INTRODUCTION

Since the dawn of the first civilization, plants have been used to cure ailments, from a simple flu, insects and animal bites to measles and even polio. In our modern times, most plants are mostly seen in gardens as either decorations or just to add something green on a patio. Some people dont even know the common name of that plant; hence, what can it contribute to peoples life. In the rise of modern medicine, simple diseases evolved faster than the development of the treatment, causing deaths to millions of people, at any age, causing the spread of viruses in the air and making it non-responsive to medication. In turn of this modern medical era; scientists, doctors, alchemists and even the infected patients are taking the ancient options, traditional and herbal medication. In this study, the researchers focused on one of the fastest evolving, complex and spreading disease that caused many lives, AIDS, Acute Immune Deficiency Syndrome. The study will discuss the history of the disease, symptoms, transmission, other related malady and how the society affects the process of treatment. In the treatment prevention and medication, the researcher focused on an ancient plant thats controversial due to its current position in society and politics. Cannabis sativa, (Marijuana) the plat contains 300 compounds; at least 66 of these are Cannabinoids which are the basis for medical and scientific use of Cannabis. This compound is said to treat symptoms of AIDS, which might prevent the Human Immunodeficiency Virus to be severe.

ACUTE IMMUNO DEFICIENCY SYNDROME HUMAN IMMUNODEFICIENCY VIRUS (HIV/AIDS)

A disease of the human immune system caused by the human immunodeficiency virus(HIV), which attacks selected cells in the Immune system and produces defects in function, leading to severe suppression of the immune systems ability to resist harmful organisms. This leaves the body open to invasion by various infections, which therefore, called opportunistic diseases. This susceptibility gets worse as the disease continues to develop to unusual cancers.
I. II. III. IV. V. VI. VII. VIII.

Kaposi's sarcoma Lymphoma Cervical cancer Anal cancer Oral cancer Testicular cancer Skin cancer Lung cancer

The virus also tends to reach certain brain cells. This leads to so called neuropsychiatric abnormalities, or psychological disturbances caused by physical damage to nerve cells. I. Kaposi's sarcoma (KS) is a rare form of relatively benign cancer that tended to occur in older people. Most common tumor in HIV-infected patients. The appearance of this tumor in young homosexual men in 1981 was one of the first signals of the AIDS epidemic. Caused by a gammaherpes virus called Kaposi's sarcoma-associated herpes virus (KSHV), it often appears as purplish nodules on the skin, but can affect other organs, especially the mouth, gastrointestinal tract, and lungs. II. Lymphoma is a malignant tumor of the specialized tissues of the lymphatic system, the bodys disease-fighting network that includes the lymph nodes, spleen, tonsils and thymus gland. Generally, lymphomas are divided into two types, Hodgkins disease and non-Hodgkins lymphomas, depending on cell pathology. Symptoms of lymphoma include painless swelling of lymph nodes in

the neck, groin or armpit, fever, weight loss, nighttime sweating, liver or spleen enlargement, and gastrointestinal and kidney disturbances. Lymphomas are treated with radiation therapy and chemotherapy. III. Cervical Cancer is the term for a malignant neoplasm arising from cells originating in the cervix uteri. One of the most common symptoms of cervical cancer is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer has progressed to an advanced stage.[1] Treatment usually consists of surgery (including local excision) in early stages, and chemotherapy and/or radiotherapy in more advanced stages of the disease. IV. Anal cancer is a type of cancer which arises from the anus, the distal orifice of the gastrointestinal tract. It is a distinct entity from the more common colorectal cancer. The etiology, risk factors, clinical progression, staging, and treatment are all different. Anal cancer is typically a squamous cell carcinoma that arises near the squamocolumnar junction. It may be keratinizing (basaloid) or non-keratinizing (cloacogenic). Other types of anal carcinoma are adenocarcinoma, lymphoma, sarcoma or melanoma. V. Oral cancer is a subtype of head and neck cancer, is any cancerous tissue growth located in the oral cavity. It may arise as a primary lesion originating in any of the oral tissues, by metastasis from a distant site of origin, or by extension from a neighboring anatomic structure, such as the nasal cavity or the Oral cancers may originate in any of the tissues of the mouth, and may be of varied histologic types: teratoma, adenocarcinoma derived from a major or minor salivary gland, lymphoma from tonsillar or other lymphoid tissue, or melanoma from the pigment-producing cells of the oral mucosa. VI. Testicular cancer is cancer that develops in the testicles, a part of the male reproductive system. VII. Skin neoplasms (also known as "skin cancer") are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises. Skin cancer generally develops in the epidermis (the outermost layer of skin), so a tumor can usually be seen. This means that it is often possible to detect skin cancers at

an early stage. Unlike many other cancers, including those originating in the lung, pancreas, and stomach, only a small minority of those affected will actually die of the disease, though it can be disfiguring. Melanoma survival rates are poorer than for non-melanoma skin cancer, although when melanoma is diagnosed at an early stage, treatment is easier and more people survive. VIII. Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary lung cancers, are carcinomas that derive from epithelial cells. Worldwide, lung cancer is the most common cause of cancer-related death in men and women, and is responsible for 1.3 million deaths annually, as of 2004. The most common symptoms are shortness of breath, coughing (including coughing up blood), and weight loss.

CRITERIA FOR AIDS

The U.S. Center for Disease Control has established criteria for defining cases of AIDS that are based on laboratory evidence such as: A. B. T4 cell count The presence of certain Opportunistic diseases i. ii. iii. iv. v. vi. vii. viii. ix. Pneumocystis pneumonia (PCP) Tuberculosis Esophagitis Toxoplasmosis Progressive multifocal leukoencephalopathy (PML) AIDS dementia complex Mycobacterium Avium Complex Cytomegalovirus Oral Thrush

Are generally the most prominent and life threatening clinical complications of AIDS. OTHER COMPLICATIONS

Fever Diarrhea Severe weight loss Swollen Lymph Nodes

HISTORY
The virus and disease are often referred to together as HIV/AIDS. The disease is a major health problem in many parts of the world, and is considered a pandemic, a disease outbreak that is not only present over a large area but is actively spreading. In 2009, the World Health Organization (WHO) estimated that there are 33.4 million people worldwide living with HIV/AIDS, with 2.7 million new HIV infections per year and 2.0 million annual deaths due to AIDS. In 2007, UNAIDS estimated: 33.2 million people worldwide had AIDS that year; AIDS killed 2.1 million people in the course of that year, including 330,000 children, and 76% of those deaths occurred in sub-Saharan Africa. According to UNAIDS 2009 report, worldwide some 60 million people have been infected since the start of the pandemic, with some 25 million deaths, and 14 million orphaned children in southern Africa alone. Genetic research indicates that HIV originated in west-central Africa during the late nineteenth or early twentieth century. AIDS was first recognized by the U. S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s. Although treatments for HIV/AIDS can slow the course of the disease, there is no known cure or HIV vaccine. Antiretroviral treatment reduces both the deaths and new infections from HIV/AIDS, but these drugs are expensive and the medications are not available in all countries. Due to the difficulty in treating HIV infection, preventing infection is a key aim in controlling the AIDS pandemic, with health organizations promoting safe sex and needle-exchange programmes in attempts to slow the spread of the virus.

NATURE OF THE VIRUS

Human Immunodeficiency Virus (HIV) is an RNA retrovirus. It has a dense cylindrical core that encases two molecules of viral RNA genetic material. Like all retroviruses, HIV possesses a special enzyme called reverse transcriptase that is able to make a DNA copy of the viral RNA. This enables he

virus to reverse the normal flow of genetic information and to incorporate its viral genes into the genetic material of its host. The virus may remain in a latent form for a variable and often lengthy period of time until it is reactivated. A critical step in HIV infection is the binding of the virus to a receptor on the cell it attacks, enabling it to gain entrance. A molecule called CD4, found on the surface of the T4 cell, serves as receptor and almost any other cell with the CD4 surface molecule can become infected with HIV. Research has shown that co receptor called CD26 helps the HIV virus invade cells.

MODE OF TRANSMISSION
Researchers have isolated HIV from a number of body fluids, including blood, semen, saliva, tears, urine, cerebrospinal fluid, breast milk and cervical and vaginal secretions. Strong evidence indicates, however, that HIV is transmitted only through three primary routes: 1. 2. 3. Sexual Intercourse (vaginal or anal with an infected individual) Exposure to infected blood or blood products From an infected mother to her child before or during birth

1. SEXUAL INTERCOURSE
Sexual transmission occurs with the contact between sexual secretions of one person with the rectal, genital or oral mucous membranes of another. Unprotected sexual acts are riskier for the receptive partner than for the insertive partner, and the risk for transmitting HIV through unprotected anal intercourse is greater than the risk from vaginal intercourse or oral sex. However, oral sex is not entirely safe, as HIV can be transmitted through both insertive and receptive oral sex. Sexual assault greatly increases the risk of HIV transmission as condoms are rarely employed and physical trauma to the vagina or rectum occurs frequently, facilitating the transmission of HIV. Drug use has been studied as a possible predictor of HIV transmission. Perry N. Halkitis found that methamphetamine usage does significantly relate to unprotected sexual behavior. The study found methamphetamine users to be at a higher risk for contracting HIV.

