Episode Transcript
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Speaker 1 (00:01):
From the WA and M Studio on the campus of
Florida A and M University.
Speaker 2 (00:04):
This is Mary Forum Radio, a weekly conversation on the
education and research of the medical marijuana being conducted at MUNI. Hi,
I'm Heidi Outway, your host for this conversations on cannabis
live virtual form, brought to you by the Medical Marijuana
Education and Research Initiative at Florida and M University. In
(00:25):
this conversation, we're talking about using medical marijuana as a
therapy for people living with HIV. So let's talk and
learn about this subject with our guests. Doctor Natalie Wilson
has more than twenty five years of clinical expertise in
primary care, HIV and sexual health. She's an educator and
(00:46):
a researcher on the topic with a focus on transforming
healthcare for individuals and systems. Doctor Wilson, Welcome to the Forum.
Tell us more, tell us more about yourself.
Speaker 1 (00:58):
Oh everyone, thank you, thank you so much for having me.
I you know, I'm an associate professor at UCSF here
in the Bay Area in California, and I've been doing
research on HIV symptom clusters for quite a number of
years and looking at how we can mitigate symptoms, manage them,
(01:22):
and inflammation caused by some of the mechanics of how
the HIV virus works in the body. I received my
doctoral degrees from the University of Alabama in Birmingham, and
a master's degree in public health from UNC Chapel Hill
and in nursing from Vanderbilt University, and I went to
(01:46):
hpcu's Filman College, graduating in the nineteen hundred's late nineteen hundreds.
Speaker 2 (01:54):
All right, well, doctor Wilson, I'm looking forward to this
conversation and learning more about your expertise. Everyone joining us
on this live forum, please share posts and tag a
friend on Facebook to have them join this conversation. If
you're on YouTube, share the links so others can join
us as well. During the forum, we want you to
send us your questions in the comment box, and we'll
(02:15):
do our best to have doctor Wilson answer them. We
also want you to tell us what you think about
this forum by completing the survey posted in the comments
on Facebook and YouTube. After the live forum, your name
will be entered into a drawing on November twelfth, twenty
twenty four, to win a one hundred dollars gift card
provided by one of Mary's partners. Now let's start this
(02:36):
conversation on cannabis. So, doctor Wilson, you know, HIV and AIDS,
you know, came out decades ago, so it might be
good just to remind everyone that is listening and watching
what is HIV and how it affects the body.
Speaker 1 (02:54):
Okay, So, HIV is a type of retrovirus that when
it gets into the body, it targets the host or
the human human's immune system, so it actually inserts itself
into the genome or like the DNA and makes copies
of itself and as a result, it ends up destroying
(03:17):
the immune system over time, and that's how it causes
acquired immune deficiency syndrome or AIDS, and someone can be
in an advanced stage of HIV or AIDS as a
result of that if they do not get treatment. It
also impacts because of the immune system, it impacts the
(03:40):
gut lining and causes like a leaky gut. And because
there's no immune system which has which is behind the gut,
there's a large amount of the immune system or the
gut associated limp tissue behind the intestines, it's not able
to protect the rest of the system from microbial products
(04:04):
from leaking through into bloodstream, and so products can get
into the bloodstream and cause the immune system that's there
to get activated and cause cause inflammation. So the viruses
is very active. We don't have a cure yet because
it's hard to get into the geno genome to cure it. Yeah.
Speaker 2 (04:29):
Well, you reference some of the symptoms when you were
describing what it is. What are some other symptoms that
people with HIV experience.
Speaker 1 (04:38):
Yeah, So people living with HIV can experience many symptoms,
primarily things like pain, difficulty sleeping, difficulty falling asleep, fatigue,
peripheral neuropathy or burning in the hands and feet, poor appetite,
(04:59):
gut symptoms, and uh we we see a lot depression, anxiety,
and brain fog, which I'm having a little bit of
right now. Brainfall that can lead to forgetfulness or just
(05:20):
not being able to think clearly. So people have that
neuroinflammation in the brain.
