Cannabis is widely used to help mitigate the symptoms of a variety of conditions and diseases. Specifically, a number of state medical cannabis programs list HIV/AIDS as a qualifying condition, as cannabis can help to eliminate a variety of symptoms associated with HIV/AIDS treatment.

Though, some clinicians have expressed concern how regular cannabis treatments in this regard may impact patient cognition. 

Researchers affiliated with the University of California at San Diego sought to investigate the cognitive impacts of cannabis use in people with HIV through a newly published meta-analysis in the journal Current HIV/AIDS Reports. 

Ultimately, they conclude that neither the use of whole-plant cannabis or cannabis-based medicines are associated with significant cognitive changes in those with HIV.

Cannabis Use Among People with HIV

In the study abstract, researchers note the potential benefits that cannabis use can offer patients with HIV while recognizing this population’s “high burden of persisting neurocognitive impairment” and physician concerns with adding cannabis into the mix, specifically its potential cognitive effects.

Cannabis use among those with HIV is far from a new trend. The U.S. Food and Drug Administration first approved synthetic oral THC capsules (dronabinol) to treat HIV-induced cachexia, or loss of appetite, in 1985.

Additionally, surveys have consistently affirmed that cannabis use is common among people with HIV, with one 2007 study predating the bulk of medical reform measures in the U.S. still finding that more than 60% of HIV/AIDS patients self-identified as medical cannabis users. 

Another more recent 2022 study noted that 77% and 34% of people with HIV reported lifetime and past-year cannabis use, respectively.

While some of these patients report recreational use as one reason, research over the years has found that cannabis is largely used among people with HIV to stimulate appetite, reduce pain, relax and ease anxiety and help with sleep.

‘Little Evidence’ of Harmful Cognitive Cannabis Impacts

With plenty of existing data to pull from, researchers reviewed data from 34 clinical studies to determine the extent that cannabis impacts cognition among patients with HIV. The results, according to the study, revealed that there is “little evidence” to support that cannabis has a harmful impact on cognition among those with HIV.

“Overall, the number of reported adverse effects were largely outnumbered by beneficial or null findings, providing insufficient support for the detrimental impact of CU [cannabis use] on cognition in PWH [people with HIV],” researchers reported, adding that the results suggest both cannabis and cannabis-based medications can be prescribed to people with HIV “while posing little threat to cognitive function.”

The topic of cannabis use and cognition has seen a recent uptick in popularity, especially given recent conversations surrounding cannabis-induced psychosis (which has largely been linked to pre-existing conditions and vulnerabilities and is not a widespread issue among cannabis consumers, with some advocates arguing that the focus on this topic is a repackaged version of “Reefer Madness” propaganda from decades past).

Of course, it’s important to look at the full picture and recognize how cannabis use and abuse may impact a variety of populations, and myriad studies attempt to look a bit more broadly at the topic.

Recent research shows that cannabis users may actually have a lower chance of cognitive decline overall.  Previous studies have also noted links between heavy cannabis use and cognitive performance, though researchers noted that particular products used, methods of consumption and the reasons for use can also impact cognitive effects associated with cannabis use.

Another recent study similarly found that adolescents who occasionally use cannabis do not see cognitive differences compared to those who abstain, once again highlighting a distinction surrounding frequency of use among other variables.

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A former disgraced pharmacist who was sentenced to prison over 20 years ago for diluting drugs for a cheap profit—impacting over 4,000 patients and likely leading to the deaths of AIDS and cancer patients—will soon walk free.

The Kansas City Star reports that Missouri native Robert Ray Courtney, 71, was convicted of diluting patients’ medications to treat serious conditions such as cancer, AIDS, multiple sclerosis, and more over 20 years ago. While Courtney has not been charged with murder, a prosecuting attorney said the man is “one of the most prolific serial killers.”

He primarily mixed intravenous drugs regardless of how critical they were to patients living with serious conditions. All the while, Courtney was supposedly an upstanding member of a church community at Northland Cathedral, an Assemblies of God megachurch in Kansas City, Missouri. Courtney was also the main character in License To Kill: Deadly Pharmacist that streamed on Oxygen in 2020. He was also featured in a 2010 documentary series episode on American Greed that aired on CNBC.

