MEDICAL POT USED BY NEARLY ONE-THIRD OF ONT. HIV PATIENTS

Rate is double that of British Columbia

TORONTO - Almost one in three HIV patients in Ontario is using marijuana for
medical reasons, according to a study presented at the 2003 Ontario HIV
Treatment Network research conference.

Of HIV-positive Ontarians, 29% use marijuana medically - almost double the
14% rate found in a British Columbia study published in 2001, said study
presenter Michelle Furler, a PhD student in pharmaceutical science at the
University of Toronto.

But the rate is consistent with research on medical marijuana use among
HIV-positive people in the U.S., she said.

The difference may arise, Furler suggested, because the B.C. survey was
conducted through that province's drug access program. Patients may have
been wary of being truthful.

By contrast, the Ontario survey was based on in-depth interviews on
complementary and alternative medicines with 104 people (55 of them men)
across the province between 1999 and 2001, as well as on chart reviews using
the HIV Ontario Observational Database.

Questions about marijuana came late in the interview, when the subjects were
comfortable with the process, she said.

The result is also consistent with a questionnaire-based anonymous survey
carried out in Toronto, Ottawa and Montreal by researchers preparing for a
randomized controlled trial of marijuana in HIV-positive people, said Sergio
Rueda, a PhD student at the University of Toronto, who was one of the
authors of the three-city study.

That survey showed about 37% of HIV-positive patients were smoking the drug,
he said. The response rate, however, (40%) was "very, very low."

In the Ontario study, 43% reported they had smoked the drug for any reason
during the year before their interview, but 29% - about two-thirds of the
smokers - said they had used it for medical reasons.

The main goals were to gain weight or increase appetite, aid sleep, and
alleviate nausea and vomiting. Significantly more women than men (45% versus
5%) used the drug for pain management.

Furler said she and her colleagues found clear differences between those who
used the drug for therapeutic purposes and those who used it for fun.

Strikingly, medical users were 10 times more likely to be poor - with a
family income of less than $20,000 a year - and three times more likely to
be unemployed.

Furler said the cause of the link between poverty, unemployment and medical
marijuana use is hard to tease out. "We can't say why it happens, we can
just say it happens," she said.

But, she added, it is possible poorer health is linked to inability to work,
which might lead to a greater need for medical marijuana. On the other hand,
the study showed no statistical differences in the usual markers of
ill-health in HV patients - CD4 cell count and viral loads.

As well, she said, medical users smoked the drug more often - 40% reported
daily use, compared to 13% of the non-medical users.

For the physician treating HIV patients, the study raises a red flag: 73% of
the medical users thought their doctor was aware of their drug use, but only
23% of their medical charts reflected that fact.

By contrast, Furler said, 27% of those who used the drug for recreation said
their doctor knew about it and 20% of the charts recorded the marijuana use.