The memory loss could be either short-term, long-term, or both. However, most patients experience short-term memory loss. According to Campbell and Blieden’s documentary film Super High Me, the experiment designed by Dr. Mitch Earleywire was created to see what effects medical marijuana has on memory, cognitive ability, and psychic ability . The subject, Doug Benson, went thirty days without using marijuana and then thirty days with constant consumption of marijuana. Dr. Gary Cohan found that Doug suffered from slight shortterm memory loss after using cannabis for thirty days. Dr. Gary Cohan had asked Doug to count backwards from one hundred subtracting seven each time. However, Doug began to subtract nine instead of seven. This documentary film demonstrates that one can experience some memory loss within thirty days of constant cannabis consumption. According to current research, medical marijuana can relieve anxiety through the CBD cannabinoid but it can also have damaging long-term effects in regular users. Depression, cognitive impairments, increased anxiety, and memory loss are serious long-term consequences to consider when prescribing medical marijuana. Most states have legalized and distribute marijuana for medical purposes but it still remains illegal under federal law due to the restricted amount of research on this subject. Therefore,cannabis grow system until there is more solid evidence that proves medical marijuana is beneficial, it should not be prescribed to patients with an anxiety disorder.
State laws and attitudes toward marijuana use have continued to evolve: twenty-three states and the District of Columbia now allow marijuana use for medical or recreational purposes . Several reports have documented an increase in marijuana use as well as daily or near daily use in the general US population since the mid-2000s. Research among HIV-seropositive individuals in the US suggests that marijuana use is common and higher than the general uninfected population. Rates of current marijuana use among HIV+ individuals have ranged from 14% to 56% as compared to 8.5% in the general US population 18+ years of age . With widespread use of antiretroviral therapy , HIV+ individuals are living longer and the focus of clinical care has shifted to the management of a chronic disease. Observational studies of HIV+ individuals cite therapeutic benefits of marijuana; including relief of HIV-related symptoms and side effects of ART , although empirical data on the efficacy and safety of use is limited . Importantly, marijuana use among HIV+ individuals has been associated with reduced ART adherence , cognitive impairment and poorer quality of life .In a recent study that assessed longitudinal patterns of marijuana use among women living with HIV, prevalence of current marijuana use decreased significantly from 21% to 14% over a 16 year period ; however, daily use increased by more than three-fold, increasing from 14.8% in 1994 to 51% in 2010 . Past studies of correlates of marijuana use among HIV+ individuals have found younger age , lower educational level , alcohol, cigarette and other illicit substances to be positively associated with marijuana use , although most of these studies have been cross sectional.
Using data from a longitudinal cohort of HIV+ women, Kuo et al. found lower initiation of weekly marijuana use among women with an undetectable HIV viral load and those receiving highly active antiretroviral therapy . A followup study in HIV+ women found marijuana users to be less likely to be on ART, but daily marijuana use to be associated with higher CD4 count . In addition, passage of medical marijuana laws may be associated with increased availability and easier access to marijuana and may contribute to increased use of marijuana. Several studies have showed that passage of MMLs is associated with increased marijuana use . Other studies either indicate no effect or a decrease in marijuana use following passage of MMLs . However, nearly all of these were among adolescents. Given that most state MMLs list HIV/ AIDS as a qualifying condition for medical use of marijuana , passage of MMLs may be associated with increased marijuana use among HIV+ individuals. The aim of the present study was to: assess trends in the annual prevalence of current and daily marijuana use over time among HIV+ and HIV− individuals determine correlates of current and daily marijuana use over time and explore whether passage of MMLs is associated with increased marijuana use. The Multicenter AIDS Cohort Study is an ongoing prospective cohort study of the natural and treated history of HIV infection among men who have sex with men in the United States. A total of 6,972 men were enrolled during the project in three waves: 4,954 men in 1984–1985, 668 in 1987–1991, and 1350 in 2001–2003 and at four centers located in Baltimore/Washington DC, Chicago, Los Angeles, and Pittsburgh. The study design of the MACS has been described previously and only the design relevant to the present analyses are described here.