Other sexually transmitted infections (STI) increase the risk of HIV transmission and infection, because they cause the disruption of the normal epithelial barrier by genital ulceration and/or microulceration; and by accumulation of pools of HIV-susceptible or HIV-infected cells (lymphocytes and macrophages) in semen and vaginal secretions. Epidemiological studies from sub-Saharan Africa, Europe and North America suggest that genital ulcers, such as those caused by syphilis and/or chancroid, increase the risk of becoming infected with HIV by about fourfold. There is also a significant although lesser increase in risk from STIs such as gonorrhea, chlamydia and trichomoniasis, which all cause local accumulations of lymphocytes and macrophages. Transmission of HIV depends on the infectiousness of the index case and the susceptibility of the uninfected partner. Infectivity seems to vary during the course of illness and is not constant between individuals. An undetectable plasma viral load does not necessarily indicate a low viral load in the seminal liquid or genital secretions. However, each 10-fold increase in the level of HIV in the blood is associated with an 81% increased rate of HIV transmission. Women are more susceptible to HIV-1 infection due to hormonal changes, vaginal microbial ecology and physiology, and a higher prevalence of sexually transmitted diseases. People who have been infected with one strain of HIV can still be infected later on in their lives by other, more virulent strains. Infection is unlikely in a single encounter. High rates of infection have been linked to a pattern of overlapping long-term sexual relationships. This allows the virus to quickly spread to multiple partners who in turn infect their partners. A pattern of serial monogamy or occasional casual encounters is associated with lower rates of infection. HIV spreads readily through heterosexual sex in Africa, but less so elsewhere. One possibility being researched is that schistosomiasis, which affects up to 50% of women in parts of Africa, damages the lining of the vagina.

2. SEXUAL INTERCOURSE

This transmission route is particularly relevant to intravenous drug users, hemophiliacs and recipients of blood transfusions and blood products. Sharing and reusing syringes contaminated with HIV-infected blood represents a major risk for infection with HIV. Needle sharing is the cause of one third of all new HIV-infections in North America, China, and Eastern Europe. The risk of being infected with HIV from a single prick with a needle that has been used on an HIV-infected person is thought to be about 1 in 150 (see table above). Post-exposure prophylaxis with anti-HIV drugs can further reduce this risk. This route can also affect people who give and receive tattoos and piercings. Universal precautions are frequently not followed in both sub-Saharan Africa and much of Asia because of both a shortage of supplies and inadequate training. The WHO estimates that approximately 2.5% of all HIV infections in sub-Saharan Africa are transmitted through unsafe healthcare injections. Because of this, the United Nations General Assembly has urged the nations of the world to implement precautions to prevent HIV transmission by health workers. The risk of transmitting HIV to blood transfusion recipients is extremely low in developed countries where improved donor selection and HIV screening is performed. However, according to the WHO, the overwhelming majority of the world's population does not have access to safe blood and between 5% and 10% of the world's HIV infections come from transfusion of infected blood and blood products.

3. FROM AN INFECTED MOTHER TO HER CHILD BEFORE OR DURING BIRTH

The transmission of the virus from the mother to the child can occur in utero during the last weeks of pregnancy and at childbirth. In the absence of treatment, the transmission rate between a mother and her child during pregnancy, labor and delivery is 25%. However, when the mother takes antiretroviral therapy and gives birth by caesarean section, the rate of transmission is just 1%. The risk of infection is influenced by the viral load of the mother at birth, with the higher the viral load, the higher the risk. Breastfeeding also increases the risk of transmission by about 4 %.

PATHOPHYSIOLOGY
The pathophysiology of AIDS is complex. Ultimately, HIV causes AIDS by depleting CD4 + T helper lymphocytes. This weakens the immune system and allows opportunistic infections. T lymphocytes are essential to the immune response and without them, the body cannot fight infections or kill cancerous cells. The mechanism of CD4+ T cell depletion differs in the acute and chronic phases Although the symptoms of immune deficiency characteristic of AIDS do not appear for years after a person is infected, the bulk of CD4+ T cell loss occurs during the first weeks of infection, especially in the intestinal mucosa, which harbors the majority of the lymphocytes found in the body. HIV seeks out and destroys CCR5 expressing CD4+ cells during acute infection. A vigorous immune response eventually controls the infection and initiates the clinically latent phase. However, CD4+ T cells in mucosal tissues remain depleted throughout the infection, although enough remain to initially ward off life-threatening infections. Continuous HIV replication results in a state of generalized immune activation persisting throughout the chronic phase. Immune activation, which is reflected by the increased activation state of immune cells and release of proinflammatory cytokines, results from the activity of several HIV gene products and the immune response to ongoing HIV replication.

CELLS AFFECTED
The virus, entering through which ever route, acts primarily on the following cells:
A.

Lymphoreticular system:
a) b) c) d)

CD4+ T-Helper cells Macrophages Monocytes B-lymphocytes

B. C.

Certain endothelial cells Central nervous system:

a) b) c) d)

Microglia of the nervous system Astrocytes Oligodendrocytes Neurones indirectly by the action of cytokines and the gp-120

THE EFFECT
The virus has cytopathic effects but how it does it is still not quite clear. It can remain inactive in these cells for long periods, though. This effect is hypothesized to be due to the CD4-gp120 interaction.
I.

The most prominent effect of HIV is its T-helper cell suppression and lysis. The cell is simply killed off or deranged to the point of being function-less (they do not respond to foreign antigens). The infected B-cells cannot produce enough antibodies either. Thus the immune system collapses leading to the familiar AIDS complications, like infections and neoplasms (vide supra).

II.

Infection of the cells of the CNS cause acute aseptic meningitis, sub-acute encephalitis, vacuolar myelopathy and peripheral neuropathy. Later it leads to even AIDS dementia complex.

III.

The CD4-gp120 interaction (see above) is also permissive to other viruses like Cytomegalovirus, Hepatitis virus, Herpes simplex virus, etc. These viruses lead to further cell damage i. e. cytopathy.

MOLECULAR BASIS
I. II. III.

Structure and genome of HIV HIV replication cycle HIV tropism

SYMPTOMS
The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages.

Opportunistic infections are common in people with AIDS. These infections affect nearly every organ system. 1. 2. 3. Pulmonary Gastrointestinal Neurological and Psychiatric a. b. c. 4. Tumors a. b. c. d. e. f. g. h. i. 5. Kaposis Sarcoma Cervical Cancer Hodgkin's disease Anal and rectal carcinomas Hepatocellular carcinomas Head and neck cancers Lung cancer Breast cancer Colon cancer Toxoplasmosis Progressive multifocal leukoencephalopathy AIDS dementia complex (ADC)

Other Infections

People with AIDS also have an increased risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system known as lymphomas. Additionally, people with AIDS often have systemic symptoms of infection like fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss.

1. PULMONARY
Pneumocystis pneumonia (originally known as Pneumocystis carinii pneumonia, and still abbreviated as PCP, which now stands for Pneumocystis pneumonia) is relatively rare in healthy, immunocompetent people, but common among HIV-infected individuals. It is caused by Pneumocystis jirovecii.

2. GASTROINTESTINAL
Esophagitis is an inflammation of the lining of the lower end of the esophagus (gullet or swallowing tube leading to the stomach). In HIV-infected individuals, this is normally due to fungal (candidiasis) or viral (herpes simplex-1 or cytomegalovirus) infections. In rare cases, it could be due to mycobacteria. In some cases, diarrhea may be a side effect of several drugs used to treat HIV, or it may simply accompany HIV infection, particularly during primary HIV infection. It may also be a side effect of antibiotics used to treat bacterial causes of diarrhea (common for Clostridium difficile). In the later stages of HIV infection, diarrhea is thought to be a reflection of changes in the way the intestinal tract absorbs nutrients, and may be an important component of HIV-related wasting.

3. NEUROLOGICAL AND PSYCHIATRIC

HIV infection may lead to a variety of neuropsychiatric sequelae, either by infection of the now susceptible nervous system by organisms, or as a direct consequence of the illness itself. a. Toxoplasmosis is a disease caused by the single-celled parasite called Toxoplasma gondii; it usually infects the brain, causing toxoplasma encephalitis, but it can also infect and cause disease in the eyes and lungs. Cryptococcal meningitis is an infection of the meninx (the membrane covering the brain and spinal cord) by the fungus Cryptococcus neoformans. It can cause fevers, headache, fatigue, nausea, and vomiting. Patients may also develop seizures and confusion; left untreated, it can be lethal. b. Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease, in which the gradual destruction of the myelin sheath covering the axons of nerve cells impairs the transmission of nerve impulses. c. AIDS dementia complex (ADC) is a metabolic encephalopathy induced by HIV infection and fueled by immune activation of HIV infected brain macrophages and microglia. These cells are productively infected by HIV and secrete neurotoxins of both host and viral origin.[27] Specific neurological impairments are manifested by cognitive, behavioral, and motor abnormalities that occur

after years of HIV infection and are associated with low CD4+ T cell levels and high plasma viral loads.

