The effectiveness of cannabis for treating symptoms related to HIV/AIDS is widely recognized. Its value as an anti-emetic and analgesic has been proven in numerous studies and has been recognized by several comprehensive, government-sponsored reviews, including those conducted by the Institute of Medicine (IOM), the U.K. House of Lords Science and Technology Committee, the Australian National Task Force on Cannabis, and others.

The IOM concluded, "For patients such as those with AIDS or who are undergoing chemotherapy and who suffer simultaneously from severe pain, nausea, and appetite loss, cannabinoid drugs might offer broad-spectrum relief not found in any other single medication."[12]

Research published in 2004 found that nearly one-quarter of AIDS patients were using cannabis. A majority reported relief of anxiety and/or depression and improved appetite, while nearly a third said it also increased pleasure and provided relief of pain.[13]

AIDS wasting syndrome was a very frequent complication of HIV infection prior to the advent of protease-inhibitor drugs,[14] and has been associated with major weight loss and cachexia, conditions that further debilitate its victims, who are already weakened by immune system failure and opportunistic infections. Cannabis has been a frequently employed alternative medicine for the condition, particularly in the USA,[15] because of its reported benefits on appetite and amelioration of other AIDS symptoms. In the rest of the world, where such medications are seldom affordable, AIDS wasting remains a common problem to the extent that it is known in Africa as 'slim disease'.[16]

Research findings on cannabis and HIV/AIDS

Beginning in the 1970s, a series of human clinical trials established cannabis' ability to stimulate food intake and weight gain in healthy volunteers. In a randomized trial in AIDS patients, THC significantly improved appetite and nausea in comparison with placebo. There were also trends towards improved mood and weight gain. Unwanted effects were generally mild or moderate in intensity. The possible benefit of cannabis in AIDS made it one of the lead indications for such treatment in the judgment of the American Institute of Medicine in their study.[17-23]

A preliminary safety trial conducted at the University of California at San Francisco found that inhaled cannabis does not interfere with the effectiveness of protease inhibitors in patients suffering from HIV or AIDS. It also found that patients in the study who used cannabis gained weight.[24]

Dronabinol (a.k.a. "Marinol" or oral THC) is approved by the U.S. Food and Drug Administration (FDA) as an anti-emetic and appetite stimulant for patients undergoing cancer chemotherapy or suffering from AIDS. The FDA approved the drug for this use in 1992 after several clinical trials determined it stimulated weight gain in HIV-infected patients.[25] In one study, 70 percent of patients administered Marinol gained weight.[26]

The 1999 report by the IOM concluded: "It is well recognized that Marinol's oral route of administration hampers its effectiveness because of slow absorption and patients' desire for more control over dosing. ... In contrast, inhaled marijuana is rapidly absorbed."[27] In a series of U.S. state studies in the 1980s, cancer patients given a choice between using inhaled marijuana and oral THC overwhelmingly chose cannabis.[28]

While the benefits of cannabis for HIV/AIDS patients are well established, research continues around the world. In 2002, researchers began a Canadian government-sponsored trial evaluating the appetite-enhancing effects of smoked cannabis in HIV/AIDS, the safety of short-term exposure to cannabis, its interaction with HIV medications, and its effects on nausea, pain, mood and neuro-cognitive function. In 2004 New South Wales in Australia will begin making cannabis available to HIV/AIDS patients and other seriously ill individuals for both research and compassionate use.

The University of California's Center for Medicinal Cannabis Research is currently conducting three HIV/AIDS related studies: two on cannabis as treatment for neuropathy, a condition which afflicts AIDS, diabetes and other patients with severe tingling and pain in their hands and feet, and one on how repeated treatment with cannabis affects the driving ability of patients with HIV-related neuropathy.

Over 30% of patients with HIV/AIDS suffer from excruciating pain in the nerve endings (polyneuropathies), many in response to the antiretroviral therapies that constitute the first line of treatment for HIV/AIDS.[29-31] But, there is no approved treatment for such pain that is satisfactory for a majority of patients. As a result, some patients must reduce or discontinue their HIV/AIDS therapy because they can neither tolerate nor eliminate the debilitating side effects of the antiretroviral first-line medications.[32]

Patients with various pain syndromes claim significant relief from cannabis. This is particularly true for patients suffering from neuropathic pain, a symptom commonly associated with HIV/AIDS and a variety of other illnesses or conditions.

In fact, British researchers have recently reported that cannabis extract sprayed under the tongue was effective in reducing pain in 18 of 23 patients who were suffering from intractable pain.[33] The validity of their experiences is corroborated by studies in which cannabinoids have been shown to be effective analgesics in animal pain models.[34]

Read more about HIV/AIDS and medical marijuana at Americans for Safe Access.