Institutional review boards at each study site approved the MACS study protocols and informed consent was obtained from all participants. MACS participants return every 6 months for a physical examination, collection of blood specimens and complete a detailed interview and questionnaires. The interview and questionnaires collect demographic, psychosocial, behavioral and medical history data. The questions about recreational drug use, including marijuana, alcohol, poppers, cocaine, crack, heroin, methamphetamine, ecstasy, injection drug use as well as smoking history were collected using audio computer assisted self-interviewing, an approach previously demonstrated to provide more accurate assessments of ‘sensitive behaviors’ than interviewadministered questionnaires among MSM . Participants—The present study uses data from 5,914 men who answered questions about marijuana use for at least two or more semi-annual visits. For the present analyses, we defined two enrollment periods: the men in the early-cohort were enrolled before 2001 and those in the late-cohort were recruited after 2001. The enrollment cohorts were analyzed separately because of differences in the individuals that were recruited: the men in the earlycohort were predominantly non-Hispanic white, had more years of education, and had fewer symptoms of depression than those in the late cohort . We included data collected from marijuana use questions from semiannual study visit 1 through visit 59 for the men in the early-cohort. The period covered for the men in the late-cohort included: semiannual visit 40 through visit 59. We selected visit 40 as the baseline for the late-cohort as this was when the sample size reached its maximum after the expansion of the cohort between 2001 and 2003. Outcome Measure: Marijuana use: Current marijuana use at each study visit was assessed with the following question “Have you used any pot, marijuana or hash since your last visit? Participants who responded ‘No’ to this question were classified as non-users. Among those who responded ‘Yes’, frequency of use was asked with the following question “How often did you use pot, marijuana grow system or hash since your last visit?” with the following response options: “daily”; “weekly”; “monthly” and “less often”. Covariates Socio-demographic Characteristics: Participant’s age at each visit was calculated from their self-reported date of birth. The baseline visit was used to define a three level categorical variable for race/ethnicity status , educational attainment and current employment . Participants were classified according to the MACS study center and whether they were enrolled prior to or after 2001. Depressive symptoms: The Center for Epidemiologic Studies Depression scale, was used to measure clinically significant symptoms of depression at each visit . This assessment was developed for use with community populations and includes components of depressed mood, feelings of worthlessness, sense of hopelessness, sleep disturbance, loss of appetite, and concentration difficulties.
Scores on the CES-D of 16 or more suggests a clinically significant level of psychological distress . Alcohol use: Using data regarding frequency of drinking and average number of alcoholic drinks since last study visit, alcohol consumption at baseline and at each visit was categorized as low-moderate , heavy or no alcohol use . Cigarette use: Participants were classified as never, former and current smokers at each study visit. Questions about smoking includes “Did you ever smoke cigarettes?” and “Do you smoke cigarettes now?”. Participants who answered ‘yes’ to both questions were considered to be current smokers. Participants were classified as former smokers if the answered ‘yes’ to the first question and ‘no’ to the second question and never smokers if they responded with a ‘no’ to both questions . Stimulant use: At each study visit participants were considered to be users of stimulant drugs if they reported the use of any of the following drugs since last study visit: crack cocaine, other forms of cocaine, methamphetamines , other recreational drugs such as “ecstasy” or MDMA . Clinical factors: HIV serostatus was assessed using enzyme-linked immunosorbent assay with confirmatory Western blot tests on all MACS participants at each participant’s initial visit and at every semiannual visit for participants who were initially HIV−. However, only participants who were seropositive as at the time of enrollment were included. Detailed descriptions of additional laboratory measures have been published elsewhere . Cluster of differentiation T-lymphocyte subset levels were categorized as <500 and ≥ 500 CD4+ cells/μL. Levels of plasma HIV ribonucleic acid were used to create a dichotomous variable to denote detectable versus undetectable. Hepatitis C virus infection status was categorized as HCV negative if HCV antibody testing was negative. Participants were classified at each semiannual visit as HCV positive if they were found to be in the process of seroconversion, acute infection, chronic infection, clearing , or previously HCV positive, but now clear of HCV RNA. In addition to the covariates described above, we considered that the prevalence of marijuana use among HIV+ participants may be influenced by factors specific to HIVinfection such as ART usage has been previously reported . Antiretroviral medications were self-reported at each semiannual visit and summarized to define HAART usage . HAART was defined according to the U.S. Department of Health and Human Services/ Kaiser Panel guidelines . Characteristics of the sample at their baseline visit stratified by HIV serostatus and cohort enrollment were described using frequencies and percentages for categorical variables and means for continuous variables. Yearly prevalence of current marijuana use was calculated as the number of participants reporting marijuana use divided by the number of participants seen in the MACS for a given year. Daily marijuana use was calculated as the number of participants reporting daily use divided by the number of current users for each given year. We plotted both prevalence of current and daily marijuana use over the follow-up period by calendar year stratified by HIV-serostatus and cohort enrollment. In order to better understand the trends, we additionally calculated and plotted the prevalence of daily use as the number of participants reporting daily marijuana use divided by the total number of participants seen in the MACS. Univariate and multivariate Poisson regression models was used to estimate population-averaged effects of correlates on current and daily marijuana use over time. These models were performed using generalized estimating equations . We accounted for the dependency between the repeated measurements of the outcome by robust estimation of the error variances and specifying an unstructured correlation structure for the repeated observations . Separate analyses were conducted for the men in the early and late cohorts. Within each enrollment cohort, analyses were conducted separately for the combined group as well as the HIV+ men. For the analysis limited to only the HIV+ men, we selected semiannual visit 25 and visit 40 as the baseline for the men in the early- and late- cohorts respectively. We selected visit 25 as the baseline for the HIV+ men in the early cohort because we were interested in the effect of HAART use on rate of marijuana use, which only became available in 1996.Our strategy for constructing the multivariate models was to include correlates that were significant in the univariate analyses. The covariates considered for inclusion in the multivariate model for the combined group included age, race, educational attainment, employment, study center, depressive symptoms, alcohol, smoking, stimulant drug use, intravenous drug use , and HCV status. Furthermore, to compare the prevalence rates of the HIV+ to the HIV− men, the model for the combined group included a variable to denote participant’s HIV-serostatus. A variable was also included to estimate the effect of MML passage on marijuana use .