4. TUMORS
Patients with HIV infection have substantially increased incidence of several cancers. This is primarily due to co-infection with an oncogenic DNA virus, especially Epstein-Barr virus (EBV), Kaposi's sarcoma-associated herpesvirus (KSHV) (also known as human herpesvirus-8 [HHV-8]), and human papillomavirus (HPV). Such as: a. b. c. d. e. f. g. h. i. Kaposis Sarcoma Cervical Cancer Hodgkin's disease Anal and rectal carcinomas Hepatocellular carcinomas Head and neck cancers Lung cancer Breast cancer Colon cancer

5. OTHER INFECTIONS
AIDS patients often develop opportunistic infections that present with non-specific symptoms, especially low-grade fevers and weight loss. These include opportunistic infection with Mycobacterium avium-intracellulare and cytomegalovirus (CMV). CMV can cause colitis, as described above, and CMV retinitis can cause blindness. Penicilliosis due to Penicillium marneffei is now the third most common opportunistic infection (after extrapulmonary tuberculosis and cryptococcosis) in HIV-positive individuals within the endemic area of Southeast Asia. An infection that often goes unrecognized in AIDS patients is Parvovirus B19. Its main consequence is anemia, which is difficult to distinguish from the effects of antiretroviral drugs used to treat AIDS itself.

DIAGNOSIS
The diagnosis of AIDS in a person infected with HIV is based on the presence of certain signs or symptoms. However, clinical staging of patients was not an intended use for these systems as they are neither sensitive, nor specific. In developing countries, the World Health Organization staging system for HIV infection and disease, using clinical and laboratory data, is used and in developed countries, the Centers for Disease Control (CDC) Classification System is used. In 1990, the World Health Organization (WHO) grouped these infections and conditions together by introducing a staging system for patients infected with HIV-1.

Stage I: HIV infection is asymptomatic and not categorized as AIDS Stage II: includes minor mucocutaneous manifestations and recurrent upper respiratory tract infections

Stage III: includes unexplained chronic diarrhea for longer than a month, severe bacterial infections and pulmonary tuberculosis

Stage IV: includes toxoplasmosis of the brain, candidiasis of the esophagus, trachea, bronchi or lungs and Kaposi's sarcoma; these diseases are indicators of AIDS.

There are two main definitions for AIDS, both produced by the Centers for Disease Control and Prevention (CDC). The older definition is to referring to AIDS using the diseases that were associated with it, for example, lymphadenopathy, the disease after which the discoverers of HIV originally named the virus. In 1993, the CDC expanded their definition of AIDS to include all HIV positive people with a CD4+ T cell count below 200 per L of blood or 14% of all lymphocytes. The majority of new AIDS cases in developed countries use either this definition or the pre-1993 CDC definition. Many people are unaware that they are infected with HIV. Less than 1% of the sexually active urban population in Africa has been tested, and this proportion is even lower in rural populations. Furthermore, only 0.5% of pregnant women attending urban health facilities are counseled, tested or receive their test results. Again, this proportion is even lower in rural health facilities; therefore, donor blood and blood products used in medicine and medical research are screened for HIV.

HIV tests are usually performed on venous blood. Many laboratories use fourth generation screening tests which detect anti-HIV antibody (IgG and IgM) and the HIV p24 antigen. The detection of HIV antibody or antigen in a patient previously known to be negative is evidence of HIV infection. Individuals whose first specimen indicates evidence of HIV infection will have a repeat test on a second blood sample to confirm the results. The window period (the time between initial infection and the development of detectable antibodies against the infection) can vary since it can take 36 months to seroconvert and to test positive. Detection of the virus using polymerase chain reaction (PCR) during the window period is possible, and evidence suggests that an infection may often be detected earlier than when using a fourth generation EIA screening test. Positive results obtained by PCR are confirmed by antibody tests. Routinely used HIV tests for infection in neonates and infants (i. e., patients younger than 2 years), born to HIV-positive mothers, have no value because of the presence of maternal antibody to HIV in the child's blood. HIV infection can only be diagnosed by PCR, testing for HIV pro-viral DNA in the children's lymphocytes.

PREVENTION
Estimated per act risk for acquisition of HIV by exposure route (US only) Exposure Route Blood Transfusion Childbirth (to child) Needle-sharing injection drug use Percutaneous needle stick Receptive anal intercourse Insertive anal intercourse
* *

Estimated chance of infection 90% 25% 0.67% 0.30% 0.50% 0.065%

*

Receptive penile-vaginal intercourse Insertive penile-vaginal intercourse Receptive oral intercourse

* *

0.10% 0.05% 0.01%

Insertive oral intercourse

*

0.005%

assuming no condom use source refers to oral intercourse performed on a man

The three main transmission routes of HIV are: 1. 2. 3. Sexual contact Exposure to infected body fluids or tissues From mother to fetus or child during the prenatal period.

It is possible to find HIV in the saliva, tears, and urine of infected individuals, but there are no recorded cases of infection by these secretions, and the risk of infection is negligible. Anti-retroviral treatment of infected patients also significantly reduces their ability to transmit HIV to others, by reducing the amount of virus in their bodily fluids to undetectable levels.

1. SEXUAL CONTACT
The majority of HIV infections are acquired through unprotected sexual relations between partners, one of whom has HIV. The primary mode of HIV infection worldwide is through sexual contact between members of the opposite sex. During a sexual act, only male or female condoms can reduce the risk of infection with HIV and other STDs. The best evidence to date indicates that typical condom use reduces the risk of heterosexual HIV transmission by approximately 80% over the long-term, though the benefit is likely to be higher if condoms are used correctly on every occasion. Studies on couples where one partner is infected show that with consistent condom use, HIV infection rates for the uninfected partner are below 1% per year. The male latex condom, if used correctly without oil-based lubricants, is the single most effective available technology to reduce the sexual transmission of HIV and other sexually transmitted infections. Manufacturers recommend that oil-based lubricants such as petroleum jelly, butter, and lard not be used with latex condoms, because they dissolve the latex, making the condoms porous. If lubrication is desired, manufacturers recommend using water-based lubricants. Oil-based lubricants can be used with polyurethane condoms.

Female condoms are commonly made from polyurethane, but are also made from nitrile and latex. They are larger than male condoms and have a stiffened ring-shaped opening with an inner ring designed to be inserted into the vagina keeping the condom in place; inserting the female condom requires squeezing this ring. Female condoms have been shown to be an important HIV prevention strategy by preliminary studies which suggest that overall protected sexual acts increase relative to unprotected sexual acts where female condoms are available. At present, availability of female condoms is very low and the price remains prohibitive for many women.

2. BODY FLUID EXPOSURE

Health care workers can reduce exposure to HIV by employing precautions to reduce the risk of exposure to contaminated blood. These precautions include barriers such as gloves, masks, protective eyewear or shields, and gowns or aprons which prevent exposure of the skin or mucous membranes to blood borne pathogens. Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection. Finally, sharp objects like needles, scalpels and glass, are carefully disposed of to prevent needle stick injuries with contaminated items. Since intravenous drug use is an important factor in HIV transmission in developed countries, harm reduction strategies such as needle-exchange programmes are used in attempts to reduce the infections caused by drug abuse.

3. MOTHER-TO-CHILD
Current recommendations state that when replacement feeding, as with a wet nurse, is acceptable, feasible, affordable, sustainable and safe, HIV-infected mothers should avoid breast-feeding their infant. However, if this is not the case, exclusive breast-feeding is recommended during the first months of life and discontinued as soon as possible.

MANAGEMENT
There is currently no publicly available HIV vaccine or cure for HIV or AIDS. The only known methods of prevention are based on avoiding exposure to the virus or, failing that, an antiretroviral treatment directly after a highly significant exposure, called post-exposure prophylaxis (PEP). PEP has a

very demanding four week schedule of dosage. It also has very unpleasant side effects including diarrhea, malaise, nausea and fatigue. Current treatment for HIV infection consists of highly active antiretroviral therapy, or HAART.] This has been highly beneficial to many HIV-infected individuals since its introduction in 1996 when the protease inhibitor-based HAART initially became available. Current optimal HAART options consist of combinations (or "cocktails") consisting of at least three drugs belonging to at least two types, or "classes," of antiretroviral agents. Typical regimens consist of two nucleoside analogue reverse transcriptase inhibitors (NARTIs or NRTIs) plus either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor (NNRTI). Side effects can also deter people from persisting with HAART, these include lipodystrophy, dyslipidaemia, diarrhoea, insulin resistance, an increase in cardiovascular risks and birth defects. Antiretroviral drugs are expensive, and the majority of the world's infected individuals do not have access to medications and treatments for HIV and AIDS. However, the costs of anti-retroviral drugs have fallen recently in low-income countries. Moreover, patients' quality of life indices benefit from anti-retroviral treatment especially if healthcare services are adequate. In the absence of a cure for AIDS, antiretroviral treatment is likely to be a cost-effective strategy for enhancing well-being of AIDS patients and their dependents. In the US, approximately 60% of HIV patients use various forms of complementary or alternative medicine (CAM). Despite the widespread use of CAM by people living with HIV/AIDS, the effectiveness of these therapies has not been established. A 2005 Cochrane review of existing high-quality scientific evidence concluded: "There is insufficient evidence to support the use of herbal medicines in HIVinfected individuals and AIDS patients."Acupuncture has only been proposed for symptomatic relief, but not to treat or cure HIV or AIDS. Vitamin or mineral supplementation has shown benefit in some studies. Daily doses of selenium can suppress HIV viral burden with an associated improvement of the CD4 count. Selenium can be used as an adjunct therapy to standard antiviral treatments, but cannot itself cure the infection. More evidence is needed before it can be established that selenium supplementation reduces mortality rates. There is some evidence that vitamin A supplementation in children reduces mortality and improves growth. A large Tanzanian trial in immunologically and nutritionally compromised pregnant and lactating

women showed a number of benefits to daily multivitamin supplementation for both mothers and children. Dietary intake of micronutrients at RDA levels by HIV-infected adults is recommended by the World Health Organization (WHO). The WHO further states that several studies indicate that supplementation of vitamin A, zinc, and iron can produce adverse effects in HIV positive adults.