Courtney began his crime spree in 1990, once he learned he could swap out expensive medications with generic drugs he could buy in the gray market, making a fortune. But that didn’t satisfy his greedy urges, so he started diluting chemotherapy drugs to multiply doses. By the late ‘90s, Courtney was diluting a swath of cancer and AIDS drugs that probably led to the deaths of patients who trusted him. (As if they didn’t already have enough to worry about.) Not only were his patients not improving, but chemo patients didn’t seem to exhibit the normal devastating side effects of the drug.

Keep in mind that throughout the investigation the FBI and FDA initially would not accept that a licensed pharmacist would do such a thing intentionally. But he did.

Courtney pleaded guilty on Feb. 27, 2002 to intentionally diluting over 98,000 prescriptions for multiple types of life-saving drugs. He was officially charged with tampering with drugs, adulteration or mislabeling of drugs, but given a hefty sentence due to the seriousness of his actions.

Police estimated that his pharmacy scheme could have impacted some 4,200 patients. Courtney was sentenced in federal court in December 2002 to a maximum of 30 years, plus a $25,000 fine and $10.4 million in restitution according to court records. And according to Bureau of Prisons records, Courtney is currently incarcerated at a federal prison in Littleton, Colorado.

Victims and their families said they received a letter indicating that Courtney will be released June 20 to a halfway house in Springfield, Missouri. He is expected to remain there until his release on May 2, 2026. 

Attorney Michael Ketchmark, who represented 275 families in wrongful death lawsuits against Courtney, said in a phone interview Monday that his phone “has been lit up all day with Robert Courtney’s victims.”

“The raw pain and emotion is overwhelming,” he said. “In my opinion, he is one of the most prolific serial killers,” Ketchmark said. “He diluted chemotherapy drugs that people need when they’re fighting for their life and he took away their hope and he took away the life of his victims.” 

Ketchmark called on the Jackson County Prosecutor’s Office to bring charges. “It’s our hope that that will happen. There’s plenty of justice still to be delivered to this man. He should never walk free again.”

Courtney’s insurance company agreed to pay $35 million to victims, and two pharmaceutical makers paid $71 million in settlements.

Pharmacists Behaving Badly

High Times has reported on the pressure to prescribe painkillers in the pharmaceutical industry that has wreaked havoc on American society. Pain Hustlers, a recent film directed by BAFTA award winner David Yates, follows a mother who gets entangled with a failing pharmaceutical startup and the addiction it leads to. 

The CDC says there were 80,411 overdose deaths in 2021—75.4% of all drug overdose deaths involved opioids, with 88% of opioid overdoses being synthetic. So given these numbers, you should be more worried about pharmaceutical abuse than street heroin. That means opioids killed more Americans—during 2021 alone—than the Vietnam War.

The Pharmacist debuted in 2020 on Netflix, a docuseries that follows a Louisiana pharmacist who takes extreme measures to expose the “rampant corruption behind the opioid addiction crisis.”

There is a flood of other popular opioid-themed shows: Netflix’s 2023 drama series Painkiller starring Matthew Broderick, Uzo Aduba, Taylor Kitsch and West Duchovny briefly took the top spot on the platform. 

Netflix reported that Painkiller has two sources, the 2003 book Pain Killer by Barry Meier and the 2017 New Yorker article, “The Family That Built an Empire of Pain” by Patrick Radden Keefe, which was later expanded into Keefe’s 2021 book Empire of Pain.

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The landlocked country of Eswatini (formerly known as Swaziland), located in southern Africa, recently made a move to legalize medical cannabis.

According to a report from VOA Zimbabwe, King Mswati III and the Eswatini government have introduced medical cannabis legislation hoping that it will help curb illegal sales and allow the country to benefit from tax revenue. “The legislation will also provide measures to guard against increasing the black market,” said spokesperson Alpheous Nxumalo. “This has robbed government taxes, Eswatini, an opportunity to grow their economy and robbed even the farmers themselves who have been trying to make a living using this cannabis. We look forward to the unbanning of the cannabis plant as an opportunity to develop the country, our economy and to empower Eswatini themselves.”