Speaker 2 (05:26):
Wow. So HIV is a qualifying condition for medical marijuana
use here in Florida. So how does cannabis relieve some
of those symptoms that you just mentioned.
Speaker 1 (05:36):
Yeah, So cannabis has quite a few anti inflammatory properties,
and antioxidant properties. It also interacts with the gut microbiome
and helps heal some of the gut uh we. Cannabis
has several components that work such as THHC, cannabi II, ALL, CBN,
(06:03):
cannabin all or CBG or CBDV. It has several different
components that actually work together to reduce inflammation which we
see in HIV and in other people. People use it
in cancer or other conditions, right, And because it reduces
the inflammation, that inflammation that causes the symptoms such as pain,
(06:26):
neuropathic pain, muscle skeletal pain, arthritic pain, anxiety, depression, it
can mitigate those symptoms.
Speaker 2 (06:35):
Right, right, So what are the typical treatments for cannabis therapy?
Speaker 1 (06:41):
What are the typical treatments?
Speaker 2 (06:43):
Yeah, So if some HIV or AIDS and they're looking
to use cannabis, what could they what would their theory,
what could their therapy look like using cannabis?
Speaker 1 (06:53):
Okay, So one, I want to want to be really
clear that cannabis does not treat HIV. So yes, So
HIV you need to have anti retroviral treatment, and that's
really important because the only way you can stop the
virus from replicating itself is to take anti retrovirals, which
(07:13):
are really easy to take. They even have injections that
last two and now six months. So once that happens,
the virus is suppressed and you know, in terms of
ending the HIV epidemic, once the virus is suppressed, you
cannot spread HIV.
Speaker 2 (07:32):
Yeah, so that's major advances since it was you know,
first came out, So thank you for sharing this.
Speaker 1 (07:41):
They used to take a lot of pills, have a
lot of side effects from pills. Now the treatments have
very little side effects, but people are still, even when
virally suppressed, having ongoing inflammation which can have an impact.
So it's really important. And I want to stress that
(08:02):
cannabis will not treat the HIV. That you need anti
retual viral treatment to treat HIV. The only thing that
cannabis can mitigate is some of the symptoms that are
a result of the inflammation, immune activation, or even the
virus or some treatments that you could be taking for
(08:25):
something else. It can mitigate those symptoms. So talk a.
Speaker 2 (08:30):
Little bit about that. So what does that mean? What
is how does it impact the body? And you know,
I think a lot of people are learning more about
the indocannabinoid system and the role that it plays in
our health. So can you kind of tie all that
together FORMU place.
Speaker 1 (08:44):
Yes, absolutely, So the endocannabinoid system is our body's natural
way of cannabis, you know, mitigating things. And it's a
network of receptors and enzymes and ligands that are in
the body and they naturally reduce inflammation and over time
(09:07):
they can start to reduce okay. And we have in
our body receptors, So we have cannabinoid receptor one and
cannabinoid receptor two and they're in most tissues. So and
they're most of the CB one receptors are most abundant
in the brain, where they modulate neurotransmitter activities and mediate
(09:31):
the effects of the phytocannabinoids or cannabis on neuro behavior.
And so you will find many of those in the
in the brain. They're not found in the respiratory center
like you know we see in opioids for example, so
you're not going to get that respiratory depression. IF one
(09:52):
receptors are also found in immune cardiac cells and testicular
cells and also in the gut. All right, and yeah,
so and then we do have expressions of c B
two receptors as well, which mostly you know, yeah, I'll
leave it that.
Speaker 2 (10:13):
So, how does cannabis help regulate this system, the indocannabinoid
system and then also the symptoms of HIV.