CANNABIS SATIVA (MARIJUANA) MEDICAL CANNABIS

Cannabis (Cannabis sativa or Marijuana) a common name to any DRUG preparation from the hemp plant, Cannabis sativa. Various forms of this drug are known by different names throughout the world. Morocco - Kif South Africa Dagga India Ganja

Cannabis have been smoked, eaten in cakes and drunk in beverages. In western cultures, marijuana is prepared most often as a tobacco-like mixture thats smoked in a pipe or rolled into a cigarette. Medical cannabis refers to the use of parts of the herb cannabis (also referred to as medical marijuana) as a physician-recommended form of medicine or herbal therapy, or to synthetic forms of specific cannabinoids such as THC as a physician-recommended form of medicine. The Cannabis plant from which the cannabis drug is derived has a long history of medicinal use, with evidence dating back to 2,737 BCE. Synthetic cannabinoids, such as Marinol and Cesamet, are available as prescription drugs in some countries. A number of studies, some disputed, claim that medical cannabis relieves symptoms and is helpful in the treatment of many diseases.

HISTORY
The use of cannabis, at least as fiber, has been shown to go back at least 10,000 years in Taiwan. "D m" (Pinyin pronunciation) is the Chinese expression for cannabis, the first character meaning "big" and the second character meaning "hemp."

ANCIENT CHINA AND TAIWAN

Cannabis, called m (meaning "hemp; cannabis; numbness") or dm (with "big; great") in Chinese, was used in Taiwan for fiber starting about 10,000 years ago. The botanist Li Hui-Lin wrote that in China, "The use of Cannabis in medicine was probably a very early development. Since ancient humans used hemp seed as food, it was quite natural for them to also discover the medicinal properties of the plant." The oldest Chinese pharmacopeia, the (ca. 100 CE) Shennong Bencaojing ("Shennong's Materia Medica Classic"), describes dama "cannabis".

The flowers when they burst (when the pollen is scattered) are called [mafen] or [mabo]. The best time for gathering is the 7th day of the 7th month. The seeds are gathered in the 9th month. The seeds which have entered the soil are injurious to man. It grows in [Taishan] (in [Shandong] ...). The flowers, the fruit (seed) and the leaves are officinal. The leaves and the fruit are said to be poisonous, but not the flowers and the kernels of the seeds.

Every part of the hemp plant is used in medicine; the dried flowers (), the achenia (), the seeds (), the oil (), the leaves, the stalk, the root, and the juice. The flowers are recommended in the 120 different forms of ( feng) disease, in menstrual disorders, and in wounds.

ANCIENT EGYPT
The Ebers Papyrus (ca. 1,550 BCE) from Ancient Egypt describes medical marijuana. Other ancient Egyptian papyri that mention medical marijuana are the Ramesseum III Papyrus (1700 BC), the Berlin Papyrus (1300 BC) and the Chester Beatty Medical Papyrus VI (1300 BC). The ancient Egyptians even used hemp (cannabis) in suppositories for relieving the pain of hemorrhoids. Around 2,000 B.C., the ancient Egyptians used cannabis to treat sore eyes. The egyptologist Lise Manniche notes the reference to "plant medical marijuana" in several Egyptian texts, one of which dates back to the eighteenth century BCE.

ANCIENT INDIA
Surviving texts from ancient India confirm that cannabis' psychoactive properties were recognized, and doctors used it for a variety of illnesses and ailments. This included insomnia,

headaches, a whole host of gastrointestinal disorders, and pain: cannabis was frequently used to relieve the pain of childbirth.

In India, the use of cannabis was widely disseminated, both as a medicine and as a recreational drug. Such a broad use may be due to the fact that cannabis maintained a straight association with religion, which assigned sacred virtues to the plant

ANCIENT GREECE
The Ancient Greeks used cannabis not only for human medicine, but also in veterinary medicine to dress wounds and sores on their horses. In humans, dried leaves of cannabis were used to treat nose bleeds, and cannabis seeds were used to expel tapeworms. The most frequently described use of cannabis in humans was to steep green seeds of cannabis in either water or wine, later taking the seeds out and using the warm extract to treat inflammation and pain resulting from obstruction of the ear.

SOUTH EAST ASIA

Patani from Asia are primary natural producers of the diuretic, antiemetic, antiepileptic, antiinflammatory, pain killing and antipyretic properties of Cannabis sativa, and used it extensively for 'Kopi Kapuganja' and 'Pecel Ganja', as recreation food, drinks and relaxing medication for centuries.

MEDIEVAL ISLAMIC WORLD

In the medieval Islamic world, Arabic physicians made use of the diuretic, antiemetic, antiepileptic, anti-inflammatory, pain killing and antipyretic properties of Cannabis sativa, and used it extensively as medication from the 8th to 18th centuries.

CLINICAL APPLICATIONS AND USE

Medical cannabis is illegal in most countries. A number of governments, including the U.S. Federal Government, allow treatment with one or more specific low doses of synthetic cannabinoids for one or more disorders.

Supporters of medical cannabis argue that cannabis does have several well-documented beneficial effects. Among these are: The amelioration of nausea and vomiting, Stimulation of hunger in chemotherapy and aids patients, Lowered intraocular eye pressure (shown to be effective for treating glaucoma), Gastrointestinal illness.

Its effectiveness as an analgesic has been suggestedand disputedas well. There are several methods for administration of dosage, including vaporizing or smoking dried buds, drinking, or eating extracts, and taking capsules. The comparable efficacy of these methods was the subject of an investigative study conducted by the National Institutes of Health. Synthetic Cannabinoids are available as prescription drugs in some countries. Examples are Marinol (The United States and Canada) and Cesamet (Canada, Mexico, the United Kingdom, and the United States). While utilizing cannabis for recreational purposes is illegal in many parts of the world, many countries are beginning to entertain varying levels of decriminalization for medical usage, including Canada, Austria, Germany, Switzerland, the Netherlands, Czech Republic, Spain, Israel, Italy, Finland, and Portugal. In the United States, federal law outlaws all use of herb parts from Cannabis, while some states have approved use of herb parts from Cannabis as medical cannabis in conflict with federal law. The United States Supreme Court has ruled in United States v. Oakland Cannabis Buyers' Coop and Gonzales v. Raich that the federal government has a right to regulate and criminalize cannabis, even for medical purposes. A person can therefore be prosecuted for a cannabis-related crime even if it is medical cannabis that is legal according to the laws of this state. A 2002 review of medical literature by Franjo Grotenhermen states that medical cannabis has established effects in the treatment of Nausea, Vomiting, Premenstrual syndrome,

Unintentional weight loss, Insomnia Lack of appetite.

Other "relatively well-confirmed" effects were in the treatment of Spasticity Painful conditions Esp. o o o o Neurogenic pain Movement disorders Asthma Glaucoma

Preliminary findings indicate that cannabis-based drugs could prove useful in treating Inflammatory bowel disease Migraines Fibromyalgia

Medical cannabis has also been found to relieve certain symptoms of Multiple sclerosis Spinal cord injuries

By exhibiting antispasmodic and muscle-relaxant properties as well as stimulating appetite. Other studies state that cannabis or Cannabinoids may be useful in treating Alcohol abuse Amyotrophic lateral sclerosis Collagen-induced arthritis Asthma Atherosclerosis Bipolar disorder

Colorectal cancer HIV-associated sensory neuropathy Depression Dystonia Epilepsy Digestive diseases Gliomas Hepatitis c Huntington's disease Leukemia Skin tumors Methicillin-resistant staphylococcus aureus (mrsa) Parkinson's disease Pruritus Posttraumatic stress disorder (ptsd) Psoriasis Sickle-cell disease Sleep apnea Anorexia nervosa

Controlled research on treating Tourette syndrome with a synthetic version of tetrahydrocannabinol, (brand name Marinol) (the main psychoactive chemical found in cannabis), showed the patients taking Marinol had a beneficial response without serious adverse effects; other studies have shown that cannabis "has no effects on tics and increases the individuals inner tension". Case reports found that marijuana helped reduce tics, but validation of these results requires longer, controlled studies on larger samples. A study done by Craig Reinarman surveyed among why people in California used medical marijuana and it found many reasons why people had used medical marijuana. It was used to relieve pain, muscle spasms, headaches, anxiety, nausea, vomiting, depression, cramps, panic attacks, diarrhea, and itching. Others used medical marijuana to improve sleep, relaxation, appetite, concentration or focus, and energy. Some patients used it to prevent medication side effects, anger, involuntary

movements, and seizures, while others used it as a substitute for other prescription medications and alcohol.