Currently only one company, Profile Solutions, has been approved to be a legal cannabis cultivator in Eswatini.

If medical cannabis is legalized in the country, it would amend a statue that was implemented by the British in 1922 through the Opium and Habit-forming Drugs Act. British control over Eswatini lasted from 1903-1968, but the country’s name of Swaziland wasn’t changed to its current name until 2018.

VOA Zimbabwe obtained a statement from Dr. Thys Louren, a medical practitioner with Occupational Health Eswatini, who believes that medical cannabis legalization would provide a multitude of benefits for the country. “I stand here urging for the transformative change of Eswatini’s health care landscape toward a healthier and more sustainable Eswatini,” Louren said. “It is not just a medical decision but a holistic solution for our patients, community and economy.”

The news outlet also spoke with Business Eswatini CEO E. Nathi Dlamini, who explained the necessity of bringing Eswatini up to speed with the global medical cannabis industry. “Many countries are well ahead in this regard in terms of developing industries to support investment, create jobs which by the way, we desperately need,” Dlamini said. “As Business Eswatini, we are very thankful that from the highest authority of the land now, we are beginning to be one-minded on this.”

Additionally, residents such as merchant Maqhawe Tsabedze admitted that he’s put his kids through school while thriving from illegal cannabis businesses. “The decriminalization of cannabis will help a lot and will perhaps stop police from raiding and confiscating our products, which we make a living from selling,” Tsavedze said. “Rain or sunshine, we make sure we put bread on the table so that our children do not go to bed on empty stomachs. Since there are no jobs, we make a living from selling cannabis on the streets.”

The medical cannabis legalization proposal has only been introduced, and requires a three-fourths vote in both the House of Assembly and Senate before it can be passed into law.

Previous attempts to get medical cannabis legalized in Eswatini have fallen short. One version was tabled by the Eswatini Ministry of Health in 2020, and resurfaced in May 2023, according to a report from Semafor Africa. The news outlet spoke with the Eswatini Cannabis Association (ESA) at the time, who explained that the proposed bill would establish a Medicines Regulatory Authority to “import, export, and trade in, by wholesale, cannabis and cannabis products.” “They cannot be both the referee and the player at the same time,” said ESA chair Saladin Magagula at the time. “You cannot as an authority give yourself an export and import license while also issuing the same to people.”

However, farmers who rely on illegally cultivating for their livelihood voiced concerns about legalization. “Lomtsetfo [the law’ might make things worse because the rich companies will become our competition,” said an anonymous farmer.

Eswatini is home to more than 1 million people, and a large percentage of which suffer from HIV/AIDS. In 2021, The Guardian covered how older women were illegally cultivating cannabis (called “Swazi Gold”) to help both their families as well as children who were orphaned as a result of the HIV/AIDS epidemic. “Poverty led me into this business,” one woman said. “There are no jobs. These children need to go to school but there is no help at all from government. I have to commit crime, farming weed, to ensure I take care of them. I had three children but they all passed away, leaving me with five grandchildren to care for. All my children were HIV positive and they died because of that. I also take care of two other children, relatives to my late husband, whose parents are also dead.”

The country was also the feature of a documentary by Strain Hunters in April 2013, which explored both the cannabis industry as well as genetics unique to the region.

Other countries in Africa have begun to embrace cannabis. Medical cannabis sales were approved back in July 2022 in Zimbabwe. Last November, the South African National Assembly approved a cannabis bill that decriminalized cannabis, but did not legalize sales. It does, however, allow residents to cultivate their own plants for personal use.

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More than any big city in America, San Francisco has always been on the cutting edge of cannabis consumption––from the beats and poets smoking “mezz” while inhabiting the 1950s North Beach “beat scene” to the openly stoned hippies of 1960s Haight-Ashbury. Cannabis consumption in the “City by the Bay” continued with the groundbreaking use of medical marijuana in the Castro District to treat those affected by HIV and AIDS, leading to America’s first dispensaries. San Francisco has likewise been the vanguard for providing consumption lounges to dispensary customers, offering a place for pot patients and weed aficionados to consume in a relaxing, safe environment.