Speaker 1 (10:22):
Yeah, so what it does is in the those receptors,
cannabis binds to those receptors and does the work that
our indocannabinoids would normally do. Okay, okay, so different components
you heard me say, like we have thc DBD, CBD, CBG,
you know, CBN those combined to those receptors and or
(10:51):
cbd actually doesn't bind to the receptors but pushes THHC
off of the receptors. But it also has an anti
inflammatory effect. They will they have an effect or on
the pro inflammatory. Uh, let's see, they have an effect
on anti inflammation basically, so to they interact with certain
(11:15):
side of kinds to reduce them.
Speaker 2 (11:19):
Okay, I hope that was clear.
Speaker 1 (11:20):
The inflammation and yeah, that's.
Speaker 2 (11:24):
The core because you said that's one of the symptoms
of HIV. So I know that you've done some studies
on cannabis therapy for people with people who are living
with HIV. Can you talk a little bit about the
studies and what you've learned, and what prompted your interest
in this subject altogether.
Speaker 1 (11:41):
Yeah, So what prompted my interest in working with cannabis
is I was doing studies on symptoms and looking at
what symptoms could be associated with microbial translocation, and which
is the translocation of the microbes from the gut into
the bloodstream that we talked about earlier, and that happens
(12:02):
through the leaky gut, you know, when those tight gap
junctions are destroyed by inflammation and you don't have the
cells to produce the side of kind that kind of
repairs them, you know, in the body naturally. And so
cannabis we were looking at excuse me, I was looking
(12:25):
at symptoms, and we discovered that people had poor appetite,
and then that those people that reported poor appetite had
higher levels of soluble CD fourteen, which is an indicator
of this microbial translocation. So I decided to interview those
people that we're living with HIV and had had reported
(12:49):
poor appetite, and many of them said, what I do
is I smoke cannabis to eat because back during that time,
men of the medications require food to take, and of
course if you don't have an appetite, you don't want
to eat, and you need to eat to take your medications.
So because I I heard that that's what they were doing,
(13:14):
I decided to look more into the impact of cannabis
on poor appetite and then discovered that there were shifts
in the microbiome as well. So that's what I started
looking at. Now. In terms of research, I published a
few reviews that looked at animal studies and the possibility
(13:40):
of using cannabis for some of these symptoms and where
we could position it with symptom management. However, it's difficult
to study cannabis because you know, the cannabis binds to
your indocannabinoid system, you know, and so we're all different.
(14:02):
And I like it to say, you know, if we
studied you know, cannabis, we would need a dosage. That's
how the medical system and research works. We need a dosage,
and say my dosage may be a little less than
say Snoop Dogg's dosage.
Speaker 2 (14:19):
Rutroduced the impact.
Speaker 1 (14:22):
You know, it's it's going to have a different impact
on people. And you know, there are various ways and
routes that you could take cannabis as well, So inhalation,
let's talk about that. Yeah. Yeah, you have inhalation which
takes an effect pretty rapidly in seconds to minutes. And
(14:46):
then you have ingestion of cannabis. You can do teactures
under the tongue, you can have edibles, and then you
can use and that takes about be anywhere from like
forty forty minutes to one hundred and eighty minutes for
that to take effect. So people need to be really
(15:08):
careful when they're saying this isn't working and then don't
take more. Just give it some time. And then you
have topicals as well, and they have other like waxes,
other ways of taking dabbing.
Speaker 2 (15:28):
I hadn't heard of a wax. Tell me about that.
Speaker 1 (15:30):
It's dabbing. It's just like a wax, and people just
dab it. I mean, there are many ways you can
get cannabis, and it depends on the impact and how
quickly you need it.
Speaker 2 (15:46):
Yeah. Yeah, And then here in Florida, you know you're
required to go to first you know, HIV is a
qualifying condition here in Florida, but you also need to
go to a qualified physician who can help that individual
determine what's the best type, and then also what's the
best way to you know, get it into the system.
(16:07):
So we want to encourage people to remember that.