Cannabis has been found to help cancer patients with pain and nausea, and recent research indicates it has tumor-reducing and anti-carcinogenic properties properties as well. It has proven highly effective at controlling the nausea associated with chemotherapy, and its appetite-stimulation properties help combat wasting. Cannabis can also help control the pain associated with some cancers, as well as that resulting from radiation and chemotherapy treatment.

Cannabis and chemotherapy side effects

One of the most widely studied therapeutic applications for cannabis and  the pharmaceutical drugs derived from cannabinoids is in the treatment of nausea and vomiting associated with cancer chemotherapy.. Numerous clinical studies have reported that the use of cannabis reduces nausea and vomiting and stimulates appetite, thereby reducing the severity of cachexia, or wasting syndrome, in patients receiving chemotherapy treatment.

The 1999 Institutes of Medicine report concluded: "In patients already experiencing severe nausea or vomiting, pills are generally ineffective, because of the difficulty in swallowing or keeping a pill down, and slow onset of the drug effect. Thus an inhalation (but, preferably not smoking) cannabinoid drug delivery system would be advantageous for treating chemotherapy-induced nausea."12

A 1997 inquiry by the British Medical Association found cannabis more effective than Marinol, and a 1998 review by the House of Lords Science & Technology Select Committee concluded that "Cannabinoids are undoubtedly effective as anti-emetic agents in vomiting induced by anti-cancer drugs. Some users of both find cannabis itself more effective."13

In the last three years, there have been major advances in both cannabinoid pharmacology and in understanding of the cancer disease process. In particular, research has demonstrated the presence of numerous cannabinoid receptors in the nucleus of the solitary tract, a brain center important in control of vomiting.

Although other recently developed anti-emetics are as effective or more effective than oral THC, nabilone or smoked cannabis, for certain individuals unresponsive to conventional anti-emetic drugs, the use of smoked cannabis can provide relief more effectively than oral preparations which may be difficult to swallow or be vomited before taking effect, as the IOM report notes.

The psychoactive/euphoriant effects of THC or inhaled cannabis may also provide an improvement in mood. By contrast, several conventional medications commonly prescribed for cancer patients, e.g. phenothiazines such as haloperidol (known as "major tranquillizers") may produce unwanted side effects such as excessive sedation, flattening of mood, and/or distressing physical "extrapyramidal" symptoms such as uncontrolled or compulsive movements.

While clinical research on using cannabis medicinally has been severely limited by federal prohibition,the accumulated data speaks strongly in favor of considering it as an option for most cancer patients, and many oncologists do. Survey data from a Harvard Medical School study in 1990, before any states had approved medical use, shows that 44% of oncologists had recommended cannabis to at least some of their patients. Nearly half said they would do so if the laws were changed. According the American Cancer Society's 2003 data, more than 1,300,000 Americans are diagnosed with cancer each year.15  At least 300,000 of them will undergo chemotherapy, meaning as many as 132,000 patients annually may have cannabis recommended to them to help fight the side effects of conventional treatments.

As the Institutes of Medicine report concluded, "nausea, appetite loss, pain and anxiety … all can be mitigated by marijuana."

Research on cannabis and chemotherapy

Cannabis is used to combat pain caused by various cancers and nausea induced by chemotherapy agents. Over 30 human clinical trials have examined the effects of cannabis or synthetic cannabinoids on nausea, not including several U.S. state trials that took place between 1978 and 1986.16 In reviewing this literature, Hall et al. concluded that ". . . THC [delta-9-tetrahydrocannabinol] is superior to placebo, and equivalent in effectiveness to other widely-used anti-emetic drugs, in its capacity to reduce the nausea and vomiting caused by some chemotherapy regimens in some cancer patients."17 A 2003 study found "Cannabinoids—the active components of cannabis sativa and their derivatives—exert palliative effects in cancer patients by preventing nausea, vomiting and pain and by stimulating appetite. In addition, these compounds have been shown to inhibit the growth of tumor cells in culture and animal models by modulating key cell-signaling pathways. Cannabinoids are usually well tolerated, and do not produce the generalized toxic effects of conventional chemotherapies."18


Authors of the Institute of Medicine report, "Marijuana and Medicine: Assessing the Science Base," found that there are certain cancer patients for whom cannabis should be a valid medical option.19 A random-sample anonymous survey conducted in the spring of 1990 measured the attitudes and experiences of oncologists concerning the antiemetic use of cannabis in cancer chemotherapy patients. Of the respondents expressing an opinion, a majority (54%) thought cannabis should be available by prescription.20

Cancer-fighting properties of cannabis

More than twenty major studies published between 2001 and 2006have shown that the chemicals in cannabis known as cannabinoids have a significant effect fighting cancer cells. We now know cannabinoids arrest many kinds of cancer growths (brain, breast, leukemic, melanoma, phaeochromocytoma, et al.) through promotion of apoptosis (programmed cell death) that is lost in tumors, and by arresting angiogenesis (increased blood vessel production).