SAFETY OF CANNABIS
SAFETY OF CANNABIS
According to an approved statement from the US Department of Justice in 1988, "Nearly all medicines have toxic, potentially lethal effects. But marijuana is not such a substance. There is no record in the extensive medical literature describing a proven, documented cannabis-induced fatality. In practical terms, marijuana cannot induce a lethal response as a result of drug-related toxicity."

GLAUCOMA
In a separate study, the use of marijuana and glaucoma was tested and found that the duration of smoked or ingested marijuana or other Cannabinoids is very short, averaging 3 to 3.5 hours. Their results showed that for marijuana to be a viable therapy, the patient would have to take in cannabis in some form every 3 hours. They said that for ideal glaucoma treatment it would take two times a day at most for compliance purposes from patients.

SPASTICITY IN MULTIPLE SCLEROSIS

A review of six randomized controlled trials of a combination of THC and CBD extracts for the treatment of multiple sclerosis (MS) related muscle spasticity reported, "Although there was variation in the outcome measures reported in these studies, a trend of reduced spasticity in treated patients was noted." The authors postulated that Cannabinoids may provide neuroprotective and anti-inflammatory benefits in MS." A small study done on whether or not marijuana could be used to control tremors of MS patients was conducted. The study found that there was no noticeable difference of the tremors in the patients. Although there was no difference in the tremors the patients felt as if their symptoms had lessened and their quality of life had improved. The researchers concluded that the mood enhancing or cognitive effects that cannabis has on the brain could have given the patients the effect that their tremors were getting better.

ALZHEIMER'S DISEASE
Research done by the Scripps Research Institute in California shows that the active ingredient in marijuana, THC, prevents the formation of deposits in the brain associated with Alzheimer's disease. THC was found to prevent an enzyme called acetylcholinesterase from accelerating the formation of "Alzheimer plaques" in the brain more effectively than commercially marketed drugs. THC is also more effective at blocking clumps of protein that can inhibit memory and cognition in Alzheimers patients, as reported in Molecular Pharmaceutics. Cannabinoids can also potentially prevent or slow the progression of Alzheimer's disease by reducing tau protein phosphorylation, oxidative stress, and

neuroinflammation.

MENTAL DISORDERS
There has been evidence that smoking marijuana can have a positive effect on disorders such as Schizophrenia, bipolar disorder, or depression. In patients with bipolar disorder subjects have been shown to actually become better after smoking marijuana increasing the rate at which these patients go from high to low. In the case of depression many users have reported that their moods have become better. Research done on lab rats and animals has shown that marijuana can act as an anti-depressant but in other studies done on humans this is not the case, actually pushing the subjects further into their depression. A study of 50,000 Swedish soldiers who had smoked at least once were twice as likely to develop schizophrenia as those who had not smoked. The study concluded that either smoking caused a higher rate of schizophrenia, or that those with schizophrenia were more likely to be drawn to marijuana.

LUNG CANCER AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE

The evidence to date is conflicting as to whether smoking cannabis increases the risk of developing lung cancer or chronic obstructive pulmonary disease (COPD) among people who do not smoke tobacco.

BREAST CANCER
According to a 2007 study at the California Pacific Medical Center Research Institute, cannabidiol (CBD) may stop breast cancer from spreading throughout the body. These researchers

believe their discovery may provide a non-toxic alternative to chemotherapy while achieving the same results minus the painful and unpleasant side effects.

HIV/AIDS
Investigators at Columbia University published clinical trial data in 2007 showing that HIV/AIDS patients who inhaled cannabis four times daily experienced substantial increases in food intake with little evidence of discomfort and no impairment of cognitive performance. They concluded that smoked marijuana has a clear medical benefit in HIV-positive patients. In another study in 2008, researchers at the University of California, San Diego School of Medicine found that marijuana significantly reduces HIV-related neuropathic pain when added to a patient's already-prescribed pain management regimen and may be an "effective option for pain relief" in those whose pain is not controlled with current medications. Mood disturbance, physical disability, and quality of life all improved significantly during study treatment. Despite management with opioids and other pain modifying therapies, neuropathic pain continues to reduce the quality of life and daily functioning in HIV-infected individuals. Cannabinoid receptors in the central and peripheral nervous systems have been shown to modulate pain perception. No serious adverse effects were reported, according to the study published by the American Academy of Neurology. A study examining the effectiveness of different drugs for HIV associated neuropathic pain found that smoked Cannabis was one of only three drugs that showed evidence of efficacy.

BRAIN CANCER
A study by Complutense University of Madrid found the chemicals in marijuana promotes the death of brain cancer cells by essentially helping them feed upon themselves in a process called autophagy. The research team discovered that Cannabinoids such as THC had anticancer effects in mice with human brain cancer cells and in people with brain tumors. When mice with the human brain cancer cells received the THC, the tumor shrank. Using electron microscopes to analyze brain tissue taken both before and after a 26- to 30-day THC treatment regimen, the researchers found that THC eliminated cancer cells while leaving healthy cells intact. The patients did not have any toxic effects from the treatment; previous studies of THC for the treatment of cancer have also found the therapy to be well tolerated.

OPIOID DEPENDENCE
Injections of THC eliminate dependence on opiates in stressed rats, according to a research team at the Laboratory for Physiopathology of Diseases of the Central Nervous System (France) in the journal Neuropsychopharmacology. Deprived of their mothers at birth, rats become hypersensitive to the rewarding effect of morphine and heroin (substances belonging to the opiate family), and rapidly become dependent. When these rats were administered THC, they no longer developed typical morphine-dependent behavior. In the striatum, a region of the brain involved in drug dependence, the production of endogenous enkephalins was restored under THC, whereas it diminished in rats stressed from birth which had not received THC.

TREATMENT OF INFLAMMATORY SKIN DISEASE

The abundant distribution of Cannabinoids receptors on skin nerve fibers and mast cells provides implications for an anti-inflammatory, anti-nociceptive action of Cannabinoids receptor agonists and suggests their putatively broad therapeutic potential.

MEDICINAL COMPOUNDS
Cannabis contains over 300 compounds. At least 66 of these are cannabinoids, which are the basis for medical and scientific use of cannabis. This presents the research problem of isolating the effect of specific compounds and taking account of the interaction of these compounds. Cannabinoids can serve as: Appetite stimulants Antiemetics Antispasmodics Some analgesic effects

Five important cannabinoids found in the cannabis plant are: I. II. III. Tetrahydrocannabinol Cannabidiol Cannabinol

IV. V.

-caryophyllene Cannabigerol

I. TETRAHYDROCANNABINOL Tetrahydrocannabinol (THC) is the primary compound responsible for the psychoactive effects of cannabis. The compound is a mild analgesic, and cellular research has shown the compound has antioxidant activity. THC is believed to interact with parts of the brain normally controlled by the endogenous cannabinoid neurotransmitter, anandamide. Anandamide is believed to play a role in pain sensation, memory, and sleep. II. CANNABIDIOL Cannabidiol (CBD) is a major constituent of medical cannabis. CBD represents up to 40% of extracts of the medical cannabis plant. Cannabidiol has been shown to relieve convulsion, inflammation, anxiety, cough and congestion, nausea, and inhibits cancer cell growth. Recent studies have shown cannabidiol to be as effective as atypical antipsychotics in treating schizophrenia. Because cannabidiol relieves the aforementioned symptoms, cannabis strains with a high amount of CBD may benefit people with multiple sclerosis, frequent anxiety attacks and Tourette syndrome. III. CANNABINOL Cannabinol (CBN) is a therapeutic cannabinoid found in Cannabis sativa and Cannabis indica. It is also produced as a metabolite, or a breakdown product, of tetrahydrocannabinol (THC). CBN acts as a weak agonist of the CB1 and CB2 receptors, with lower affinity in comparison to THC. IV. -CARYOPHYLLENE Part of the mechanism by which medical cannabis has been shown to reduce tissue inflammation is via the compound -caryophyllene. A cannabinoid receptor called CB2 plays a vital part in reducing inflammation in humans and other animals. -Caryophyllene has been shown to be a selective activator of the CB2 receptor. -Caryophyllene is especially concentrated in cannabis essential oil, which contains about 1235% -caryophyllene.

V. CANNABIGEROL Like cannabidiol, cannabigerol is not psychoactive. Cannabigerol has been shown to relieve intraoccular pressure, which may be of benefit in the treatment of glaucoma.

MARINOL FACTS

Medical marijuana already exists. It's called Marinol. A pharmaceutical product, Marinol, is widely available through prescription. It comes in the form of a pill and is also being studied by researchers for suitability via other delivery methods, such as an inhaler or patch. The active ingredient of Marinol is synthetic THC, which has been found to relieve the nausea and vomiting associated with chemotherapy for cancer patients and to assist with loss of appetite with AIDS patients.

Unlike smoked marijuana--which contains more than 400 different chemicals, including most of the hazardous chemicals found in tobacco smoke-Marinol has been studied and approved by the medical community and the Food and Drug Administration (FDA), the nation's watchdog over unsafe and harmful food and drug products. Since the passage of the 1906 Pure Food and Drug Act, any drug that is marketed in the United States must undergo rigorous scientific testing. The approval process mandated by this act ensures that claims of safety and therapeutic value are supported by clinical evidence and keeps unsafe, ineffective and dangerous drugs off the market.

