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Analysis: Marijuana Legalization Associated with Improved Clearance Rates for Violent Crimes

Salt Lake City, UT: The legalization of marijuana is associated with improvements in police clearance rates for multiple types of violent crimes, according to data published online ahead of print in The International Journal of Drug Policy.

A pair of researchers affiliated with the University of Utah and the University of China assessed trends in crime clearance rates in Oregon versus control states in the years prior to and immediately following the enactment of adult-use legalization.

Investigators identified "significant increases in the clearance rate for overall violent crimes and for aggravated assault in Oregon counties relative to those in non-legalized states following legalization." They concluded, "The finding largely aligns with the argument made by the proponents of marijuana legalization that legalization would improve police effectiveness in addressing serious crimes, and as a result would increase clearance rates and generate a crime deterrence effect."

Their findings are consistent with those of a prior study documenting improved crime clearance rates in Colorado and Washington following legalization, particularly for violent crimes and property crimes.

Commenting on the study's findings, NORML's Deputy Director Paul Armentano said: "These conclusions reaffirm the notion that states can sensibly regulate the adult use and sale of cannabis in a manner that doesn't adversely impact public safety. Moreover, in some cases, legalization may contribute to an environment that positively affects police officers' performance in solving serious crimes."

Full text of the study, "Effect of recreational marijuana legalization on clearance rates for violent crimes: Evidence from Oregon," appears in The International Journal of Drug Policy.

Clinical Trial: CBD Cigarettes Associated with Reductions in Antipsychotic Medications in Patients with Schizophrenia

Basel, Switzerland: The adjunctive use of CBD is associated with a reduction in patients' use of antipsychotic medicines, according to placebo-controlled trial data published in the journal Frontiers in Psychiatry.

An international team of researchers from Canada, Switzerland, and Germany assessed the use of CBD cigarettes versus placebo in a cohort of acutely psychotic patients with schizophrenia or other psychotic disorders. Patients received either CBD or a placebo daily for 28 days in addition to their standard treatments.

Investigators reported that both CBD and placebo were associated with similar reductions in psychotic symptoms and depression, but that those participants who consumed CBD cigarettes used fewer antipsychotic medication during treatment. Conversely, those in the placebo group increased their use of prescription medications.

They concluded: "The main group effects in the discontinuous multilevel model were higher subjective well-being and less overall antipsychotic medication use throughout the acute therapy for the CBD-group. These results may suggest an antipsychotic medication sparing effect of CBD-cigarettes as adjunctive therapy in acutely psychotic patients. ... However, future studies with more rigorous study designs and larger samples are needed."

CBD administration is established to have anxiolytic and antipsychotic effects in human subjects, and its use is associated with changes in brain activity that may lower some people's risk of a psychotic episode. Previously published clinical trial data indicates that the daily administration of high doses of CBD (1,000mg) reduces psychotic symptoms in patients with schizophrenia in a manner that is superior to the prescription antipsychotic agent amisulpride.

Full text of the study, "Cannabidiol cigarettes as adjunctive treatment for psychotic disorders โ€“ A randomized, open-label pilot study," appears in Frontiers in Psychiatry.

South Dakota: State's Supreme Court Strikes Down Adult-Use Marijuana Vote

Pierre, SD: Justices on the South Dakota Supreme Court ruled 4 to 1 last week to strike down a voter-approved initiative (Constitutional Amendment A) legalizing the adult-use possession and sale of cannabis.

"Legalization opponents cannot succeed in the court of public opinion or at the ballot box," NORML's Deputy Director Paul Armentano said. "Thus, they are now petitioning the courts to overturn the will of the people. Whether or not one supports marijuana legalization, Americans should be deeply concerned by this trend and by the outcome of this case."

Fifty-four percent of South Dakota voters decided on Election Day in favor of the ballot measure. However, shortly following the vote, Republican Gov. Kristi Noem facilitated litigation seeking to strike down the law as unconstitutional. In February, Judge Christina Klinger of the state's Sixth Judicial Circuit Court ruled in favor of the challenge - opining that the amendment violated state requirements that ballot measures not encompass more than one topic. Last week, the majority of the Supreme Court affirmed her ruling, opining that the amendment "violated the single subject requirement in the South Dakota Constitution."

The decision marks the second time this year that a state Supreme Court has nullified the result of a statewide vote legalizing the use of cannabis. In May, justices of the Mississippi Supreme Court ruled 6 to 3 to nullify Initiative 65, which sought to regulate medical cannabis access in the state. Seventy-three percent of Mississippi voters had approved the measure on Election Day.

Over the past year, political opponents of marijuana law reform have been more frequently turning to the courts in efforts to either repeal cannabis-related votes or to stop them from taking place. In Nebraska, members of the state Supreme Court struck down a 2020 ballot initiative months after it had been approved by the Secretary of State's office. Polling in the state showed that 77 percent of Nebraskans backed the proposal. More recently, Florida's Republican attorney general successfully brought suit to preemptively deny a proposed 2022 legalization initiative from appearing on the ballot.

South Dakota voters last November also decided in favor of a separate ballot measure (Measure 26) regulating medical marijuana access by qualified patients. State lawmakers have not challenged that law from taking effect.

Proponents behind Amendment A have already taken steps to place a new legalization measure before voters in 2022. Some state lawmakers are also recommending that the legislature implement legalization legislation next year.

A summary of the decision is available online from the Supreme Court of South Dakota.

Study: Cannabis Use History Inversely Associated with Common Stomach Infection

Pittsburgh, PA: The use of cannabis is associated with a decreased risk of Helicobacter Pylori infection (HPI) โ€“ a bacterial stomach infection that can be associated with abdominal pain, weight loss, and ulcers. HPI is relatively common in adults worldwide, though many people with it do not experience severe symptoms.

A team of investigators from the United States and Canada assessed the relationship between cannabis use and an HPI diagnosis in a nationally representative cohort of 4,556 subjects.

They reported that subjects with no prior use of cannabis were nearly twice as likely to have HPI as compared to subjects with a history of marijuana use, even after authors adjusted for demographic confounders and comorbidities.

They concluded: "Recreational cannabis use is associated with diminished risk of HPI. These observations suggest the need for additional research assessing the effects of medical cannabis formulations on HPI."

Separate studies have shown that cannabis can provide relief to patients with a variety of gastrointestinal disorders, including IBS, Crohn's disease, while preclinical data indicates that cannabinoids can inhibit the development of gastric ulcers.

Full text of the study, "Relationship between recreational cannabis use and Helicobacter pylori infection," appears in Cannabis and Cannabinoid Research.

Study: Maternal Cannabis Use Not Linked to Higher Risk of Autism in Children

Aurora, CO: Mothers with a history of consuming cannabis in the months prior to or during pregnancy do not possess a greater likelihood of having children with autism spectrum disorder (ASD), according to data published in the Journal of Autism and Developmental Disorders.

A team of researchers with the University of Colorado, School of Public Health assessed whether mothers with a self-reported history of maternal cannabis use are more likely to give birth to children with either ASD or development disorders. They reported that mothers with a history of marijuana use were no more likely than non-users to have children with either autism or developmental delays by age five.