Recent scientific advances in the study of cannabinoid receptors and endocannabinoids have produced exciting new leads in the search for anti-cancer treatments.

There is growing evidence of direct anti-tumor activity of cannabinoids, specifically CB1 and CB2 agonists, in a range of cancer types including brain (gliomas), skin, pituitary, prostate and bowel. The antitumor activity has led in laboratory animals and in-vitro human tissues to regression of tumors, reductions in vascularisation (blood supply) and metastases (secondary tumors), as well as direct inducement of death (apoptosis) among cancer cells. Indeed, the complex interactions of endogenous cannabinoids and receptors are leading to greater scientific understanding of the mechanisms by which cancers develop.

The findings of these studies are borne out by the reports of such patients as Steve Kubby, whose cannabis use is credited with keeping a rare, terminal cancer in a state of remission for decades beyond conventional expectations.

Research on tumor reduction

Although cannabis smoke has been shown to have precancerous-causing effects in animal tissue, epidemiological studies on humans have failed to link cannabis smoking with cancer.21,22  If smoke inhalation is a concern, cannabis can be used with a vaporizer, orally in baked goods, and topically as a tincture or a suppository.

Cannabinoids, the active components of cannabis, have been shown to exhibit anti-tumor properties. Multiple studies published between 2001 and 2006 found that cannabinoids inhibit tumor growth in laboratory animals.23-27 In another study, injections of synthetic THC eradicated malignant brain tumors in one-third of treated rats, and prolonged life in another third by as much as six weeks.28 Other journals have also reported on cannabinoids' antitumoral potential.29-35 Italian research teams reported in 1998 and 2001 that the endocannabinoid anandamide, which binds to the same brain receptors as cannabis, "potently and selectively inhibits the proliferation of human breast cancer cells in vitro" by interfering with their DNA production cycle.36-38 Cannabis has been shown in recent studies to inhibit the growth of thyroid, prostate and colorectal cancer cells.39-41 THC has been found to cause the death of glioma cells.42,43 And research on pituitary cancers shows cannabinoids are key to regulating human pituitary hormone secretion.44-47

In 2004 an Italian research team demonstrated that the administration of the non-psychoactive cannabinoid cannabidiol (CBD) to nude mice significantly inhibited the growth of subcutaneously implanted U87 human glioma cells. The authors of the study concluded that "… CBD was able to produce a significant antitumor activity both in vitro and in vivo, thus suggesting a possible application of CBD as an antineoplastic agent (an agent that inhibits the growth of malignant cells.)"48  

More recently, investigators at the California Pacific Medical Center Research Institute reported that the administration of THC on human glioblastoma multiforme cell lines decreased the proliferation of malignant cells and induced apoptosis (programmed cell death) more rapidly than did the administration of an alternative synthetic cannabis receptor agonist.49

In the largest study of it's kind, Dr. Donald Tashkin, a researcher and professor at UCLA, determined that marijuana use - even extremely heavy use - does not cause lung, neck, or mouth cancer.

"We know that there are as many or more carcinogens and co-carcinogens in marijuana smoke as in cigarettes," researcher Donald Tashkin, MD, of UCLA's David Geffen School of Medicine tells WebMD. "But we did not find any evidence for an increase in cancer risk for even heavy marijuana smoking." ⁽³⁾

Dr. Tashkin was kind enough to do an interview with the Marijuana And Prohibition Project, or MAPP, to discuss this and his other findings. The video is available online in two parts, which you can view here:

View Dr. Tashkin Video Part 1 | View Dr. Tashkin Video Part 2

Part 1

Part 2

In 1988, the DEA's Chief Administrative Law Judge, Francis L. Young, ruled after extensive hearings that,

"Marijuana, in its natural form, is one of the safest therapeutically active substances known... It would be unreasonable, arbitrary and capricious for the DEA to continue to stand between those sufferers and the benefits of this substance... ⁽¹⁾"

In 1996, California legalized the use of marijuana as medicine. The wording of Proposition 215 allowed for cannabis to be recommended for any illness. In response, the Clinton Administration commissioned the National Academy of Sciences’ Institute of Medicine to report on medical marijuana. In 1999 they released their report, entitled "Marijuana and Medicine - Assessing the Science Base." In it, they came to the conclusion that marijuana has significant potential as medicine on a number of ailments, that "except for the harms associated with smoking, the adverse effects of marijuana use are within the range of effects tolerated for other medications," and that "the short-term immunosuppressive effects are not well established but, if they exist, are not likely great enough to preclude a legitimate medical use. ⁽²⁾".

Read more about cancer and medical marijuana at Americans for Safe Access.