Speaker 1 (16:10):
Uh, yeah, you'll want to, Yeah, you'll want to talk
to the bud tender about specifically what your needs are
and ask for recommendations. And usually they're pretty good about
supporting you if you're new to cannabis and looking up
what would be right for you. You know, like my
mother I had her she was having difficulty sleeping, and
(16:33):
I sent her CBN, you know, like some cannabis to
help her sleep, and that has a very sedating property,
and so those were in edibles like in lozenges or
little gummies, and you know she had because she had
a lung condition, she can't smoke, you know, right, And
(16:57):
you want to also consider or maybe topicals as well,
because that can absorb into the skin, you know, and
provide some pain relief. Yeah.
Speaker 2 (17:11):
Yeah, So you mentioned you know your mother's experience, and
you've done a lot of studies. Can you share any
success stories or testimonials from people who are living with
HIV who found symptom relief by using medical cannabis.
Speaker 1 (17:27):
Yeah, I mean, many of the people that are living
with HIV that use cannabis, they use it for pain,
depending on who they are, whether I recommend them vaping
or smoking, you know, just because it goes into the
lung system. But I think you know, it is fine
(17:48):
to use cannabis. You can get some pain relief almost immediately.
I think it's great as an adjunct therapy for taking
your medications or for side effects of medications. Some people
use it for anti nausea. However, if you get intoxicated
(18:13):
and have too much, it will cause nausea, and that
can be mitigated by some CBD, like pure CBD.
Speaker 2 (18:24):
Yeah, hot shower, Oh, hot shower. Oh that's a verse,
that's a VERSI I heard.
Speaker 1 (18:30):
No, if you really start getting really sick, you can
take a hot shower and it will kind of like
mitigate that.
Speaker 2 (18:39):
Very interesting. So what advice would you give someone who's
been recently diagnosed with HIV and they're considering cannabis as
part of their symptom management.
Speaker 1 (18:51):
So, One, make sure you're on anti retroviral therapy. That'd
be the first and one that works for you. Two,
I would look at what symptoms you're having and focus
on what strains would be best for you. So the
sativa strain has more of a euphoric It has more
(19:13):
THC in it, so it has more of a euphoric
energetic side effect, I would side effect to it. And
I want to say as I say that you do
not have to get high on cannabis. You don't have
to get that euphoria. You can take one puff, two
(19:34):
puffs and it is adding that phyto conabinoid, those those
components into your body, so you can just do what
you need to do and it doesn't have to alter anything.
They also have in a constrain, which is more of
the relaxation people associated with being stoned. You know you're
(19:57):
gonna come down on that stream. And then they have hybrids,
and they have a cistiva hybrid which you can get
some of the impacts of a sativa which is brightening, euphoric,
and you can also kind of come down. So if
you want to wake up, but you need to go
(20:17):
to work, so you don't need to be totally happy
over the place. And then you have indicome blends where
you don't want to fall asleep, but you need to
really kind of calm down. Say if you had anxiety,
like and you need to come down. It'll have that impact,
(20:38):
but you need to stay awake and it'll have a
little bit of sativa in it of that type of hybrid.
So your bud tender or an expert in cannabis for
medical can can make recommendations for that. And then also
there's a website leafly dot com leefly dot com that
(21:00):
really great about you putting in like your symptoms and
recommendations for you because the names are all over the place. Yeah, yeah, yeah,
you have so many names that people come up with,
and I don't know how they come up with those names.
That's a whole study in and of itself, right, Yeah, Yeah,
(21:22):
you could just go on there and it will give
you recommendations and sometimes where you can purchase those. And
then weed maps as well, so you can just type
in your area and it'll tell you how to get
your card, yeah, and where to get can Yeah.
Speaker 2 (21:43):
And I just want to take a minute to remind
everyone that they can also visit the Florida Department of
Health's Office of Medical Marijuana Use where you can actually
learn how to get a legal medical marijuana card and
also identify the qualified physicians that are in your area
that can support you if you with cannabis therapy. So
I just wanted to throw that out there. Doctor Wilson,
(22:05):
this has been a really rich conversation and I've learned
a lot, and I wanted to know, is there anything
else that you want to share with our viewers and
listeners as they're considering, you know, not only for themselves,
but maybe a loved one or a family member or
a friend who may be living with HIV or newly
diagnosed and just you know, want to know is this
something that they should consider.