Other studies have shown inconsistent results with respect to in utero cannabis exposure and certain neonatal outcomes, including birth weight and certain behavioral outcomes.

Full text of the study, "Per-pregnancy cannabis use and autism spectrum disorder in the offspring: Findings from the study to explore early development," appears in the Journal of Autism and Developmental Disorders.

FDA: No Regulations on OTC CBD Products Forthcoming

Washington, DC: Nearly three years following the passage of federal legislation legalizing hemp production, the US Food and Drug Administration (FDA) has yet to promulgate rules regulating the marketing and sale of commercial products containing hemp-derived CBD.

Speaking last month at the National Industrial Hemp Business Summit in Washington, DC, FDA representative Gail Sipes said that the agency cannot move forward with regulations without more data on the safety of CBD products. She reiterated the agency's position that companies which market CBD-infused products as either food products or as dietary supplements are violating the Food, Drugs, and Cosmetics Act.

NORML and other groups have urged the FDA to provide regulatory guidelines overseeing the production, testing, labeling, and marketing of hemp-derived CBD products. Analyses conducted by the FDA and others have consistently reported that many over-the-counter (OTC) CBD products are of variable quality and potency, and that they may contain contaminants or elevated levels of heavy metals.

Survey data compiled last year by the National Consumers League reported that more than eight in ten US voters desire greater federal regulatory oversight over the labeling and marketing of commercially available CBD products.

In a report provided by the FDA to Congress in 2020, the agency said that regulating OTC CBD products presents unique challenges because the substance is already available as a FDA-approved medicine (Epidiolex).

Additional information is available from the NORML fact sheet, "FAQs About Cannabidiol (CBD)."

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National Polling Shows Strong Bipartisan Support for Legalization

Asbury Park, NJ: Nearly two-thirds of US adults, including 54 percent of Republicans, support 'the national legalization of marijuana," according to polling data compiled and released this week by Rasmussen Reports.

Overall, 62 percent of respondents expressed support for legalization โ€“ a percentage that is consistent with prior national polls. Only 23 percent of respondents voiced opposition to legalizing cannabis. Last week, national polling data provided by Gallup reported that 68 percent of Americans endorse making the use of marijuana legal.

Similar to previous surveys, Rasmussen reported that 50 percent of US adults acknowledged having personally tried cannabis.

Commenting on the latest polling data, NORML's Deputy Director Paul Armentano said: 'Voters' support legalizing marijuana regardless of political party affiliation. At a time when politics remain acutely polarized, elected officials ought to come together in a bipartisan manner to repeal the failed policy of cannabis prohibition. It is one of the few policy reforms that voters on the right and on the left can all agree upon."

Report: Legal Cannabis Among Nation's Most Valuable Crops

Seattle, WA: Cannabis cultivated in 20202 for the state-legal adult-use market possessed a wholesale harvest value of more than $6 billion, ranking it among the nation's most valuable crops, according to an analysis.

Nationwide, state-legal cannabis ranks fifth among America's most valuable crops โ€“ trailing only corn, soybeans, hay, and wheat. In five states โ€“ Alaska, Colorado, Massachusetts, Nevada, and Oregon โ€“ cannabis grown for the adult-use market is the 'single most valuable crop."

Last year, 11 states licensed commercial marijuana growers to produce cannabis for the adult-use retail market. In those states, over 13,000 state-licensed farmers produced over 2,200 metric tons of cannabis, Leafly calculated.

'With US state cannabis prices ranging from about $500 to $3,000 per wholesale pound, you're looking at a crop worth $6.175 billion per year," the authors of the report estimated. 'As measured against US Department of Agriculture (USDA) data, the value of America's legal cannabis crop ranks fifth nationwide, ahead of cotton."

Authors concluded: 'By refusing to recognize cannabis crops and cannabis farmers, the USDA ignores a fact that exists in plain sight: Cannabis is now a major agricultural commodity that supports thousands of American farmers, farm families, and farm communities."

Full text of the report, 'Leafly Cannabis Harvest Report 2021," is available online.

CRS Report: President Lacks Constitutional Authority to End Cannabis Prohibition by Executive Order

Washington, DC: Congressional lawmakers, not the President, possess the authority to declassify cannabis from the US Controlled Substances Act โ€“ thereby repealing federal marijuana prohibition, affirms a newly issued report by the Congressional Research Service.

The report indicates that the President does not possess unilateral authority to amend drug policies โ€“ stating: 'The CSA does not provide a direct role for the President in the classification of controlled substances, nor does Article II of the Constitution grant the President power in this area. ... Thus, it does not appear that the President could directly deschedule or reschedule marijuana by executive order."

However, the President can engage in various activities that can influence federal marijuana policies and their enforcement โ€“ such as directing the Department of Justice 'to exercise its discretion not to prosecute some or all marijuana-related offenses." Last month, Senators Corey Booker and Elizabeth Warren drafted a letter to US Attorney General Merrick Garland asking him to 'initiate the process to decriminalize cannabis." The Office has not yet provided a response.

The President also possesses the discretion to issue mass pardons and/or to provide general amnesty to a class of people, such as those with criminal records for federal marijuana violations. Earlier this year, dozens of members of Congress signed on to a letter calling for the President to 'issue a general pardon to all former, federal, non-violent cannabis offenders in the United States."

By contrast, on the explicit issue of changing the status of a controlled substance or the punishment for controlled substances offenses, 'Congress unquestionably holds the power to amend the CSA to reschedule or deschedule a controlled substance or change applicable penalties." Several pieces of legislation to do so are currently pending in Congress. Last year, members of the House of Representatives voted in favor of one such bill, The MORE Act, to remove marijuana from the CSA. That language was never taken up by the US Senate.

Commenting on the report, NORML's Deputy Director Paul Armentano said: 'NORML has long argued that the President can set the tone for the national political discussion surrounding marijuana, but that the office lacks the unilateral authority to repeal marijuana prohibition via the stroke of a pen. That authority primarily lies with the 535 members of Congress and sweeping federal changes will likely only occur when a majority of members from both chambers advance legislation to the President's desk. That is why constituents need to continue to pressure their members of Congress to advance this issue and to support legislative efforts to end the federal criminalization of cannabis."

Full text of the CRS report โ€“ 'Does the President Have the Power to Legalize Marijuana?" โ€“ is online. NORML's memorandum, 'Federal Marijuana Prohibition Can Only Be Repealed by Descheduling, Not Rescheduling, Cannabis from the Controlled Substances Act," appears online.

Analysis: Grey Market Delta-8 Products Frequently Mislabeled

Tustin, CA: The percentages of cannabinoids advertised on the labels of grey market delta-8 THC products is typically inaccurate, according to an analysis of products by an independent testing laboratory.

Of the 51 products analyzed, 77 percent possessed less delta-8 THC than advertised. Three-quarters of the products also contained higher levels of THC than permitted by federal law. Dozens of assessments of the potency and quality of unregulated, over-the-counter CBD products have revealed similar discrepancies.

