A small study among PLWH found no association between prescription opioid misuse or pain levels and the concurrent use of marijuana. However, the herb was linked to three-fold greater odds of a detectable viral load compared to participants not using it. The findings were published in the Journal of Acquired Immune Deficiency Syndromes.
The study was conducted at two safety-net hospitals in Boston, Massachusetts, and Atlanta, Georgia, between July 2015 and December 2016. It involved 166 PLWH (65% men; 72% black) who had been prescribed opioids for chronic pain.
While 85% of participants reported marijuana use at some point, 57% of those who used marijuana said they hadn't done so in the past 12 months. The remainder were split across several usage frequencies, the most common being 14% who used marijuana "a few times" in the past 12 months and 6% reporting daily use.
As the study authors noted, prior research is both sparse and mixed regarding the relative benefits and dangers of concurrent use of marijuana and opioids, despite their common usage among PLWH with chronic pain. The current study provides new data points, but without additional clarity: It found that marijuana use had neither a beneficial nor harmful effect on opioid use, and also that it had no significant relationship with a person's level of reported pain severity.
It also found, in a post-hoc analysis, an average odds ratio (OR) of 3.03 (P = .03) for detectable viral load among people who reported marijuana use within the past year. "It is possible that PLWH who have chronic pain and are on [chronic opioid therapy] already face significant health and quality of life challenges, and adding marijuana to this affected their adherence to [antiretroviral treatment] or retention in care," study authors hypothesized. The OR spread was wide for this relationship: 95% OR was 1.11 to 8.31.
Since only 5% of participants had a medical marijuana card, most self-reported use was likely illicit at the time, study authors noted. Laws regarding marijuana usage have eased in both Massachusetts and Georgia since the study took place. Study authors called for prospective studies on the impact of marijuana on pain, opioid use, and HIV outcomes.