Assessing the dose, amount, and heavy use patterns among adults with HIV who use marijuana

Robert L. Cook,
University of Florida

Objective: Marijuana flower, commonly used to help manage symptoms and conditions, may be obtained either within or outside of the formal medical marijuana system. There is a desire to identify the optimal dose and frequency for different conditions. As part of an ongoing cohort study of marijuana use in persons with HIV, we sought to identify and quantify the average amount of marijuana flower consumed per dose and per day, and to identify the frequency of heavy daily use. 

Methods: Persons with HIV were recruited from community and clinic settings in Florida, self-reported marijuana use was confirmed by urine drug screen.  A timeline follow-back was used to inquire about specific doses, patterns, and modes of consumption during the past 30-days, using pictures of of marijuana flower to help estimate the amount per dose, and a calendar to identify patterns.  We examined the distribution of responses, and present the median amounts due to right skewed distribution of the data. 

Results: The sample included 212 persons with HIV who use marijuana (55% age 50+, 58% male 67% non-hispanic black, 15% Hispanic). Nearly all users obtained marijuana from outside of the formal medical system, and 83% used only marijuana flower in the previous 30 days. Among these users, 52% used daily, with a median quantity of 0.8 grams/day.  The most common modes of flower consumption and their median quantity of flower were blunts (48%, 1.0g), joints (42%, 0.5g), and pipes (10%, 0.06g per hit/toke/puff). The proportion who had at least one heavy use day in a month, or heavy use every day of the month was 30% and 6% when heavy use was defined as 3g/day, 43% and 13% for 2g/day, and 59% and 23% for 1g/day.

Conclusion: The amount of marijuana flower consumed can be hard to estimate. Our results are similar to others in defining the average quantity of a joint or hit/toke.  Over half of this sample consumed > 1g flower/day in the previous month.  Additional research should compare health outcomes and side effects from these different doses and patterns.

Co-authors: Zhi Zhou¹, Yancheng Li¹, Verlin Joseph¹, Gabriela Plazarte², Bomi Choi², Yan Wang¹

_{¹University of Florida ² University of South Florida}