Although delta-8 THC appears organically in cannabis, it is only produced in minute amounts. By contrast, the elevated quantities of delta-8 THC found in grey market products is the result of a chemical synthesis during which manufacturers convert CBD to delta-8 THC. Manufacturers engaged in synthetizing delta-8 THC are not regulated and may use potentially dangerous household products to facilitate this process.

Statements issued by the US Drug Enforcement Agency in the Federal Register in 2020 indicated that delta-8 THC products are federally illegal because they contain 'synthetically derived" cannabinoids. The substance is also among those explicitly identified as a Schedule I drug by the DEA. In recent months, lawmakers in several states have also taken steps to prohibit the manufacture and sale of such products.

Last month, NORML issued a report on delta-8 THC and other novel, synthetically derived cannabinoids that cautioned consumers to avoid these unregulated products because they are untested and may contain impurities.

Full text of NORML's report, 'NORML's Guide to Delta-8 THC and Other Novel Cannabinoids," appears online.

Federal Housing Authority to Continue to Take Punitive Actions Against Marijuana Consumers

Washington, DC: A representative with the US Department of Housing and Urban Development (HUD) affirmed this week that the agency will continue to discriminate against those who use cannabis, including those who do so in compliance with state and local laws.

In a letter addressed to Rep. Eleanor Holmes-Norton, the agency says that it will continue to enforce policies that involve the 'termination of the tenancy of any household" in instances where a tenant is found to have engaged in the use of a controlled substance while on the premises - 'including [the use of] state legalized medical marijuana."

Because cannabis remains classified under federal law as a Schedule I controlled substance, 'HUD prohibits the admission of users of marijuana to HUD assisted housing, including those who use medical marijuana," the letter reads.

Representative Norton had contacted the agency in May, requesting that it 'use executive discretion to not enforce rules against marijuana use in federally assisted housing" in jurisdictions where cannabis use is state-regulated. 'Individuals living in federally assisted housing should not be denied admission, or face eviction, for using a legal product," her letter opined.

Representative Norton has long advocated for changes in HUD policies with respect to state-legal marijuana use and she is the sponsor of HR 3212: The Marijuana in Federally Assisted Housing Parity Act of 2021. Similar bills spearheaded by Rep. Holmes-Norton have failed to garner significant legislative support in past sessions of Congress.

NORML's Political Director Justin Strekal strongly criticized the federal agency's decision. 'It is a travesty that the Administration would prioritize process over people when it comes to the issue of fair housing. No one should be evicted or denied public housing simply because they use cannabis responsibly in private. With tens of millions of patients - many of them veterans - now using medical cannabis in compliance with state laws, federal actions must be taken to accommodate and reflect this reality."

A copy of the HUD letter is available online.

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Gallup Poll: Americans’ Support for Marijuana Legalization Holds at Record High

United States: The percentage of Americans who believe that “the use of marijuana should be legal,” remains at a record high, according to nationwide polling data reported today by Gallup.

Sixty-eight percent of respondents endorse legalization – the same level of support reported by Gallup last year. That ties the highest percentage of support ever reported in a national Gallup poll. “As was the case in 2020, solid majorities of U.S. adults in all major subgroups by gender, age, income and education support legalizing marijuana,” Gallup pollsters determined.

Gallup Marijuana Poll
“There is no buyer’s remorse on the part of the American people. In the era of state-level legalization, voters’ support for this issue has grown rapidly – an indication that these policy changes have been successful and are comporting with voters’ desires and expectations.” NORML’s Executive Director Erik Altieri said. “Today, voters of every age and in virtually every region of the country agree that marijuana should be legal. We have a mandate from the American people and we intend to make sure that elected officials abide by it.”

In 1969, when Gallup first began surveying the question, only twelve percent of Americans backed marijuana legalization. In 1996, when California voters became the first state in the nation to legalize cannabis for medical use, 25 percent of Americans said that marijuana should be legal for those ages 21 and older. Since 2012, when Colorado and Washington became the first two states to legalize marijuana for adults, public support for legalization has risen nationally some 20 percentage points. Legalization has enjoyed majority support among Americans since 2013.

Consistent with previous polls, Gallup reported that most Democrats (83 percent) and political independents (71 percent) support marijuana legalization. By contrast, Republicans are nearly evenly split on the question (50 percent in favor; 49 percent opposed).

Analysis: โ€˜Government-Grade’ Marijuana More Closely Resembles Hemp, Has Little in Common with Commercially Available Cannabis

Greeley, CO: Marijuana provided by the University of Mississippi for clinical research purposes is genetically dissimilar to the types of cannabis products commercially available at retail markets in legal states, according to an analysis published in the journal Frontiers in Plant Science. Since 1968, the University of Mississippi’s farm, which is governed by the US National Institute on Drug Abuse, has been the only legal source of cultivated cannabis for use in FDA-approved research.

A team of researchers affiliated with the University of Northern California performed genetic analyses on NIDA-provided “research-grade marijuana” samples and then compared them to samples of commercially available cannabis.

Consistent with prior assessments, authors reported: “Our results clearly demonstrate that NIDA cannabis samples are substantially genetically different from most commercially available drug-type strains and share a genetic affinity with hemp samples in several of the analyses. We do not claim that NIDA is supplying hemp for cannabis research, rather we are confident that our analyses show that the โ€˜research grade marijuana’ supplied by NIDA is genetically different from the retail drug-type samples analyzed in this study.”

They added, “Given both this genetic and previous chemotypic investigations have concluded that NIDA is supplying product that does not align with what is available for consumers, our hope is that the NIH and NIDA will support the cultivation of cannabis that is representative of what medical and recreational consumers are using. Medical practitioners, researchers and patients deserve access to cannabis products that are comparable to products available on the legal market.”

Scientists wishing to conduct FDA-approved clinical trials on cannabis have long complained that federally-provided samples are of poor quality. According to NIDA’s marijuana menu, no available samples contain more than seven percent THC and all samples contain less than one percent CBD.

In May, the US Drug Enforcement Administration announced for the first time its intent to license additional entities to cultivate marijuana for FDA-approved research purposes. The move came some five years after the agency had initially announced plans to expand the supply of cannabis available to federally-approved researchers.

NORML has long argued that scientists ought to be permitted to bypass NIDA’s exclusive marijuana supply and instead utilize cannabis products manufactured by state-licensed producers. Last month, a bipartisan group of lawmakers reintroduced legislation, The Medical Marijuana Research Act, in the US House of Representatives to permit FDA-approved scientists to access state-legal cannabis products in clinical research trials. House lawmakers passed the same measure last year, but the language was never taken up in the Senate.

Full text of the study, “Comparative genetic structure of cannabis sativa โ€“ including federally produced, wild collected, and cultivated samples,” appears in Frontiers in Plant Science.

Federal Survey Identifies Marked Decline in Youth Marijuana Use

Rockville, MD: Federal data compiled annually by the US National Institutes of Health and released last week reports a significant decline in the percentage of young people using cannabis nationwide.