There are no FDA-approved medications that are smoked. For one thing, smoking is generally a poor way to deliver medicine. It is difficult to administer safe, regulated dosages of medicines in smoked form. Secondly, the harmful chemicals and carcinogens that are byproducts of smoking create entirely new health problems. There are four times the level of tar in a marijuana cigarette, for example, than in a tobacco cigarette.

Morphine, for example, has proven to be a medically valuable drug, but the FDA does not endorse the smoking of opium or heroin. Instead, scientists have extracted active ingredients from opium, which are sold as pharmaceutical products like morphine, codeine, hydrocodone or oxycodone. In a similar vein, the FDA has not approved

smoking marijuana for medicinal purposes, but has approved the active ingredient-THCin the form of scientifically regulated Marinol.

The DEA helped facilitate the research on Marinol. The National Cancer Institute approached the DEA in the early 1980s regarding their study of THC's in relieving nausea and vomiting. As a result, the DEA facilitated the registration and provided regulatory support and guidance for the study.

The DEA recognizes the importance of listening to science. That's why the DEA has registered seven research initiatives to continue researching the effects of smoked marijuana as medicine. For example, under one program established by the State of California, researchers are studying the potential use of marijuana and its ingredients on conditions such as multiple sclerosis and pain. At this time, however, neither the medical community nor the scientific community has found sufficient data to conclude that smoked marijuana is the best approach to dealing with these important medical issues.

The most comprehensive, scientifically rigorous review of studies of smoked marijuana was conducted by the Institute of Medicine, an organization chartered by the National Academy of Sciences. In a report released in 1999, the Institute did not recommend the use of smoked marijuana, but did conclude that active ingredients in marijuana could be isolated and developed into a variety of pharmaceuticals, such as Marinol.

In the meantime, the DEA is working with pain management groups, such as Last Acts, to make sure that those who need access to safe, effective pain medication can get the best medication available.

HIV/AIDS AND MEDICAL CANNABIS

The AIDS pandemic can also be seen as several epidemics of separate subtypes; the major factors in its spread are sexual transmission and vertical transmission from mother to child at birth and through breast milk. Despite recent, improved access to antiretroviral treatment and care in many regions of the world, the AIDS pandemic claimed an estimated 2.1 million (range 1.92.4 million) lives in

2007 of which an estimated 330,000 were children under 15 years. Globally, an estimated 33.2 million people lived with HIV in 2007, including 2.5 million children. An estimated 2.5 million (range 1.84.1 million) people were newly infected in 2007, including 420,000 children.

HISTORY
The history of the medical use of cannabis dates back to 2700 B.C. in the pharmacopoeia of Shen Nung, one of the fathers of Chinese medicine. In the west, it has been recognized as a valued, therapeutic herb for centuries. In 1823, Queen Victoria's personal physician, Sir Russell Reynolds, not only prescribed it to her for menstrual cramps but wrote in the first issue of The Lancet, "When pure and administered carefully, [it is] one of the of the most valuable medicines we possess."

CANNABIS AND HIV/AIDS

Marijuana can help HIV patients in several ways; it can:
I. II. III. IV. V.

Ease nausea Increase appetite Control nerve pain Ease depression Help sleeping

I. MARIJUANA AND NAUSEA A valuable effect of marijuana is its ability to reduce nausea, a property which is used to good effect in helping cancer patients deal with the side-effects of chemotherapy. Many HIV patients become nauseated at the thought of taking their anti-viral medication; marijuana can help control that nausea, thus ensuring that all medications are taken as scheduled. II. MARIJUANA AND APPETITE The fatigue that accompanies HIV infection can also cause patients to feel nauseous. It becomes a vicious circle; the fatigue makes you feel sick, feeling sick makes eating difficult, not eating leads to fatigue. This complex cycle can lead to AIDS-wasting. Anybody who has used marijuana will have

experienced the munchies. This increase in appetite can help prevent, or at least slow down, AIDS wasting. III. MARIJUANA AND NERVE PAIN (NEUROPATHY) There have been countless anecdotal reports of marijuana relieving the pain, nausea and muscular spasticity that often accompany cancer, AIDS, multiple sclerosis and other ailments. In 2008, scientists reported that cannabis can ease nerve pain. Researchers at University of California Davis examined whether marijuana produces analgesia for patients with neuropathic pain. The thirty-eight patients in the study were given either high-dose cannabis, low-dose cannabis, or a placebo. In the placebo group, less than a quarter reported pain reduction. But both the cannabis receiving groups showed a measurable reduction in pain levels. Interestingly, they showed the same level of pain reduction; that is, pain reduction was not dose related. This means that smoking more cannabis does not result in greater pain reduction. However, patients suffering from debilitating nerve pain got as much or more relief by smoking marijuana as they would typically get from prescription drugs and with fewer side effects. IV. MARIJUANA AND DEPRESSION Now this is a Pandoras Box like no other in the world of marijuana some saying that marijuana contributes to depression and others saying that it helps it. Back in 2007 researchers actually found that it does both. According to researchers McGill University and Le Centre de Recherch Fernand Seguin of Hpital in Quebec and lUniversit de Montral in Montreal from THC, the active ingredient in marijuana, increases serotonin when smoked in low doses, similar to SSRI antidepressants, such as Prozac. However, at higher doses, the effect reverses itself and can actually worsen depression and other psychiatric conditions like psychosis. The antidepressant and intoxicating effects of cannabis are due to its chemical similarity to natural substances in the brain known as endo-cannabinoids, which are released under conditions of

high stress or pain. The study demonstrated that these receptors have a direct effect on the cells producing serotonin, which is a neurotransmitter that regulates the mood. V. MARIJUANA AS A SLEEP AID One of the most common side effects of marijuana is drowsiness, which makes it a helpful sleep aid for just about anyone having difficulty sleeping. Many insomniacs will smoke a little bit of marijuana in the evening before they know they need to go to sleep. For certain individuals, using marijuana is the only way they can fall asleep at night and get a full nights rest. However, some users report that cannabis-induced sleep is far from refreshing. Its a case of finding out whats right for the patient.

HIV/AIDS AND MEDICAL CANNABIS CLINICAL INFORMATION AND RESEARCH

Testimonials from both doctors and patients reveal valuable information on the use of cannabis therapies, and supporting statements from professional health organizations and leading medical journals support its legitimacy as a medicine. In the last few years, clinical trials in Great Britain, Canada, Spain, Israel, and elsewhere have shown great promise for new medical applications. This study is intended to be a starting point for the consideration of applying cannabis therapies to specific conditions; it is not intended to replace the training and expertise of physicians with regard to medicine, or attorneys with regard to the law. But as patients, doctors and advocates who have been working intimately with these issues for many years. This study has seen how helpful cannabis can be for a wide variety of indications. But, this doesnt inhibit the doctors to want the freedom to practice medicine and patients the freedom to make decisions about their healthcare.

LEGAL RECOMMENDATION FOR CANNABIS

In 2004, the United States Supreme Court upheld earlier federal court decisions that doctors have a fundamental Constitutional right to recommend cannabis to their patients.

HISTORY

Within weeks of California voters legalizing medical cannabis in 1996, federal officials had threatened to revoke the prescribing privileges of any physicians who recommended cannabis to their patients for medical use. In response, a group of doctors and patients led by AIDS specialist Dr. Marcus Conant filed suit against the government, contending that such a policy violates the First Amendment. The federal courts agreed at first the district level, then all the way through appeals to the Ninth Circuit and then the Supreme Court.

LIMITATIONS OF DOCTORS
In Conant v. Walters, the Ninth Circuit Court of Appeals held that the federal government could neither punish nor threaten a doctor merely for recommending the use of cannabis to a patient. But it remains illegal for a doctor to "aid and abet" a patient in obtaining cannabis. This means a physician may discuss the pros and cons of medical cannabis with any patient, and issue a written or oral recommendation to use cannabis without fear of legal reprisal. This is true regardless of whether the physician anticipates that the patient will, in turn, use this recommendation to obtain cannabis. What physicians may not do is actually prescribe or dispense cannabis to a patient or tell patients how to use a written recommendation to procure it from a cannabis club or dispensary. Doctors can tell patients they may be helped by cannabis. They can put that in writing. They just can't help patients obtain the cannabis itself.

SCIENTIFIC RESEARCH SUPPORTS MEDICAL CANNABIS

Between 1840 and 1900, European and American medical journals published more than 100 articles on the therapeutic use of the drug known then as Cannabis Indica (or Indian hemp) and now simply as cannabis. Today, new studies are being published in peer-reviewed journals that demonstrate cannabis has medical value in treating patients with serious illnesses such as AIDS, glaucoma, cancer, multiple sclerosis, epilepsy, and chronic pain. 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. AIDS wasting syndrome was a very frequent complication of HIV infection prior to the advent of protease-inhibitor drugs, 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, 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'.

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. 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. 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. In one study, 70 percent of patients administered Marinol gained weight. 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." 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. 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 neurocognitive 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. 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. 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. The validity of their experiences is corroborated by studies in which Cannabinoids have been shown to be effective analgesics in animal pain models.

