Weight Loss Associated With HIV and AIDS — HIV/AIDS: Research and Palliative Care
  17. Dronabinol and Marijuana in HIV-Positive Marijuana Smokers. Caloric Intake, Mood, and Sleep — Journal of Acquired Immune Deficiency Syndromes
  18. Effectiveness of Raw, Natural Medical Cannabis Flower for Treating Insomnia Under Naturalistic Conditions — Medicines
  19. Cannabis, Cannabinoids, and Sleep: A Review of the Literature — Current Psychiatry Reports
  20. Chronic Insomnia as a Risk Factor for Developing Anxiety and Depression — Sleep
  21. Cannabidiol in Anxiety and Sleep: A Large Case Series — The Permanente Journal
  22. Sleep Deficiency and Chronic Pain: Potential Underlying Mechanisms and Clinical Implications — Neuropsychopharmacology
  23. Cannabis-Based Products for Chronic Pain: A Systematic Review — Annals of Internal Medicine
  24. Cannabis (Marijuana) DrugFacts — National Institute on Drug Abuse
  25. Cannabinoid Hyperemesis Syndrome — Cedars-Sinai
  26. Warning Letters and Test Results for Cannabidiol-Related Products — U.S. Food and Drug Administration
    Posted on April 4, 2023
    All updates must be accompanied by text or a picture.

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    Barry S. Zingman, M.D. specializes in HIV/AIDS medicine and general infectious disease. Review provided by VeriMed Healthcare Network. Learn more about him here
    Simi Burn, PharmD is a seasoned pharmacist with experience in long-term care, geriatrics, community pharmacy, management, herbal medicine, and holistic health.. Learn more about her here

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