Data provided by the Substance Abuse Mental Health Services Administration’s (SAMHSA) latest National Survey on Drug Use and Health finds that marijuana use fell significantly year-over-year among those ages 12 to 17. Specifically, it reports that past-year use of marijuana by teens fell from 13.2 percent in 2019 to 10.1 percent in 2020 – a decline of some 25 percent. Past-month marijuana use fell some 20 percent among those in the same age group – declining from 7.4 percent nationwide to 5.9 percent.

Among those ages 18 to 25, marijuana use rates (past month and past year) remained largely unchanged. Among those ages 26 and older, self-reported cannabis use (over either the past month or over the past year) increased, a finding that is consistent with other surveys showing an uptick in marijuana use by adults post-legalization, but no parallel rise in underage consumption.

Self-reported use of other controlled substances by young people remained largely unchanged between 2019 and 2020.

Commenting on the data, NORML Deputy Director Paul Armentano said, “These findings ought to reassure lawmakers that cannabis access for adults can be legally regulated in a manner that is safe, effective, and that does not inadvertently impact young people’s habits.”

Data published in September in the journal JAMA Open Network reported “no increases … in the odds of past-year or past-month cannabis use post-RCL [recreational cannabis laws] enactment among … individuals aged 12 to 20 years for all races and ethnicities” in a cohort of over 838,000 people residing in states with adult-use cannabis legalization laws. Separate data published in JAMA Pediatrics reports that the establishment of adult-use marijuana laws is associated with decreased rates of marijuana use among young people.

Full text of the 2020 SAMHSA report is available.

Analysis: Steel Heating Mechanisms of Some THC Vape Cartridges May Result in Exposure to Heavy Metals

Fife, WA: The use of certain portable THC vape cartridges may be associated with inadvertent exposure to various heavy metals, according to data published in the journal Chemical Research in Toxicology.

Investigators affiliated with a Washington state analytical laboratory analyzed aerosol mixtures produced from 13 commercially available electronic cannabis cartridges. Researchers identified the presence of heavy metals, including copper and nickel, in both vapor and in the oil itself. The authors identified various parts of the cartridges โ€“ including heating coils, wicks, metal cores, and mouthpieces โ€“ as the sources of the elemental emissions. A higher prevalence of metal contaminants was identified following the use of the cartridges’ heating mechanisms. Researchers identified an inverse relationship between metal contamination and terpene content, but they did not offer any definitive explanation for this phenomenon.

Investigators reported: “[T]his study … has … shown that commercially available electronic cannabis devices (ECD) are a potential source for inhalation exposure to metals. … [C]hromium, copper, nickel, as well as smaller amounts of lead, manganese, and tin migrate into the cannabis oil and inhaled vapor phase, resulting in a possible acute intake of an amount of inhaled metals above the regulatory standard of multiple governmental bodies. … It was shown that leaching after periods of time at ambient or elevated temperatures was responsible for the migration of metals from the ECD into the liquid. … The metal content of vaping aerosols decreased with the addition of terpenes to the cartridge liquid. At this time, the mechanism by which the addition of terpenes reduces these metal emissions is unknown, but future research is being undertaken to establish if this is a phenomenon unique to terpenes or if it is a general trait of less viscous liquids.”

Prior analyses of unregulated vapor pen products containing THC have similarly identified the presence of heavy metals and other adulterants. Separate analyses of the aerosol produced by nicotine-filled e-cigarette devices have also detected metal emissions. Metal exposure over time has been linked to a variety of serious health concerns, including lung disease, brain damage, and cardiovascular disease

Full text of the study, “Metals in cannabis vaporizer aerosols: Sources, possible mechanisms, and exposure profiles,” appears in Chemical Research in Toxicology.

Study: Patients Report Improvements in Their Insomnia Following Cannabis Use

Hamilton, Canada: The use of cannabis prior to bedtime is associated with reduced symptoms of insomnia, according to data published in the Journal of Medical Internet Research.

Canadian investigators with McMaster University in Ontario assessed cannabis use trends in 991 subjects with self-reported insomnia. Study participants self-administered cannabis products at home and reported symptom changes in real time on a mobile software application. Investigators analyzed reports from over 24,000 cannabis-use sessions recorded over a three-year period (February 2017 through February 2020).

Researchers reported: “Results from this large naturalistic sample of medicinal cannabis users who tracked their insomnia symptoms before and after cannabis use suggest significant improvements in insomnia symptoms. … Although all strains were reported to be beneficial for the management of insomnia, predominant indica and indica hybrid strains were found to be more efficacious than [were] CBD and predominant sativa strains.”

They concluded: “This general perceived improvement in insomnia symptoms highlights the potential for cannabis to be used as a treatment option for sleep disorders. Future research should investigate the benefits and harms of cannabinoids for insomnia through rigorous randomized placebo-controlled trials.”

The findings are consistent with those of a 2018 study reporting that subjects who used herbal cannabis before bedtime “experienced a statistically and clinically significant improvement (4.5 points on a zero to 10-point scale) in perceived insomnia levels.”

In a recently published placebo-controlled trial, patients who consumed sublingual cannabis-plant extracts over a two week period showed significantly reduced symptoms of insomnia and experienced improved sleep quality.

Full text of the study, “The use of cannabinoids for insomnia in daily life: Naturalistic study,” appears in the Journal of Medical Internet Research.

Survey: Women with Pelvic Pain Frequently Substitute CBD in Place of Other Analgesic Medications

Ann Arbor, MI: Women suffering from chronic pelvic pain (CPP) are frequently consuming CBD to mitigate their symptoms, and they are also using it in lieu of other prescription medications, according to data published in the Journal of Minimally Invasive Gynecology.

Researchers affiliated with the University of Michigan, Department of Obstetrics and Gynecology assessed prevalence and patterns of CBD consumption in a cohort of 1,382 women with fibromyalgia and CPP.

Over one-third of respondents identified as current consumers of CBD. Among these consumers, 81 percent said that the use of CBD products “improved their pain.” Seventy-six percent of users reported substituting CBD for other medications, including opioids, NSAIDS, gabapentinoids, and benzodiazepines. Patients also reported perceived benefits in their sleep, anxiety, depression, and in their overall health after initiating the use of CBD products.

The results are consistent with those of prior studies similarly finding that a growing percentage of women are using cannabis and similar products to effectively mitigate chronic pelvic pain and to reduce their reliance on prescription opioids.

Full text of the study, “Cannabidiol use, substitution for medications, and perceptions of effectiveness in women with chronic pelvic pain,” appears in the Journal of Minimally Invasive Gynecology

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Study: Endometriosis Patients Report Successfully Managing Symptoms with Cannabis

Sydney, Australia: Patients with endometriosis report effectively managing their pain and other symptoms with cannabis, according to data published in the journal PLoS One.

A team of Australian researchers assessed the self-reported efficacy of cannabis in a cohort of 252 Canadian subjects with endometriosis. Study participants self-administered legally obtained cannabis products at home and reported symptom changes in real time on a mobile software application. Investigators analyzed reports from over 16,000 cannabis-use sessions recorded over a nearly three-year period.

Study participants reported that their use of cannabis was effective at mitigating endometriosis-related pain and gastrointestinal issues. Respondents also reported improvements in mood following marijuana consumption.

