Marijuana Rivals Mainstream Drugs for Alleviating HIV/AIDS Symptoms

May 29, 2009

Science Daily/SAGE Publications

Those in the United States living with HIV/AIDS are more likely to use marijuana than those in Kenya, South Africa or Puerto Rica to alleviate their symptoms, according to a new study published in Clinical Nursing Research, published by SAGE. Those who did use marijuana rate it as effective as prescribed or over the counter (OTC) medicines for the majority of common symptoms, once again raising the issue that therapeutic marijuana use merits further study and consideration among policy makers.

A significant percentage of those with HIV/AIDS use marijuana as a symptom management approach for anxiety, depression, fatigue, diarrhoea, nausea, and peripheral neuropathy. Members of the University of California, San Francisco (UCSF) International HIV/AIDS Nursing Research Network examined symptom management and quality of life experiences among those with HIV/AIDS in the US, Africa, and Puerto Rico, to gain a fuller picture of marijuana’s effectiveness and use in this population.

With data from a longitudinal, multi-country, multi-site, randomised control clinical trial, the researchers used four different evaluation tools to survey demographics, self-care management strategies for six common symptoms experienced by those living with HIV/AIDS, quality of life instrument and reasons for non-adherence to medications.

Either marijuana use for symptom management is vastly higher in the US, or participants elsewhere chose not to disclose that they use it: nine tenths of study participants who said they used marijuana live in the US. No African participants said they used it, and the remaining ten percent were from Puerto Rico.

The researchers found no differences between marijuana users and nonusers in age, race, and education level, income adequacy, having an AIDS diagnosis, taking ARV medications, or years on ARV medications. But the two groups did differ in that marijuana users had been HIV positive longer, and were more likely to have other medical conditions. Transgender participants were also more likely to use marijuana.

Participants using marijuana as a management strategy were spread fairly consistent across all six symptoms, ranging from a low of 20% for fatigue to a high of 27% for nausea. Prescribed medications were used by 45% of those with fatigue, ranging down to almost 18% of those with neuropathy.

The findings contained nuances when comparing marijuana to other medications. Those who used marijuana rated their anxiety significantly lower than those who did not, and women who used marijuana had more intense nausea symptoms. For those who use both marijuana and medications for symptom management, antidepressants were considered more effective than marijuana for anxiety and depression, but marijuana was rated more highly than anti-anxiety medications. Immodium was better for diarrhoea than marijuana, as were prescribed medications for fatigue. However, marijuana was perceived to be more effective than either prescribed or OTC medications for nausea and neuropathy. However, the differenced in perceived efficacy in all these results were slight.

As found in previous studies, those who used marijuana were less likely to comply with their regime of ARV medications. But perhaps counter-intuitively of the many reasons given for skipping pills, ‘forgetfulness’ was no different in this group than among those who did not use marijuana. Marijuana use is known to contribute to patients’ lack of compliance with ARV drugs, however those who use marijuana to target a particular symptom are actually more likely to stick closely to their ARV regimen too. The researchers point out that of those who used marijuana for their symptoms, it is not known whether they also used the drug for recreation. Patterns of how marijuana use interferes with patients’ adherence to medication regimens, along with other drugs, warrant further study.

The 775 participants were recruited from Kenya, South Africa, two sites in Puerto Rico, and ten sites in the United States. They had on average been diagnosed for a decade - the majority (70%) were taking anti-retroviral (ARV) medications and more than half had other medical conditions alongside HIV/AIDS. It is hard to pinpoint the marijuana use targeted to alleviate symptoms of those other illnesses as distinct from those relating solely to HIV/AIDS.

Data suggest that marijuana is a trigger among those susceptible to psychosis, and is also associated with the risk of suicidal thoughts. However it is not linked to an increased risk of lung cancer (over and above risks associated with smoking it along with tobacco).

The question of the use of marijuana for symptom management when legal drugs are available remains a practice and policy issue.

“Given that marijuana may have other pleasant side effects and may be less costly than prescribed or OTC drugs, is there a reason to make it available?” asks study leader Inge Corless.  “These are the political ramifications of our findings. Our data indicate that the use of marijuana merits further inquiry.”

https://www.sciencedaily.com/releases/2009/05/090529081627.htm

Mindful movement may help lower stress, anxiety

June 21, 2018

Science Daily/Penn State

Taking a walk may be a good opportunity to mentally review your to-do list, but using the time to instead be more mindful of your breathing and surroundings may help boost your wellbeing, according to researchers who found that while students reported being less stressed while they were on their feet and moving, they received an even greater benefit when they reported also being more mindful.

The researchers found that while students reported being less stressed while they were on their feet and moving, they received an even greater benefit when they reported also being more mindful.

Chih-Hsiang "Jason" Yang, a postdoctoral scholar at the University of Southern California who led the study while earning his doctorate at Penn State, said the results suggest a simple way for people to boost their wellbeing throughout the day.

"It can be difficult to ask people to spend a lot of time doing moderate or vigorous activity by going to the gym or out for a run, especially if they feel stressed," Yang said. "But if they don't need to change their everyday behavior, and can instead try to change their state of mind by becoming more mindful, they can probably see this beneficial effect. You don't need to exert a lot of extra effort in order to improve your wellbeing by being more mindful while you're moving around."

David Conroy, professor of kinesiology at Penn State, also said the findings -- recently published in the journal Psychology of Sports and Exercise -- could help people who are not able to engage in strenuous exercise.

"If someone is looking for a way to manage these kinds of feelings, it may be worth trying some sort of mindful movement," Conroy said. "This option may be especially beneficial for people who don't enjoy exercise and would prefer a less intense form of physical activity."

According to the American College Health Association, more than half of college students experience anxiety, sadness or mental exhaustion at least once a year, suggesting a need for a simple way to reduce these negative states. Because students are often moving throughout their days, as they walk to class and go about other activities, the researchers wanted to see if there was a connection between mindfulness, movement and a reduction in negative states.

The researchers recruited 158 Penn State students for the study. For two weeks, a special mobile phone app, called Paco, randomly prompted the participants eight times a day to answer questions about their current activity and states of mind. The prompts included questions about where the participant was, if they were moving, and if they were stressed or anxious, as well as questions designed to assess mindfulness.

After analyzing the data, the researchers found that in the moments when participants were more mindful or active than usual, they showed reduced negative affect. They also found a possible synergistic effect when people were both mindful and active.

"When people were both more mindful and more active than usual, they seem to have this extra decrease in negative affect," Yang said. "Being more active in a given moment is already going to reduce negative affect, but by also being more mindful than usual at the same time, you can see this amplified affect."

Conroy said it was interesting to see patterns emerge within the individual participants, instead of just comparing people who are generally more mindful to people who are generally less mindful.

"Most studies in this area have focused on the differences between people who are more versus people who are less mindful, but we saw that college students often slipped in and out of mindful states during the day," Conroy said. "Developing the ability to shift into these states of mindfulness as needed may be valuable for improving self-regulation and well-being."

To better explore the causal role of mindfulness on lower negative states of being, Yang completed a second study, in which older adults who participated in an outdoor mindfulness activity then reported on their feelings of stress, anxiety and depression. Yang found that the mindful walking was associated with lower levels of these feelings.

The researchers said that in the future, studies that collect more objective data -- like gathering information about physical activity by using accelerometers -- and include more varied populations could be useful.

https://www.sciencedaily.com/releases/2018/06/180621112007.htm