EFFICACY AND SIDE EFFECTS

The many medications currently employed to fight HIV/AIDS include many that produce serious side effects, including severe nerve pain, nausea and wasting. These side effects frequently threaten the health of the patient and require other medications to combat them. Drugs commonly prescribed against AIDS-related weight loss include megestrol acetate (Megace), an anticachectic. Serious side effects of this medicine include high blood pressure, diabetes, inflammation of the blood vessels, congestive heart failure, seizures, and pneumonia. Less serious side

effects of this medicine include diarrhea, flatulence, nausea, vomiting, constipation, heartburn, dry mouth, increased salivation, and thrush; impotence, decreased libido, urinary frequency, urinary incontinence, urinary tract infection, vaginal bleeding and discharge (including breakthrough bleeding); disease of the heart muscle, palpitation, chest pain, chest pressure, and edema; shortness of breath, cough, pharyngitis, lung disorders, and rapid breathing; insomnia, headache, weakness, numbness, confusion, seizures, depression, and abnormal thinking. Synthetic human growth hormones, such as Somatropin, also known as Genotropin, Humatrope, Norditropin, Nutropin, Nutropin AQ, Saizen, and Serostim, are also prescribed for AIDS wasting syndrome. Serious side effects of this medicine include: abdominal pain or swelling of the stomach; cancer; decrease in red blood cells; diarrhea; enlargement of face, hands, or feet; fever; headache; high blood pressure; high blood sugar; increased sweating; limp or pain in hip or knee; loss of appetite; pain in ear(s); pain and swelling where the shot was given; pain and tingling of fingers and toes; protein in the urine; rapid heart beat; severe tiredness; skin rash or itching; stomach upset; swelling of lymph nodes; trouble sleeping; vision changes; and vomiting. Less serious side effects of this medicine include: enlargement of breasts; increased growth of birthmarks; joint pain; muscle pain; swelling of hands, feet, or lower legs; unusual tiredness or weakness; and wrist pain. Testosterone and anabolic steroids are being studied for use against AIDS wasting, as isThalidomide, a drug that was taken off the market in the 1960s when it was found to cause severe birth defects. Opiod analgesics are commonly prescribed to combat the polyneuropathy associated with HIV/AIDS. The opioid analgesics commonly used to combat pain includecodeine (Dolacet, Hydrocet, Lorcet, Lortab, Vicodin);morphine (Avinza, Oramorph);Oxycodone (Oxycontin, Roxicodone, Percocet, Roxicet);propoxyphene (Darvon, Darvocet) and tramadol (Ultram, Ultracet). These medicines can cause psychological and physical dependence, as well as constipation, dizziness, lightheadedness, mood changes, nausea, sedation, shortness of breath and vomiting. Taking high doses or mixing with alcohol can slow down breathing, a potentially fatal condition. Cannabis: By comparison, the side effects associated with cannabis are typically mild and are classified as "low risk." Euphoric mood changes are among the most frequent side effects. Cannabinoids can exacerbate schizophrenic psychosis in predisposed persons. Cannabinoids impede cognitive and

psychomotor performance, resulting in temporary impairment. Chronic use can lead to the development of tolerance. Tachycardia and hypotension are frequently documented as adverse events in the cardiovascular system. A few cases of myocardial ischemia have been reported in young and previously healthy patients. Inhaling the smoke of cannabis cigarettes induces side effects on the respiratory system. Cannabinoids are contraindicated for patients with a history of cardiac ischemia. In summary, a low risk profile is evident from the literature available. Serious complications are very rare and are not usually reported during the use of Cannabinoids for medical indications.

SAFETY ON RECOMMENDATION
One of marihuana's greatest advantages as a medicine is its remarkable safety. It has little effect on major physiological functions. There is no known case of a lethal overdose; on the basis of animal models, the ratio of lethal to effective dose is estimated at 40,000 to 1. By comparison, the ratio is between 3 and 50 to 1 for secobarbital and between 4 and 10 to 1 for ethanol. Marihuana is also far less addictive and far less subject to abuse than many drugs now used as muscle relaxants, hypnotics, and analgesics. The chief legitimate concern is the effect of smoking on the lungs. Cannabis smoke carries even more tars and other particulate matter than tobacco smoke. But the amount smoked is much less, especially in medical use, and once marihuana is an openly recognized medicine, solutions may be found; ultimately a technology for the inhalation of cannabinoid vapors could be developed.

CANNABIS OR MARINOL?
Those committed to the prohibition on cannabis frequently cite Marinol, a Schedule III drug, as the legal means to obtain the benefits of cannabis. However, Marinol, which is a synthetic form of THC, does not deliver the same therapeutic benefits as the natural herb, which contains at least another 60 Cannabinoids in addition to THC. Recent research conducted by GW Pharmaceuticals in Great Britain has shown that Marinol is simply not as effective for pain management as the whole plant; a balance of Cannabinoids, specifically CBC and CBD with THC, is what helps patients most. In fact, Marinol is not labeled for pain, only appetite stimulation and nausea control. But studies have found that many severely nauseated patients experience difficulty in getting and keeping a pill down, a problem avoided by use of inhaled cannabis.

Clinical research on Marinol vs. cannabis has been limited by federal restrictions, but a New Mexico state research program conducted from 1978 to 1986 provided cannabis or Marinol to about 250 cancer patients for whom conventional medications had failed to control the nausea and vomiting associated with chemotherapy. At a DEA hearing, a physician with the program testified that cannabis was clearly superior to both Chlorpromazine and Marinol for these patients. Additionally, patients frequently have difficulty getting the right dose with Marinol, while inhaled cannabis allows for easier titration and avoids the negative side effects many report with Marinol. As the House of Lords report states, "Some users of both find cannabis itself more effective."

THE EXPERIENCE OF PATIENTS

KEITH VINES
I am an Assistant District Attorney for the City and County of San Francisco, a position I have held since 1985. I am a retired Air Force Captain and JAG Corps prosecutor, a former foot soldier in the war on drugs, and the proud father of a son who will turn 18 this summer. I am also an AIDS patient who credits medical marijuana as an important link to saving my life. To stimulate my appetite one of my physicians prescribed Marinol, a synthetic derivative of THC, which is one of the main active ingredients of marijuana. I found, however, that I could not tolerate Marinol's harsh and unpredictable side effectsside effects that I tried to endure despite only a marginal improvement in appetite. Not infrequently, a single Marinol capsule would make me feel "stoned" for several hours, such that I was unable to function at a level at which I felt comfortable or competent. Other times the Marinol put me right to sleep. Because I continued to work full-time as an Assistant District Attorney, this was for me an unacceptable state of affairs. I need to be at the top of my game. Marinol deprived me of something I have always valued deeply: a sense of control over my mind and body. I informed my physicians that I could no longer tolerate the Marinol because of the unacceptable side effects. At that point, two of my doctors suggested that I try marijuana. They explained that in their practices, they had observed that for many AIDS patients, smoking marijuana stimulated appetite better than its synthetic cousin, and did so without many of the deleterious side effects of Marinol.

I found that it took only two or three puffs from a marijuana cigarette for my appetite to return. Moreover, the beneficial effect took place within minutes rather than the hours that I sometimes waited after swallowing a Marinol capsule. Because I only required a small dose to stimulate my appetite, I did not need to get stoned in order to eat. I remain on my growth hormone therapy and I continue to take 15-20 pills a day as part of my antiviral and vitamin regimens. I also use medical marijuana as needed to stimulate my appetite. My marijuana use is quite modest. I find that I need to take a couple of puffs only two or three times a week, in the evenings, in order to eat. There are also periods of weeks at a time when the marijuana is unnecessary. I do not smoke before or during business hours. I have not become addicted to marijuana. I continue to work, as I have for the past 12 years, as a city and county prosecutor. The thought processes and motor skills that I use on the job are not the least impaired by the couple of puffs of cannabis I occasionally take before an evening meal. I am not a danger to myself or others. Perhaps most important, I am not wasting away. I am still contributing to society rather than draining its resources. I am thriving on my own, rather than existing as a burdeneither financially or emotionallyto my family, friends, or the government.

DANIEL J. KANE
Wasting syndrome, in combination with other HIV-related symptoms and conditions, left me thoroughly disabled and desperate to obtain relief. I suffered severe nausea, chronic exhaustion and physical weakness, neurological complications, persistent anxiety, and a total loss of appetite. It was my impression, confirmed by my doctor, that these symptoms were likely caused, or exacerbated, by one or more of the 11 different prescription drugs I had taken for some time. I was dangerously malnourished and the symptoms persisted. I became too ill to ingest the pills that lay at the core of my treatment. Despite my attempts, I simply could not swallow them with any regularity. When I did swallow them, I rarely kept them down. I also tried suppositories for the nausea and the pain, but I was physically unable to tolerate them either. I was warned that my treatment would not work if I could not comply with the protocol. In August of 1996, after several prescription medications had given me no relief, my doctor informed me that marijuana, in small quantities, might act as both an anti-nauseant and an appetite stimulant. I

tried smoking marijuana to combat the nausea. I found that it reduced my nausea and restored my appetite, allowing me to eat and regain my strength with no noticeable side effects. Having tried the other medications, I know from personal experience that, at least for me, nothing compares to marijuana in terms of results. I use marijuana only a few times a weeksometimes lessbut since I started, I have been able to eat and I've regained weight, muscle mass and hope. That small amount of marijuana has enabled me to function in the world again.