‘With emerging evidence internationally demonstrating that women are utilizing illicit cannabis as a self-management strategy for the pain and the associated symptoms of endometriosis, this paper demonstrates that Canadian women are also utilizing legally obtained and quality-assured products to manage endometriosis symptoms across domains such as pelvic pain, gastrointestinal symptoms and mood,” authors concluded. ‘Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.”

Survey data has previously reported that endometriosis patients find relief from medical cannabis use and that they often substitute it in place of other medications, particularly opioid-based analgesics.

Full text of the study, ‘Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms,” appears in PLoS ONE.

Analysis: Indica, Sativa Labels ‘Poorly” Reflect Variations Between Cannabis Plants

Nova Scotia, Canada: The nomenclature ‘indica’ and ‘sativa’ poorly capture genetic variations between cannabis plants, according to data published in the journal Nature Plants.

A team of scientists from Canada and from the Netherlands analyzed the composition of 297 cannabis plant samples. Consistent with prior studies, they identified few genomic differences between samples explicitly labeled ‘indica’ or ‘sativa.’

‘Our results demonstrate that the ‘sativaโ€“indica’ scale currently used to label cannabis poorly captures overall genomic and metabolomic variation,” authors concluded. ‘Cannabis labelling is instead probably driven primarily by a small number of key terpenes whose concentrations contribute to the characteristic aromas commonly associated with ‘sativa’ and ‘indica.'”

Other analyses have similarly reported few distinctions in cannabis plants labeled either ‘indica’ or ‘sativa’ โ€“ reporting, ‘Ubiquitous interbreeding and hybridization renders [these] distinctions meaningless.”

Full text of the study, ‘Cannabis labelling is associated with genetic variation in terpene synthase genes,” appears in Nature Plants.

Study: Medical Cannabis Improves Quality of Life in Older Adults with Chronic Pain

Gainesville, FL: The use of medical cannabis by older adults with a chronic pain condition is associated with improvements in their quality of life, according to data published in the journal Cannabis.

Investigators with the University of Florida at Gainesville assessed the use of medical cannabis over a three-month period in a cohort of 46 middle-aged and older adults diagnosed with chronic pain.

They reported that subjects experienced significantly lower levels of pain following the use of medical cannabis, as well as improvements in sleep, anxiety/depression, and in overall quality of life.

The findings are consistent with numerous other studies documenting that the use of cannabis is associated with sustained improvements in chronic pain patients and that it is linked with enhanced quality of life outcomes in older adults.

Full text of the study, ‘Health outcomes among adults initiating medical cannabis for chronic pain: A 3-month prospective study incorporating ecological momentary assessment,” appears in Cannabis.

New York: Statewide Regulations Limit Discriminatory Actions Against Employees Who Consume Cannabis While Away from Work

New York, NY: Employers may no longer sanction workers for their off-hours marijuana use absent evidence of ‘articulable symptoms of cannabis impairment,” according to newly issued guidelines provided by the New York Department of Labor.

The new rules only permit employers to take disciplinary action if there exists ‘objectively observable indications that [an] employee’s performance of the essential duties or tasks of their position are decreased or lessened.” A positive drug screen for past cannabis exposure is not considered to be evidence of impaired performance in the workplace. The odor of cannabis is also not considered to be evidence of marijuana-induced impairment.

Employees that are drug tested for cannabis under federally mandated rules will still be subject to sanctions if they test positive for the past use of marijuana. Under the new guidelines, employers can take disciplinary action against employees who consume cannabis while on the job, but they are not required to do so.

NORML’s Deputy Director Paul Armentano praised the policy change. He said: ‘Suspicionless marijuana testing in the workplace is not now, nor has it ever been, an evidence-based policy. Rather, this discriminatory practice is a holdover from the zeitgeist of the 1980s ‘war on drugs.’ But times have changed; attitudes have changed, and in many places, the marijuana laws have changed. It is time for workplace policies to adapt to this new reality and to cease punishing employees for activities they engage in during their off-hours that pose no workplace safety threat.”

In recent months, several states and municipalities have enacted legislation limiting employers’ ability to take punitive actions against workers, or those seeking to be hired, who test positive for marijuana on a drug test.

Full text of the Department’s new rules are online. Additional information is available from NORML’s fact sheet, ‘Marijuana Legalization and Impact on the Workplace.’

New York: Officials Move to Vacate Over 400,000 Marijuana Convictions

New York, NY: State officials have sealed nearly 200,000 marijuana-related criminal convictions and are in the process of expunging several hundred thousand more, according to data provided by the New York State Office of Cannabis Management.

According to an update provided by the agency at its most recent meeting: ‘Approximately 203,000 marijuana related charges are presently being suppressed from background searches and in process to be sealed or expunged. โ€ฆ This will add to the approximately 198,000 sealing accomplished as part of the first round of marijuana expungements for the 2019 expungement legislation.”

For decades, New York State – and New York City specifically – led the nation in the criminal prosecution of low-level marijuana offenders. In 2019, lawmakers amended marijuana possession penalties and established a system to facilitate the review and expungement of cannabis-specific criminal records. State lawmakers then legalized adult-use cannabis possession and retail sales this year.

New York is among several states in recent months to take steps to either vacate or seal marijuana-specific criminal records. In Illinois, officials have moved to expunge an estimated 500,000 marijuana-related records. California officials have cleared nearly 200,000 records, and New Jersey courts have expunged over 362,000 records. Last week, officials in Virginia announced that they have sealed some 330,000 low-level marijuana possession convictions and another 64,000 misdemeanor distribution convictions.

More than a dozen states have enacted legislation explicitly permitting or facilitating the process of having past marijuana convictions expunged, vacated, otherwise set aside, or sealed from public view.

Florida: Survey of State-Legal Medical Marijuana Patients Finds That Most Reduce Their Use of Prescriptions, Over-the-Counter Drugs

Fort Myers, FL: The majority of patients registered with the state of Florida to access medical cannabis products report reducing their consumption of other medications over time, according to data published in the journal Medical Cannabis and Cannabinoids.

A team of researchers affiliated with Florida Gulf Coast University surveyed 157 state-registered medical cannabis patients. Sixty-five percent of respondents said that they had either reduced or eliminated their use of at least one prescription or over-the-counter medication following their initiation of medical cannabis. Patients were most likely to report discontinuing their use of opioids (18 percent), anxiolytics (18 percent), or antidepressants (15 percent). Some patients also reported substituting medical cannabis for NSAIDS and sleep aids, among other medications.

The finding is similar to dozens of other studies similarly reporting patients’ decreased use of prescription medications, particularly opioids, following their use of medical cannabis.

Similar to other studies, respondents perceived cannabis to be ‘very effective” at providing symptom relief, particularly for pain and anxiety. Respondents were more likely to report consuming cannabis flowers than edible products โ€“ a finding that is also consistent with prior research.

Full text of the study, ‘Demographics, perceptions, and use of medical marijuana among patients in Florida,” appears in Medical Cannabis and Cannabinoids.