Big Top Pot

Marijuana was always a big part of gay culture in San Francisco, but it was purely for pleasure in those hedonistic, liberating days of the 1970s. That is, until the very first cases of AIDS were reported in the city in 1980. By the mid-’80s AIDS had developed into a genuine crisis in the SF gay community, with thousands of men being infected with HIV (the virus that leads to AIDS), and developing “wasting syndrome,” also called cachexia, characterized by an involuntary loss of body weight, with prolonged diarrhea, weakness, and fever.

But hope arrived with Dennis Peron, who began dealing weed out of his apartment in the Castro, dubbed the “Big Top Pot Supermarket.” In the mid-’80s, Peron’s partner, Jonathan West, was diagnosed as HIV-positive, and cannabis helped West deal with the symptoms. Weed’s appetite stimulating phenomenon was an obvious fit to combat AIDS wasting syndrome. People with AIDS want to avoid or delay the loss of appetite from wasting syndrome because it’s a calling card that the body’s shutting down.

West passed away from AIDS in 1990, and buoyed by San Francisco’s 1991 pro-medical cannabis initiative Proposition P, Peron opened the first public medical marijuana dispensary in America, the Cannabis Buyers Club (CBC) on Church Street in the Castro in 1994. Peron later moved the club to a more high-profile Market Street location in downtown San Francisco, where it was raided and became the subject of headlines and controversies throughout the mid-’90s.

Peron co-authored California’s Proposition 215, the Compassionate Use Act of 1996. In August 1996 then-California attorney Dan Lungren authorized a raid on the CBC pot club and lounge in a move that some maintained was politically motivated. Lungren’s cynical ploy failed to dissuade voters, as Prop. 215 passed with 56% of the vote on Nov. 5, 1996, making California the first state to formally legalize any form of cannabis.

In October 2003 California Senate Bill 420 was passed, along with San Francisco’s Article 33: Medical Cannabis Act, establishing guidelines for regulating medical cannabis dispensaries.

David Goldman, president of the Brownie Mary Democratic Club of San Francisco, along with his husband, Kenneth Michael Koehn, secretary of the Brownie Mary Democratic Club, remember the revolutionary times at the CBC.

“In 1994 Michael and I started going to the Cannabis Buyers Club, located at 194 Church Street in San Francisco, which was a very pleasant experience,” Goldman said. “I know that Dennis [Peron] always wanted to have a safe consumption space for people, where they could socialize. And so the need to have a safe space for consumption was apparent to Dennis, and that motivated him to start at 194 Church Street.”

Goldman explained that about a year later the club was moved to 1444 Market Street within “a building that had four floors, which was a big step up in terms of use of space and the number of people it could accommodate.”

“We started going to that Market Street CBC lounge location every Friday after work,” he said. “They had two different floors for the cannabis; one floor had some of the higher quality cannabis they’d call either ‘A-plus’ or ‘A-double plus’—they didn’t give them strain names back then. And patients could hang out there, and they offered snacks, and people would sing and play music. It was a very relaxed, chill environment; a wonderful way to spend our Fridays after work.”

Koehn added a sobering perspective reflecting on those uncertain years.

“There was also an element of fear in the dispensary lounges during that time,” Koehn said. “The fear of getting busted, that the AG [former Attorney General Dan Lungren] would raid the dispensary. We weren’t personally there when it was raided in 1996, but every time you went there, there was this fear hanging over your head, that this could be the day that trouble starts.”

Ultimately, Goldman associates positive memories with Peron’s club.

“There was a sense of community at the CBC because during that era of HIV, the gay community and the cannabis community highly intersected and we were able to contact and connect with one another,” he said.

Continuing the Tradition

The 2003 SB-420 legislation paved the way for benevolent bud entrepreneurs like Martin Olive to open up his pioneering medical pot dispensary known as Vapor Room, which still exists to this day.

