British Columbia Centre on Substance Use, Vancouver, Canada.
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Drug Alcohol Rev. 2021 Nov;40(7):1325-1333. doi: 10.1111/dar.13294. Epub 2021 Apr 11.
People living with HIV who use drugs commonly experience chronic pain and often use illicit opioids to manage pain. Recent research suggests people living with HIV use cannabis for pain relief, including as an adjunct to opioids. This underscores the need to better understand how people living with HIV who use drugs use cannabis for pain management, particularly as cannabis markets are undergoing changes due to cannabis legalisation.
From September 2018 to April 2019, we conducted in-depth interviews with 25 people living with HIV who use drugs in Vancouver, Canada to examine experiences using cannabis to manage pain. Interviews were audio-recorded, transcribed and coded. Themes were identified using inductive and deductive approaches.
Most participants reported that using cannabis for pain management helped improve daily functioning. Some participants turned to cannabis as a supplement or periodic alternative to prescription and illicit drugs (e.g. benzodiazepines, opioids) used to manage pain and related symptoms. Nonetheless, participants' access to legal cannabis was limited and most continued to obtain cannabis from illicit sources, which provided access to cannabis that was free or deemed to be affordable.
Cannabis use may lead to reduced use of prescription and illicit drugs for pain management among some people living with HIV who use drugs. Our findings add to growing calls for additional research on the role of cannabis in pain management and harm reduction, and suggest the need for concrete efforts to ensure equitable access to cannabis.
患有艾滋病且吸毒的人群普遍会经历慢性疼痛，且经常会使用非法阿片类药物来缓解疼痛。最近的研究表明，艾滋病患者会使用大麻来缓解疼痛，包括作为阿片类药物的辅助药物。这突显了人们需要更好地了解艾滋病患者如何使用大麻来进行疼痛管理，尤其是由于大麻合法化，大麻市场正在发生变化。
2018 年 9 月至 2019 年 4 月，我们在加拿大温哥华对 25 名患有艾滋病且吸毒的人进行了深入访谈，以研究他们使用大麻缓解疼痛的经验。访谈进行了录音、转写和编码。采用归纳和演绎方法确定主题。
大多数参与者报告称，使用大麻缓解疼痛有助于改善日常功能。一些参与者转向大麻作为补充或周期性替代处方和非法药物（如苯二氮䓬类、阿片类药物）来管理疼痛和相关症状。然而，参与者获得合法大麻的机会有限，大多数人继续从非法来源获取大麻，这些来源提供了免费或被认为负担得起的大麻。
大麻的使用可能会导致一些患有艾滋病且吸毒的人群减少使用处方和非法药物来管理疼痛。我们的研究结果增加了对大麻在疼痛管理和减少伤害方面的作用的进一步研究的呼吁，并表明需要做出具体努力确保公平获得大麻。
