MEMO-Medical Marijuana and Opioids Study

The overarching goal of the study is to understand how medical cannabis use affects opioid
analgesic use over time, with particular attention to THC/CBD content, HIV outcomes, and
adverse events. The study will include a cohort of 250 HIV+ and HIV- adults with (a) severe
or chronic pain, (b) opioid analgesic use, and (c) new certification for medical cannabis.
Over 18 months, participants will have 7 in-person visits every 3 months and 39 web-based
questionnaires every 2 weeks. Data sources will include questionnaires; medical, pharmacy,
and Prescription Monitoring Program records; and urine and blood samples. Over each 2-week
time period (unit of analysis), the primary exposure measure will be number of days of
medical cannabis use, and the primary outcome measure will be cumulative opioid analgesic
dose. Qualitative interviews will also be conducted with a subgroup of 30 participants to
explore perceptions of how medical cannabis use affects opioid analgesic use. Qualitative
findings will help understand the reasons underlying the findings of the cohort study.

Inclusion Criteria:

- At least 18 years of age

- English or Spanish fluency

- New certification for medical cannabis within 90 days

- No medical cannabis use in the 6 months prior to certification

- Medical cannabis qualifying complication of "chronic or severe pain"

- Use of prescribed or illicit opioid analgesics within 30 days

Exclusion Criteria:

- Inability to provide informed consent

- Inability to complete study visits over 18 months

- Qualifying conditions for medical cannabis in NY that are likely to cause unique pain
syndromes (cancer, epilepsy, multiple sclerosis, spinal cord injury, amyotrophic
lateral sclerosis, Parkinson's disease, inflammatory bowel disease, Hungtington's
disease)

- Terminal illness

- Current or prior psychotic disorder