“We opened in late 2003 in the SF neighborhood known as Lower Haight,” Olive said. “I worked at another dispensary prior to this and it was like a lot of dispensaries back then, most of the lounges were just folding tables and plastic chairs, and not very comfortable for people.”

Olive said he outfitted the Vapor Room with 1970s furniture; big, plush couches, gaudy pyrex ashtrays, and wood paneling.

“We made it like your cool uncle’s stoner basement apartment. And it was a hit! It really was the first of its kind in San Francisco, along with the CHAMP dispensary, they had a beautiful lounge.”

CHAMP opened at the Market Street location after the CBC departed in 1998 and closed in 2002. In opening the Vapor Room, Olive sought out to build community through cannabis.

“We had a couple tables set up, so it was about 1,500 square feet, not super-big but big enough,” he said. “And [the lounge] really created a communal aspect; medicinal cannabis was this great unifier of all different types of people.”

Even after Vapor Room was forced into a change of location, Olive adapted and made the lounge experience even better.

“Due to some city regulations, we had to move in the building next door around 2006-07,” Olive said. “We took that opportunity to up our game a little bit, so we created a French cafe/apothecary atmosphere; marble tables, nice wooden chairs, with really nice subdued color pallets. It was a little bit more sophisticated than the typical lounge. We had Volcanoes on every table, bongs available, fresh water, hot tea, things like that. So we were giving people more than just a place to access medical cannabis, we were giving them a safe, clean comfortable space in a community setting.”

Even though medical marijuana continued making great strides in San Francisco, this was not acceptable to the federal government.

“In 2012, we got caught up in the Department of Justice crackdown on dispensaries throughout the state of California, and we were evicted without much compassion,” he said. “Leaving Lower Haight was a deep loss for the community, not only for the patients, but for the local businesses that were being supported by the 300 to 400 people we brought into our dispensary on a daily basis. That’s why I think dispensary lounges are so important, they really do support the neighborhoods they’re in.”

Over half of a decade passed until Olive resurrected Vapor Room.

“When we finally reopened in 2018, we found a location in a downtown ‘corporate corridor’ where Twitter, Uber, and Dolby are. So we definitely miss the residential community small business aspect of Lower Haight, but this is what was available. It’s about 700-800 square feet and we are making it work, with a couple of benches for people to smoke at. We do have a beautiful location; it’s nice, clean, and crisp with a big window, and a lot of sunlight and plants.”

But the fact that the club is located within a business district means people generally aren’t hanging out all day.

“It’s more like people on their lunch breaks or in for a meeting,” Olive said. “They’ll come in to buy a joint, take a few puffs and be on their way. Usually we’ll have anywhere from five to 15 people hanging out and chatting. And it is a really good communal atmosphere because you’re basically sitting right next to another person consuming cannabis, regardless if they’re a stranger or not, so you’re buddied up by default.”

The Continued Transformation of Social Consumption

Goldman and Koehn have seen the dispensary lounge landscape morph over the years.

“After CBC closed we didn’t go to dispensary lounges till at least 2006, when I became a medical cannabis patient because I was already using it medicinally and I wanted access to the highest quality cannabis,” Goldman said. “We began to see each lounge had a different vibe. Lounge 847 above the Green Door, on Howard street in SoMa [South of Market district], was our favorite lounge and easy to get to.

“Lounge 847 opened in 2012 and Michael and I held meetings there for Americans for Safe Access and the Brownie Mary Democratic Club. We had a lot of politicians visit there and they were impressed that we had such a great space to hold meetings.”

The Green Door is currently closed but may be reopened pending a multi-million dollar renovation.

“I’m glad we have a diversity of lounges in the city, but most of the new dispensaries don’t get a lot of business, so the lounges are going to waste in that they aren’t being used, which is a shame.”

One Commonality

For Olive one top aspect a cannabis lounge should provide is a comfortable and safe atmosphere for all.

