DIRECTOR of the Caribbean Drug and Alcohol Research Institute Dr Marcus Day believes the time has come for regional governments to legalise marijuana to counteract the spread of HIV.
"I think we should regulate cannabis (marijuana) use the same way we regulate alcohol use, the same way they are talking about regulating it in the states of Washington and Colorado in America," said Day, an HIV/AIDS specialist and coordinator of the Caribbean Harm Reduction Coalition.
"Cannabis actually keeps viral progression down in a body. If you are HIV positive and you are not on medication, smoking cannabis is actually therapeutic, and that's science, not people's opinion," he told the Jamaica Observer on a visit to the island last week.
Day believes HIV patients — especially those who haven't started anti-retroviral drugs for whatever reason — should be allowed to ingest marijuana as a tea or in pastry such as brownies. Statistics show that approximately 30 per cent of those living with HIV in the Caribbean are not on any type of treatment.
The legalisation of marijuana should also be considered as a prospective harm reduction mechanism, said Day, who noted that some crack smokers had resorted to selling sex as a means of supporting their habit, and this increases their vulnerability to HIV/AIDS.
"A lot of the research that we have done over the years has pointed to the fact that many of these women only began to engage in sex work as a regular activity after they started to use substances and we also find that probably 20 per cent of the men who are homeless crack users are also engaged in selling sex, primarily to other men," he said.
"We encourage the crack smokers that we work with to substitute their crack for cannabis and to smoke cannabis instead. Even though it's probably not the best thing, it's much better than crack smoking. We don't know anybody who sells sex for cannabis, we don't know anybody who is breaking into houses for cannabis, nobody stealing cars; and cannabis users are not coming down the streets and pulling your chain off your neck. These are things that are associated with cocaine," he said.
Day, who is based in St Lucia, said the region should at least begin talks on the issue as a public health matter, although he is well aware of some of the arguments against its use.
"All substances have their downside," the doctor acknowledged. "Regulating dosage with marijuana is very difficult; regulating any substance that's illicit is a problem."
He found support with co-chair of the Caribbean Vulnerable Communities (CVC), John Waters, who believes the use of marijuana to treat HIV and cancer patients in the Caribbean is definitely worth exploring.
"One of the things we do need to look more closely at is harm reduction in the Caribbean. Harm reduction is something that is not very well accepted by and large because people have a lot of misconceptions about what that entails," he said.
"There are people who are taking stronger drugs that are more harmful and there are documented cases of using marijuana as a substitute, so it's less risky. It's more manageable to use marijuana instead of smoking crack, for example, or instead of injecting heroine," said Waters who is from the Dominican Republic.
Waters and Day were among several regional HIV/AIDS advocates and policymakers who met in Jamaica this past week to review the progress being made to meet the needs of vulnerable communities in the Caribbean.
The CVC, through funding from the Pan Caribbean Partnership against HIV, has given grant funding amounting to US$10 million to Jamaica, the Dominican Republic and Trinidad & Tobago in 2010 to further their work with persons within these communities. The groups targeted for this project were men who sleep with men (MSMs), drug users and marginalised youth.
"For a long time we have placed emphasis on changing behaviours, and attitudes to get people to reduce their risk to HIV, but we have also realised that this works only up to a certain point. But if we don't address some of the structural issues, then these populations will continue to be at risk," said Waters.
The next phase of the project will see Haiti, Suriname and Guyana benefiting from a similar grant.