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Survey: A Plurality of Americans Prefer to Reside Where Cannabis Use is “Fully Legal”

New York, NY: A plurality of US adults desire to reside in a jurisdiction where “marijuana is fully legal.”

In a survey of new movers compiled by the real estate brokerage firm Redfin, 46 percent of respondents said that they would either “prefer” to live in a jurisdiction where cannabis was legal or that they would “only” live in a legalization state. Twenty-two percent of respondents did not want to reside in a legal state. Thirty-two percent of respondents had no opinion.

Studies have previously reported that cannabis legalization is correlated with increased property values. Data reported in July concluded, “[T]here is strong evidence that legalization drives higher property values – particularly in areas that allow recreational marijuana and welcome retail dispensaries. โ€ฆ These investments can improve quality of life in communities across the nation while attracting tourism and new residents who drive real estate demand.”

Separate data have shown that states experienced spikes in tourism following adult-use legalization.

Additional information is available in the NORML fact sheet, โ€˜Marijuana Regulation: Impact on Health, Safety, Economy.’

Study: Cannabis Use Inversely Associated with Obesity in HBV Patients

Marseille, France: Cannabis consumption is associated with lower rates of obesity among patients with hepatitis B, according to data published in the journal Cannabis and Cannabinoid Research.

A team of investigators affiliated with France’s National Institute of Health assessed the relationship between cannabis use and body weight in a cohort of 3,700 patients diagnosed with chronic hepatitis B virus (HBV) infection.

After researchers adjusted for confounders, they reported that subjects who consumed cannabis possessed a 59 percent lower risk of central obesity (based on waist circumference) than did those with no history of use. The use of cannabis was also significantly associated with a lower risk of being overweight.

Authors concluded: “Cannabis use was associated with lower risks of overweight and obesity in patients with HBV chronic infection. Future studies should test whether these potential benefits of cannabis and cannabinoid use translate into reduced liver disease progression in this high-risk population.”

Previous studies involving nationally representative cohorts have similarly reported that cannabis use is linked with lower rates of obesity and with lower body mass index. Several other studies have also reported that marijuana is associated with the reduced prevalence of non-alcoholic fatty liver disease.

Full text of the study, “Cannabis use is inversely associated with overweight and obesity in Hepatitis B virus-infected patients,” appears in Cannabis and Cannabinoid Research.

Survey: ADHD Patients Report Improvements Following Cannabis Consumption

Pullman, WA: Patients with ADHD (attention-deficit/hyperactivity disorder) report that cannabis mitigates symptoms of the disorder and reduces some of the adverse side effects associated with their prescription medications, according to survey data published in the Journal of Attention Disorders.

A pair of investigators with Washington State University conducted an online survey involving 1,738 students with ADHD.

They reported: “Participants with ADHD who have used cannabis reported that cannabis has acute beneficial effects on many symptoms of ADHD (e.g., hyperactivity, impulsivity). Further, they perceived cannabis to improve most of their medication side effects (e.g., irritability, anxiety). Finally, cannabis use frequency was a significant moderator of the associations between symptom severity and executive dysfunction.”

Authors concluded, “[P]eople with ADHD may be using cannabis to self-medicate for many of their symptoms and medication side effects and that more frequent use may mitigate ADHD-related executive dysfunction.”

Prior studies have reported that both inhaled cannabis as well as the administration of cannabis extracts mitigate ADHD symptoms in human subjects. Israeli data published last year further reported that ADHD patients with legal access to medical cannabis products significantly reduce their use of prescription medications.

Full text of the study, “Self-reported effects of cannabis on ADHD symptoms, ADHD Medication side effects, and ADHD-related executive dysfunction,” appears in the Journal of Attention Disorders.

Virginia: Officials Seal Nearly 400,000 Marijuana Convictions

Richmond, VA: State officials have sealed nearly 400,000 marijuana-related criminal records in recent months, according to data provided by the state’s Cannabis Oversight Commission.

At the Commission’s most recent meeting, officials announced that regulators have moved to seal some 330,000 low-level marijuana possession convictions and another 64,000 misdemeanor distribution convictions. Regulators were tasked with reviewing and sealing past records when the state first decriminalized and then later legalized adult-use marijuana possession.

“These initial record sealings by Virginia State Police are a small step toward righting the wrongs of cannabis prohibition,” said NORML Development Director, JM Pedini, who also serves as Virginia NORML Executive Director. “There remains much work to be done to permanently remove these stains from Virginians’ records, and we’re committed to continuing our efforts in the 2022 General Assembly to help expedite that process.”

Earlier this year, Virginia lawmakers enacted House Bill 2113, to establish a process for the automatic expungement of past criminal records for certain marijuana convictions.

Virginia is among several states in recent months to take steps to either vacate or seal marijuana-specific criminal records. In Illinois, officials have moved to expunge an estimated 500,000 marijuana-related records. California officials have cleared nearly 200,000 records, and New Jersey courts have expunged over 362,000 records.

More than a dozen states have enacted legislation explicitly permitting or facilitating the process of having past marijuana convictions expunged, vacated, otherwise set aside, or sealed from public view.

Minnesota: Supreme Court Denies Workers’ Compensation for Costs of Medical Marijuana

St. Paul, MN: Justices on the state’s Supreme Court have determined that employees cannot be financially reimbursed for their use of medical cannabis to recover from a workplace injury.

The ruling reverses an order from the Workers’ Compensation Court of Appeals which had determined that medical cannabis related costs were eligible for reimbursement. The Court’s decision also strikes down a 2015 administrative rule enacted by the Minnesota Department of Labor and Industry that excluded medical marijuana from the list of “illegal substances” ineligible for workers’ compensation.

The Court’s majority held that employees were ineligible for reimbursement because cannabis remains classified as a Schedule I controlled substance under federal law and that it would be inappropriate to require employers to “finance” an employee’s acquisition of an illicit substance.

Supreme Courts in several other states have also ruled on this issue. This year, courts in three states upheld employees’ ability to be financially reimbursed for their use of medical cannabis.

Currently, five states – Connecticut, New Hampshire, New Jersey, New Mexico, and New York โ€“ explicitly allow for employees to have their medical cannabis expenses reimbursed. By contrast, seven states expressly prohibit workers’ compensation insurance from reimbursing medical marijuana-related costs: Maine, Massachusetts, Minnesota, Florida, North Dakota, Ohio, and Washington.

In all other jurisdictions, the law is either silent on the issue or states that insurers are “not required” to reimburse employees who are injured on the job for the costs related to their use of medical cannabis.

The case is Musta v. Mendota Heights Dental Center et al.

Case Report: THC/CBD Administration Associated with Lung Tumor Regression

Watford, United Kingdom: The daily consumption of cannabinoid extracts is associated with tumor regression in an elderly patient with lung cancer, according to a case study published in the journal BMJ Case Reports.

British investigators reported on the case of a woman in her 80s diagnosed with a cancerous tumor in her lungs. She refused conventional anti-cancer treatments but reported ingesting cannabinoid extracts (21 percent CBD and 20 percent THC) two-to-three times a day for a period of 2.5 years. CT scans showed a 76 percent reduction in the size of her tumor over this time period.