“There’s no room in this concept for any kind of bigotry or racism or classism,” he said. “You can have your fancy Apple store style dispensary and lounge, but if you’re not making the regular guy and girl on the street and low-income people feel comfortable and safe and valid for being there, then you’re doing something wrong. A lounge should contribute to the culture of the cannabis community where people are meeting one another. The one commonality they all have is their love for cannabis, that’s the key element.”

In terms of what’s next Olive wants to go back to the future.

“Remember what the lounge is for amidst all the spreadsheets and profit margins; to provide high quality weed for people who use it for a variety or reliefs, be it symptoms issues, or for just feeling better about their day,” he said.

This article was originally published in the June 2023 issue of High Times Magazine.

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Portugal approved the decriminalization of synthetic drugs, The Portugal News reports. Portugal has had the most liberal approach to all drugs across Europe for decades. The drug strategy, put in place in 2000 and enacted in July 2001, was initially created to reduce the HIV/AIDS toll stemming from intravenous drug use cases using a harm reduction model. (In 1999, Portugal had the highest rate of HIV amongst such drug users in the European Union.) Their policy included decriminalizing personal drug possession and would influence similar efforts in places such as Oregon. And it worked, at least at drastically reducing HIV rates. As The Washington Post reports, HIV transmission rates via syringes plummeted. 

However, while drugs are decriminalized for those who enjoy them, their policies maintain criminal penalties for drug trafficking. So basically, you can get in trouble if you supply, but not if you use. Anyone familiar with how drug culture works can understand that while the goal is admirable, this approach is far from perfect if the true goal is to protect the public’s health. People will always find a way to get drugs whether their suppliers get arrested or not. But what such suppliers are selling is changing. 

Synthetic drugs are artificially modified from naturally-occurring substances. For example, fentanyl is a synthetic opioid. The new law equates the legal approach to these substances with that of “classic drugs” like cannabis, heroin, and cocaine. The debate regarding synthetic drugs that led to their decriminalization centered on these new substances’ adverse effects on communities. While Portugal’s laws offered hope to harm reductionists worldwide, as The Washington Post notes, unfortunately, due to more recent and deadlier drugs, and other factors, the country still has drug problems. Drug use is apparently more visible on the streets than ever, and interest in offering help for substance use disorders seems to be dwindling. 

“At the end of the day, the police have their hands tied,” said António Leitão da Silva, chief of Municipal Police of Porto, adding the matter now is much like the years before decriminalization was implemented in 2000.

“Twenty-seven years later, it is necessary to change the current legal framework in order to cover this new and harsh reality,” social democratic deputy Sara Madruga da Costa said, calling back to the 2000 law, adding they plan to provide a “faster response and more effective response to this complex and alarming phenomenon” which mainly affects Madeira and the Azores regions in Portugal.

Madruga da Costa says that the distinction between consumer and dealer “is fundamental” to combat the horrors of synthetic drugs by applying their current laws to newer drugs. In addition to decriminalizing synthetic drugs, the text further eliminates the criteria based on the number of doses, or amount of drugs, to distinguish between consumers and traffickers (i.e. who can get arrested). However, it still aims to differentiate one from the other, so suppliers can’t relax yet. 

Cláudia Santos, deputy of the PS (Portuguese Socialist Party), noted that 23 years ago, the “historic decision” was made to decriminalize the possession of drugs for consumption in Portugal. Despite this legislature, from 2009 onward, the number of citizens convicted of crimes of consumption went up. “With this project, we want to reaffirm the option made for the prevention and treatment of consumers,” said the PS parliamentarian, considering that possessing drugs for consumption “should not be a crime,” The Portugal News reports.

Part of Portugal’s drug policy has always included treatment, and they hope to offer care more than ever, as psychiatric hospitalization due to unhealthy use of synthetic drugs has spiked, Business Insider reports. However, their system is far from perfect. There are currently year-long waits for state-funded rehabilitation treatment. 

You should know that while the country developed a progressive drug policy reputation early on, cannabis remains illegal. 

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Every month is Pride when you can buy queer cannabis year-round from these incredible LGBTQIA+ weed brands.

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Queer health and weed go hand in hand. Cannabis plays a significant role in the health and wellness of the LGBTQIA+ community.

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