THE EXPERIENCE OF DOCTORS

Marcus A. Conant, M.D.
Medical marijuana has been used extensively by physicians throughout the United States in the treatment of cancer and AIDS patients. It stimulates the appetite and promotes weight gain, in turn strengthening the body, combating chronic fatigue, and providing the stamina and physical well-being necessary to endure or withstand both adverse side effects of ongoing treatment and other opportunistic infections. It has been shown effective in reducing nausea, neurological pain and anxiety, and in stimulating appetite. When these symptoms are associated with (or caused by) other therapies, marijuana has been useful in facilitating compliance with more traditional therapies. It may also allow individual patients to engage in normal social interactions and avoid the despair and isolation which frequently accompanies long-term discomfort and illness. In my practice, marijuana has been of greatest benefit to patients with wasting syndrome. Likewise, for some of my patients undergoing chemotherapy, when conventional drugs fail to relieve the severe nausea and vomiting, I often find that marijuana provides the patient with the ability to eat and to tolerate aggressive cancer treatments. I was one of the principal investigators of an FDA-supervised trial conducted by Unimed, Inc. on the safety and efficacy of Marinol as an appetite stimulant in HIV/AIDS patients suffering from wasting syndrome. Marinol is a form of THC, one of the key active components of marijuana; it is essentially a marijuana extract. It was approved by the FDA five years ago, and has been widely prescribed by physicians treating both AIDS and cancer patients.

I am aware, however, thatMarinol (like any medication) is not effective in treating allpatients. In some cases, the reason is simple: Marinol is taken orally, in pill form. Patients suffering from severe nausea and retching cannot tolerate the pills and thus do not benefit from the drug. There are likely other reasons why smoked marijuana is sometimes more effective than Marinol. The body's absorption of the chemical may be faster or more complete when inhaled. Means of ingestion is often critical in understanding treatment efficacy.
Dr. Marcus Conant is a physician who has practiced medicine for 33 years in San Francisco. Dr. Conant is Medical Director of the Conant Medical Group, one of the largest private AIDS practices in the United States. He is a professor at the University of California Medical Center in San Francisco and is the author or co-author of over 70 publications on treatment of AIDS. He and his colleagues provide primary care for over 5,000 HIV patients, including 2,000 with AIDS.

Neil M. Flynn, M.D., MPH

I participate in the care of approximately 1,500 AIDS patients. I am the primary physician for 200 AIDS patients. Intractable nausea and wasting syndrome are frequent symptoms associated with AIDS and the treatment of AIDS. The nausea, which can last for days, weeks or months, is one of the most severe forms of discomfort or pain that the human being can experience. It destroys the quality of life of the patient, whose sole objective is to make it through the next hour, the next day. Racked by intense vomiting and queasiness, time for the patient seems to stand still. Wasting can take a similar psychological and physical toll. If I am unable to relieve the patient's nausea with [conventional] remedies, I next prescribe Marinol, a synthetic version of THC, one of the main active compounds found in marijuana. Marinol is also helpful in stimulating appetite in patients suffering from AIDS wasting, as are other drugs, Megace, anabolic steroids, and human growth hormone. If Marinol does not provide adequate relief from nausea and/or wasting, I may suggest that the patient try a related remedy, marijuana. I firmly believe that medical marijuana is medically appropriate as a drug of last resort for a small number of seriously ill patients. Over 20 years of clinical experience persuade me of this fact. The anecdotal evidence is overwhelming. Almost every patient I have known to have tried marijuana achieved relief from symptoms with it. That success rate far surpasses that for Compazine. Accordingly, as with any other medication that I consider potentially beneficial to my

patients, I must discuss the option of medical marijuana in detail when appropriate. Anything less is malpractice.... In my nearly thirty years of clinical experience caring for the HIV/AIDS patients, many near to or at the end of life, I have found marijuana to be a valuable medication for the alleviation of intense suffering associated with nausea, wasting, and neuropathic pain. Marijuana has helped patients overcome these potentially life threatening symptoms, and has done so safely and without the debilitating side effects induced by many mainline therapies. I have seen marijuana restore patients' will to live by restoring their ability to eat, gain strength, and perform simple, daily activities free from crippling nausea or pain. There is no doubt in my mind that for some seriously ill patients, marijuana can help make the difference between life and death; and that for other terminally ill patients, marijuana can make the difference between exercising control over their final months and days and passing in relative peace and comfort, or dying in constant and severe agony (or incapacitated in a prolonged sedated haze, unaware of their surroundings). Marijuana, in short, can help sick and dying persons achieve autonomy over their lives by alleviating the intense suffering caused by their illnesses or the side effects of their medications. For some patients (for example those suffering from operable cancer), medical marijuana may allow them to continue their treatments and thus serve as a bridge to eventual cure; for others marijuana may help promote relative well-being and prolong a life free from intolerable pain; and for still other patients, marijuana may help them control the manner and timing of their deaths consistent with their values, beliefs and dignity.
Dr. Neil M. Flynn is a Professor of Clinical Medicine at the University of California at Davis School of Medicine where he established the UCD AIDS and Related Disorders Clinic and is a member of the Chancellor's Committee on AIDS. He is attending physician in the University Medical Center's Infectious Diseases Clinic and at the Center for AIDS Research, Education and Services. He is the author of numerous articles and a member of many professional organizations.

SUMMARY
This study/research attempted to assess the effectiveness of Cannabis sativa (Marijuana) to patients infected with Human Immunodeficiency Virus (HIV) that causes Acute Immune Deficiency Syndrome, in terms of treatment and prevention. It particularly focused on the following aspects: 1. The Benefits and Effects of Cannabis sativa as a treatment and prevention of the AIDS causing virus called Human Immunodeficiency Virus and other diseases associated with HIV/AIDS. 2. 3. The Effects of Medical Cannabis to Patients and Doctors. The Potential of Cannabis sativa to cure majority of complex diseases and syndromes, under strictly monitored experiments and study of experts.

CONCLUSIONS
Based on the research and studies, the following conclusions are derived:
1. One of the major criticisms of cannabis as medicine is opposition to smoking as a method of consumption. However, smoking is no longer necessary due to the development of healthier methods. Today, medicinal marijuana patients can use vaporizers, where the essential marijuana compounds are extracted and inhaled. This is somewhat similar to steaming vegetables to avoid cancerous byproducts that are produced at higher temperatures. In addition, edible marijuana, which is produced in various baked goods, is also available, and has demonstrated longer lasting effects. 2. The study concluded that smoking cannabis is not recommended for the treatment of any disease condition, but did conclude that nausea, appetite loss, pain and anxiety can all be mitigated by marijuana. While the study expressed reservations about smoked marijuana due to the health risks associated with

smoking, the study team concluded that until another mode of ingestion was perfected that could provide the same relief as smoked marijuana, there was no alternative. In addition, the study pointed out the inherent difficulty in marketing a non-patentable herb. Pharmaceutical companies will not substantially profit unless there is a patent. 3. Marinol was less effective than the steroid megestrol in helping cancer patients regain lost appetites. A phase III study found no difference in effects of an oral cannabis extract or THC on appetite and quality of life (QOL) in patients with cancer-related anorexia-cachexia syndrome (CACS) to placebo 4. The harm caused by smoking can be minimized or eliminated by the use of a vaporizer or ingesting the drug in an edible form. Vaporizers are devices that heat the active constituents to a temperature below the ignition point of the cannabis, so that their vapors can be inhaled. Combustion of plant material is avoided, thus preventing the formation of carcinogens such as polyaromatic hydrocarbons, benzene and carbon monoxide. A pilot study led by Donald Abrams of UC San Francisco showed that vaporizers eliminate the release of irritants and toxic compounds, while delivering equivalent amounts of THC into the bloodstream. 5. The profile of cannabinoid drug effects suggest that they are promising for treating wasting syndrome in AIDS patients. Nausea, appetite loss, pain, and anxiety are all afflictions of wasting, and all can be mitigated by marijuana. Although some medications are more effective than marijuana for these problems, they are not equally effective in all patients. A rapid-onset (that is, acting within minutes) delivery system should be developed and tested in such patients. Smoking marijuana is not recommended. The long-term harm caused by smoking marijuana makes it a poor drug delivery system, particularly for patients with chronic illnesses." 6. When appropriately prescribed and monitored, marijuana/cannabis can provide immeasurable benefits for the health and well-being of HIV/AIDS patients."

RECOMMENDATION
1. The patients as well as the doctors should know and observe LIMITS especially about their toxicity level. 2. All people, esp. those who are involved in using Cannabis medically, either synthetic or the hemp itself, should be under strict medical condition. 3. The Government should be open minded on the clinical benefits of Traditional Medicine.

BIBLIOGRAPHY
BOOKS
Lexicon Universal Encyclopedia (De Luxe Home Edition - 1993) AIDS 1:198-201, Africa, History of 1:160c, immune system 11:58, virus 11:59 Lexicon Universal Encyclopedia (De Luxe Home Edition - 1993) MARIJUANA 13:152-153, drug abuse 6:279-80, hemp 10:120 Websters Dictionary

TRIBUNAL REPORTS/JOURNALS/MAGAZINES/BROCHURE
Americans for Safe Access 510.251.1856 or toll-free 888.929.4367 info@safeaccessnow.org site map Oakland Los Angeles Washington DC

INTERNET SOURCE
WIKIPEDIA AIDS HIV CANNABIS SATIVA MARIJUANA