Authors concluded, “The potential for cannabinoids to be used as an alternative to augment or replace conventional primary cancer treatments definitely justifies further research.”

Various cannabinoids have been shown to possess potent anti-cancer activity in preclinical models, though these effects have rarely been replicated in controlled human trials. A series of case studies published in 2019 linked the use of CBD with improved life expectancy in brain cancer patients, while other case reports have similarly reported reductions in tumor growth following the self-administration of cannabinoids.

Full text of the study, “Lung cancer patient who had declined conventional cancer treatment: Could the self-administration of โ€˜CBD oil’ be contributing to observed tumor regression,” appears in BMJ Case Reports.

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Harris Poll: Two-Thirds of US Adults Favor Legalizing Marijuana

Marijuana Poll; Chicago, IL: Two-thirds of US adults favor a repeal of federal marijuana prohibition, according to nationwide polling data compiled by Harris Research.

Sixty-six percent of respondents in a nationally representative sample endorse legalizing cannabis for adults, with support being strongest among millennials (79 percent) and members of Generation X (76 percent). By contrast, just under 50 percent of Baby Boomers (those born between 1946 and 1964) backed adult-use legalization.

The results are consistent with those of other recent national polls, including those by Gallup, Morning Consult, and Quinnipiac University, showing that a supermajority of Americans believe that marijuana ought to be legalized for adults.

When asked whether cannabis should be legal for medical purposes, 84 percent of respondents answered affirmatively – a percentage that is also consistent with prior polling.

Survey: Users of CBG-Dominant Cannabis Report Efficacy for Pain, Other Conditions

Pullman, WA: Those who consume cannabis and/or cannabis preparations high in the cannabinoid cannabigerol (CBG) say that they are effective therapeutics and that they possess few adverse side-effects, according to data published in the journal Cannabis and Cannabinoid Research.

CBG acid is the parent compound precursor to the more popularized cannabinoids THC and CBD. It is typically only found in minute quantities in harvested cannabis plants. However, in recent years, specially cultivated varieties of the plant possessing higher concentrations of CBG have been reported, particularly in the pacific northwest region of the United States.

A team of researchers affiliated with Washington State University and the University of California at Los Angeles surveyed subjects who self-identified as consumers of CBG-dominant cannabis products.

A majority of survey participants said they used CBG-dominant preparations of cannabis exclusively for medical purposes. Respondents most frequently did so to mitigate symptoms of anxiety, chronic pain, depression, and insomnia.

Most respondents described their symptoms as either “much improved” or “very much improved” following their use of CBG-dominant cannabis, and three-quarters rated it as “superior” to their conventional medications.

Authors concluded: “This is the first patient survey of CBG use to document self-reported efficacy of CBG-predominant cannabis, particularly for anxiety, chronic pain, depression, and insomnia. Most respondents claimed greater efficacy of CBG over conventional pharmacotherapy … and reported a very benign adverse event profile and negligible withdrawal. … This study demonstrates that CBG-predominant cannabis and related products are available and being used by cannabis consumers and demonstrates the urgent need for randomized controlled trials of CBG-predominant cannabis-based medicines to be studied rigorously to assess safety and efficacy as a function of dose, mode of administration, and specific therapeutic indications.”

Full text of the study, “Survey of patients employing cannabigerol-predominant cannabis preparations: Perceived medical effects, adverse events, and withdrawal symptoms,” appears in Cannabis and Cannabinoid Research.

Study: Legal Cannabis Markets Experienced Far Fewer Cases of Vaping Illness

New Haven, CT: States with legal adult-use cannabis markets were far less likely to experience incidences of the vaping-related lung illness EVALI (e-cigarette or vaping product use-associated lung injury), which was responsible for several thousand hospitalizations in 2019. The US Centers for Disease Control and Prevention eventually acknowledged that vitamin E acetate – a diluting agent sometimes present in counterfeit, unregulated vape pen products – was responsible for the outbreak.

New data published in the journal Drug and Alcohol Dependence reported that cases of EVALI were more than 40 percent lower in legal cannabis states and that they were over 60 percent lower in jurisdictions that permitted home cultivation. Home grow laws were also associated with fewer incidences of consumers engaging in the use of marijuana vape pens.

Authors concluded: “Given that EVALI cases stemmed primarily from informally-sourced vaporizable marijuana concentrates, these results are consistent with crowd-out, whereby introduction of one market (legal marijuana) displaces utilization of another (informally-sourced marijuana products). Simply put, if the public can obtain products legally from reputable sources, there is less demand for illicit market products. Thus, RM [recreational marijuana] legalization could have dampened market penetration of tainted marijuana concentrates by reducing consumption of informally-sourced marijuana products more generally.”

The findings are consistent with those of several other studies also concluding that EVALI cases were largely concentrated in states where consumers did not have legal access to cannabis products.

Full text of the study, “State marijuana policies and vaping associated lung injuries in the US,” appears in Drug and Alcohol Abuse.

Analysis: THC Levels Not Indicative of Driving Impairment

New Haven, CT: The presence of THC concentrations in either blood or saliva is an unreliable predictor of impaired driving performance, according to a literature review published in the journal Frontiers in Psychiatry.

Researchers affiliated with Yale University assessed multiple papers specific to the issue of marijuana and driving performance. Consistent with prior reviews, authors reported that the presence of THC in bodily fluids is not a consistent predictor of impairment and that state-imposed per se limits for THC are not evidence-based.

Authors reported, “While legislators may wish for data showing straightforward relationships between blood THC levels and driving impairment that parallel those of alcohol, the widely different pharmacokinetic properties of the two substances … make this goal unrealistic.”

They added: “[S]tudies suggest that efforts to establish per se limits for cannabis-impaired drivers based on blood THC values are still premature at this time. Considerably more evidence is needed before we can have an equivalent ‘BAC for THC.’ The particular pharmacokinetics of cannabis and its variable impairing effects on driving ability currently seem to argue that defining a standardized per se limit for THC will be a very difficult goal to achieve.”

Researchers concluded: “Until there is more evidence-based consensus of opinion on meaningful thresholds for per se laws, we would recommend against reliance on such legislation. This is particularly the case given the significant inconsistencies in threshold values currently determined by different states in the US, and the rather weak scientific basis for such decisions. Any such laws cannot claim to be strongly based on current scientific evidence, which suggest collectively that standard based on detectable blood THC levels are not useful.”

Their findings are consistent with those of numerous other studies and expert review panels concluding that the presence of THC is an unreliable indicator of either recent cannabis exposure or impairment of performance. A 2019 report issued by the Congressional Research Service similarly determined: “Research studies have been unable to consistently correlate levels of marijuana consumption, or THC in a person’s body, and levels of impairment. Thus, some researchers, and the National Highway Traffic Safety Administration, have observed that using a measure of THC as evidence of a driver’s impairment is not supported by scientific evidence to date.”

