CHINAZO CUNNINGHAM (2017-07-01 to 2022-06-30) Does medical cannabis reduce opioid analgesics in HIV+ and HIV- adults with pain?. Amount: $1802093

医用大麻是否会减少艾滋病病毒阳性和阴性感染者的阿片类镇痛药？

Abstract

Over the past decade, opioid analgesic use has doubled, becoming a leading strategy to manage chronic pain. Simultaneously, opioid use disorder and overdoses have dramatically increased. To address this opioid epidemic, one rapidly expanding strategy to manage chronic pain is medical cannabis. As of January 2017, medical cannabis is legal in 28 states, and 27 states include pain as a qualifying condition. Although studies demonstrate analgesic effects of cannabis, few have examined how medical cannabis affects opioid analgesic use. Studies have not examined long-term medical cannabis use or compared medical cannabis products with different ?9-tetrahydrocannabinol (THC) and cannabidiol (CBD) content. Managing chronic pain in HIV+ adults is particularly challenging, yet few studies have focused on this population. With a high prevalence of chronic pain, opioid analgesic use, and cannabis use among HIV+ adults, it is important to understand how, in HIV+ adults, medical cannabis use affects opioid analgesic use and HIV outcomes. Despite its potential benefits, cannabis has potential adverse events. Few studies have examined adverse events with long-term medical cannabis use, and none have examined adverse events specific to THC/CBD content. Our overarching goal is to understand how medical cannabis use affects opioid analgesic use over time, with attention to THC/CBD content, HIV outcomes, and adverse events.  We will conduct a cohort study of 250 HIV+ and HIV- adults with (a) severe or chronic pain, (b) current opioid analgesic use, and (c) who are newly certified for medical cannabis. Over 18 months, we will collect data via 7 in-person visits every 3 months and 39 web-based questionnaires via cellphones every 2 weeks. Data sources will include: questionnaires; medical, pharmacy, and Prescription Monitoring Program (PMP) records; urine and blood samples; and qualitative interviews. Over participants? 2-week time period (unit of analysis), medical cannabis exposure will be the number of days of medical cannabis use (primary exposure measure), and opioid analgesic use will be the cumulative opioid analgesic dose (primary outcome measure). We will examine how medical cannabis use affects: 1) opioid analgesic use, 2) HIV outcomes, and 3) adverse events. We hypothesize that (1) medical cannabis use will be associated with a reduction in opioid analgesic use, (2) the association between medical cannabis and opioid analgesic use will differ by THC/CBD content, (3) HIV outcomes will differ by medical cannabis use and THC/CBD content, and (4) more medical cannabis use and higher THC (vs. CBD) content will be associated with more adverse events. In addition, we will qualitatively explore individuals? perceptions of how their medical cannabis use affects their opioid analgesic use. As medical cannabis use continues to expand, and as the opioid epidemic continues to grow, our study findings will have important individual and public health implications that have the potential to shape clinical care and medical cannabis policies.

在过去十年中，阿片类镇痛药的使用量增加了一倍，成为治疗慢性疼痛的主要策略。同时，阿片类药物使用障碍和过量用药急剧增加。为了解决这种阿片类药物的流行，一种迅速扩大的治疗慢性疼痛的策略是医用大麻。截至2017年1月，医疗大麻在28个州合法，27个州将疼痛列为合格条件。虽然研究表明大麻的镇痛作用，但很少有人研究过医用大麻如何影响阿片类镇痛药的使用。研究尚未研究长期使用大麻或将医用大麻产品与不同的9-四氢大麻酚（THC）和大麻二酚（CBD）含量进行比较。管理HIV阳性成人慢性疼痛尤其具有挑战性，但很少有研究关注这一人群。由于艾滋病病毒阳性成人中慢性疼痛，阿片类镇痛药和大麻的使用率很高，因此了解艾滋病病毒阳性成人中使用大麻的医用大麻如何影响阿片类药物镇痛药的使用和艾滋病毒检测结果非常重要。尽管有潜在的好处，但大麻有潜在的不良事件。很少有研究检查过长期使用大麻的不良事件，没有人研究过THC / CBD含量特异性的不良事件。我们的首要目标是了解医用大麻的使用方式如何影响阿片类药物镇痛药的使用，并注意THC / CBD含量，HIV结果和不良事件。我们将对250名HIV阳性和HIV阴性成人进行一项队列研究，其中包括（a）严重或慢性疼痛，（b）目前的阿片类镇痛药使用，以及（c）新近获得医疗大麻认证的人群。超过18个月，我们将每3个月通过7次面对面访问收集数据，每2周通过手机收集39份基于网络的问卷。数据来源包括：问卷调查;医疗，药房和处方监测计划（PMP）记录;尿液和血液样本;和定性访谈。参与者？ 2周时间段（分析单位），医用大麻暴露将是医用大麻使用天数（初次接触量），阿片类镇痛药用量将是累积阿片类镇痛剂量（主要结局指标）。我们将研究医用大麻的使用如何影响：1）阿片类镇痛药的使用，2）艾滋病毒的结果，以及3）不良事件。我们假设（1）医用大麻的使用与阿片类镇痛药的使用减少有关，（2）医用大麻与阿片类镇痛药的使用之间的关联因THC / CBD含量而不同，（3）医疗大麻的HIV结果会有所不同使用和THC / CBD含量，以及（4）更多的医用大麻使用和更高的THC（对比CBD）含量将与更多的不良事件相关联。另外，我们会定性探索个人吗？对他们的医用大麻使用如何影响其阿片类镇痛药使用的看法。随着医疗大麻使用量的不断增加，随着阿片类药物流行病的持续增长，我们的研究结果将对个人和公共卫生产生重大影响，有可能影响临床护理和医疗大麻政策。

------------------------------------------------------------------

欲流之远者，必浚其源泉。
欢迎关注JUNYUAN，我们的理念是科技改变生活！

在这里，你可以检索美国国立卫生研究院经费数据库NIH，更重要的是，我们将同您一起探索生命科学带来的技术创新。

今天我要推荐一个自动免费追踪文献的人工智能神器：stork;

仅仅需要一个邮箱，1分钟可以注册30个账号一点都不夸张；你只要添加自己关注的文献关键词，这款神器就相当于个人量身定制的微博热搜，每天用这款神器精准追踪文献，xx再也不会担心你毕业延期了~~

以下是注册地址，

https://www.storkapp.me/?ref=93617

当然也可以扫二维码