Speaker 1 (22:27):
Yeah. I mean one of the things that's coming up
for me is you want to be really careful if
you're under the age of twenty six and selecting you know, cannabis,
you don't want to do too much because you do
have indocannabinoids likely in your body, and you may have
been diagnosed with with HIV and you can you know,
(22:49):
get on treatment. But cannabis is a stabilizing drug. It
stabilizes things, and so if you're still in brain development,
it using cannabis on a regular basis will stabilize the
growth of brain. So you want to be really careful
(23:13):
with using it. And it doesn't mean that you can't
get benefits like anti inflammatory benefits, like cannabis is used
for seizures CBD mostly it's used for seizures, So that's
that's helpful, And that's probably where I would make recommendations
if you had to use cannabis, but I would stay
(23:34):
away from really activating those CB one receptors with cannabis.
Speaker 2 (23:42):
Yeah. Are there any other risks that people should consider?
I mean, I thought what you just brought up was
very eye opening. Any other risks that people should be
considering if if they use cannabis. I mean, we haven't
even delved into whether or not for some that are
listening in states where recreational is allowed. When you talk
about using you know, non medical grade cannabis that you
(24:04):
know folks are buying, not initially in a dispensary.
Speaker 1 (24:08):
Yeah, yeah, I think, you know, I think any street
level drugs, like buying things off the streets are you know,
I don't have as much trust with that. Usually when
you're getting it from this dispensary, they it's regulated. Yeah,
heavily regulated, and you know what you're getting. And I
(24:29):
know you guys are going through a midmic three. I
think that the recreational use allows for access to get
cannabis safely from people. So I think that that's definitely
helpful and it's regulated, like you know what you're getting,
(24:54):
So yeah, I would just I think it's just being careful.
I think it's rate if that does pass for you all,
because it decriminalizes cannabis and people can start using it
effectively as opposed to just you know, getting just getting
(25:15):
high and then being responsible with cannabis. It's it is
a super food, but you don't want to misuse it
because it does have an impact on your body.
Speaker 2 (25:27):
Yeah. Yeah, And so again just reminding people here in Florida,
make sure that you go to a qualified position again
so that you have a good experience if you choose
to use medical cannabis as a therapy for HIV. So
finalely before we wrap up, any close and comments you
want to share with our listeners and viewers. This has
(25:48):
been a very informative and rich conversation, So thank you.
Speaker 1 (25:51):
No, if I think of anything with the questions, I will,
you know. I think it's a it's it's it's wonderful
on inflammation, which is its job, and it's very effective
at managing symptoms and people with HIV do have symptoms
and you just got to be really careful.
Speaker 2 (26:13):
Yeah, all right, well, doctor Wilson, thank you so much
for being a guest on our Conversations on Cannabis live
virtual form brought to you by the Medical Marijuana Education
and Research Initiative at Florida and M University. Thank you
to everyone watching this program. Tell us what you think
about this form by completing the survey posted in the
comment boxes on YouTube and Facebook after this live program.
(26:36):
If you complete the survey, your name will be entered
into a drawing on November twelfth, twenty twenty four, to
win a one hundred dollars gift card provided by one
of Mary's partners. We also want to encourage you to
go to the Florida Department of Health Office of Medical
Marijuana Use website to learn how to obtain a legal
medical marijuana cart in the state of Florida. We also
(26:57):
encourage you to go to Florida and M University's Merry
website to learn more about this initiative, its educational programs,
and additional information about cannabis use in Florida. Thanks everyone.
Speaker 1 (27:12):
The views and opinions of our invited guests are not
necessarily the views and opinions of Florida Agricultural and Mechanical University,
or the Medical Marijuana Education and Research Initiative