Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA.
Department of Biostatistics, Boston University School Public Health, Boston, MA, USA.
AIDS Care. 2023 Aug;35(8):1235-1242. doi: 10.1080/09540121.2023.2208321. Epub 2023 May 18.
Cannabis is often used by people with HIV (PWH) for pain, yet study results are inconsistent regarding whether and how it affects pain. This study examines whether greater cannabis use frequency is associated with lower pain interference and whether cannabis use modifies the association of pain severity and pain interference among 134 PWH with substance dependence or a lifetime history of injection drug use. Multi-variable linear regression models examined the association between past 30-day cannabis use frequency and pain interference. Additional models evaluated whether cannabis use modified the association between pain severity and pain interference. Cannabis use frequency was not significantly associated with pain interference. However, in a model with interaction between cannabis use frequency and pain severity, greater cannabis use frequency attenuated the strength of the association between pain severity and pain interference ( = 0.049). The adjusted mean difference (AMD) in pain interference was +1.13, + 0.81, and +0.05 points for each 1-point increase in pain severity for those with no cannabis use, 15 days of use, and daily use, respectively. These findings suggest that attenuating the impact of pain severity on pain-related functional impairment is a potential mechanism for a beneficial role of cannabis for PWH.
大麻经常被感染 HIV 的人（HIV 感染者）用于缓解疼痛，但研究结果对于大麻是否以及如何影响疼痛存在不一致。本研究考察了在 134 名有物质依赖或终生使用注射药物史的 HIV 感染者中，大麻使用频率与疼痛干扰的相关性，以及大麻使用是否改变了疼痛严重程度和疼痛干扰之间的关联。多变量线性回归模型考察了过去 30 天大麻使用频率与疼痛干扰之间的关联。额外的模型评估了大麻使用是否改变了疼痛严重程度和疼痛干扰之间的关联。大麻使用频率与疼痛干扰之间无显著相关性。然而，在大麻使用频率与疼痛严重程度之间存在交互作用的模型中，大麻使用频率越高，疼痛严重程度与疼痛干扰之间的关联强度越弱（ = 0.049）。对于无大麻使用、使用 15 天和每天使用的患者，疼痛严重程度每增加 1 分，疼痛干扰的调整平均差异（AMD）分别为 +1.13、+0.81 和 +0.05 分。这些发现表明，减轻疼痛严重程度对疼痛相关功能障碍的影响可能是大麻对 HIV 感染者有益作用的一个潜在机制。