NORML has long opposed the imposition of THC per se thresholds for cannabinoids in traffic safety legislation, opining: “The sole presence of THC and/or its metabolites in blood, particularly at low levels, is an inconsistent and largely inappropriate indicator of psychomotor impairment in cannabis consuming subjects. … Lawmakers would be advised to consider alternative legislative approaches to address concerns over DUI cannabis behavior that do not rely solely on the presence of THC or its metabolites in blood or urine as determinants of guilt in a court of law. Otherwise, the imposition of traffic safety laws may inadvertently become a criminal mechanism for law enforcement and prosecutors to punish those who have engaged in legally protected behavior and who have not posed any actionable traffic safety threat.”

In recent months, lawmakers in two states – Indiana and Nevada – have rolled back their THC per se laws.

The study’s authors acknowledged that acute cannabis-induced intoxication can influence driving behavior, but also recognized that “the relative risk of such impaired driving is significantly lower than other legislated drug use while driving, such as that resulting from alcohol.”

Full text of the study, “Cannabis and Driving,” appears in Frontiers in Psychiatry.

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FBI Report: Marijuana Arrests Plunge More Than 30 Percent in 2020

Washington, DC: The estimated number of persons arrested in the United States for violating marijuana laws declined precipitously in 2020, according to data released this week by the US Federal Bureau of Investigation.

According to the FBI…s Uniform Crime Report, police made an estimated 350,150 arrests for marijuana-related violations in 2020. This total is a 36 percent decrease from 2019, when police made an estimated 545,602 marijuana-related arrests. Not since the early 1990s has the FBI reported so few marijuana-related arrests in a single year.

US Marijuana Arrests
Marijuana arrests are down more than 50 percent from their peak in 2008, when police made over 800,000 marijuana-related arrests. Since 2012, 18 states and Washington, DC have enacted laws legalizing the possession of small amounts of cannabis by adults.

“As more states move toward the sensible policy of legalizing and regulating cannabis, we are seeing a decline in the arrest of non-violent marijuana consumers nationwide,” NORML Executive Director Erik Altieri said.

He added: “The fight for legalization is a fight for justice. While these numbers represent a historic decline in arrests, even one person being put into handcuffs for the simple possession of marijuana is too many.”

Of those arrested for cannabis-related activities, some 91 percent (317,793) were arrested for marijuana possession offenses only. Marijuana-related arrests represented 30.3 percent of all drug-related arrests in the United States in 2020.

Marijuana-related arrests were least likely to occur in western states โ€” most of which have legalized the possession of the substance โ€” and were most prevalent in the northeast, where they constituted an estimated 50 percent of all drug arrests. This will likely change going forward, as several northeastern states, including Connecticut, New Jersey, and New York have all legalized their marijuana markets in recent months.

Twin Study: Adolescent Cannabis Exposure Not an Independent Cause of Psychosis in Adulthood

Minneapolis, MN: Cannabis exposure during adolescence is not independently associated with either adult-onset psychosis or signs of schizophrenia, according to longitudinal data published in the Journal of Abnormal Psychology.

Researchers affiliated with the University of Minnesota Institute of Child Development assessed the relationship between adolescent cannabis use and adult-onset psychosis in a longitudinal co-twin control analysis. Scientists identified no dose-response relationship in models that compared the greater cannabis using twin to the lesser using co-twin with respect to psychosis-proneness in adulthood. They also reported no differing effects on subjects… levels of cannabis exposure and their later risk of schizophrenia.

Researchers reported: “Epidemiological studies have repeatedly shown that individuals who use cannabis are more likely to develop psychotic disorders than individuals who do not. It has been suggested that these associations represent a causal effect of cannabis use on psychosis, and that psychosis risk may be particularly elevated when use occurs in adolescence. … This study, however, does not support these hypotheses, suggesting instead that observed associations are more likely due to confounding by common vulnerability factors.”

They concluded, “[T]he results suggest this association is likely attributable to familial confounds rather than a causal effect of cannabis exposure. … Our results suggest that the threat of potential harm to adolescents via meaningful increases in risk of long-term psychotic illness may be overstated. … Thus, clinical and public health interventions aimed at decreasing the prevalence and burden of psychotic illnesses may benefit from focusing their attention elsewhere.”

Full text of the study, “Adolescent cannabis use and adult psychoticism: A longitudinal co-twin control analysis using data from two cohorts,” appears in the Journal of Abnormal Psychology.

Study: Enactment of Adult-Use Marijuana Laws Is Not Associated with Increased Odds of Youth Use

New York, NY: The enactment of statewide marijuana legalization policies is not associated with increases in the use of cannabis by those ages 12 to 20 years of age, according to data published in the journal JAMA Open Network.

A team of researchers affiliated with Columbia University…s Department of Epidemiology assessed trends in self-reported past-year and past-month marijuana use in a cohort of over 838,000 people residing in states with adult-use cannabis legalization laws.

Consistent with other studies, authors reported “no increases … in the odds of past-year or past-month cannabis use post-RCL [recreational cannabis laws] enactment among … individuals aged 12 to 20 years for all races and ethnicities.”

Authors did identify an uptick in self-reported use among White adults and Hispanic adults (ages 21 or older), but not among Black adults, following legalization. However, they reported that legalization was “not associated with frequent use or use disorder among cannabis users, including among members of demographic subgroups most affected by criminalization.”

Full text of the study, “Racial and ethnic differences in cannabis use following legalization in US states with medical cannabis laws,” appears in JAMA Open Network.

Use of CBD-Dominant Cannabis Products Is Associated with Decreases in Anxiety and Depressive Symptoms

Baltimore, MD: Patients who consume CBD-dominant varieties of cannabis or cannabis products experience decreased levels of anxiety and depressive symptoms than do similarly matched controls, according to data published in the journal Frontiers in Psychiatry.

Investigators affiliated with John Hopkins University in Baltimore and the University of South Carolina in Charleston assessed longitudinal trends in self-reported anxiety and depressive symptoms in a cohort of cannabis consumers and non-consumers. The majority of subjects in the study who were aware of the cannabinoid composition of their products said that they primarily consumed CBD-dominant cannabis.

Researchers reported: “Initiation of medicinal cannabis during the follow-up period [of the study] was associated with significantly decreased anxiety and depressive symptoms, an effect that was not observed in controls that never initiated cannabis use. … Adverse effects attributed by participants to cannabis product use were infrequent, were more associated with THC-dominant product use. … It is recommended that this antidepressant effect of CBD be evaluated further in placebo-controlled clinical trials.”

Full text of the study, “Antidepressant and anxiolytic effects of medicinal cannabis use in an observational trial,” appears in Frontiers in Psychiatry.

Survey: Women Increasingly Turning to Cannabis to Mitigate Symptoms of Menopause

Edmonton, Canada: Middle-aged women are frequently acknowledging using cannabis to treat symptoms associated with menopause, according to survey data presented at the annual meeting of The North American Menopause Society.

Investigators with the University of Alberta surveyed nearly 1,500 middle-aged Canadian women about their use of cannabis. Marijuana is legal for both medical and recreational purposes in Canada.

One-third of those surveyed acknowledged having used cannabis products within the past month. Among current users, 75 percent defined their use as medicinal and most said that cannabis successfully mitigated their menopause-related issues, including irritability, muscle and joint aches, and sleep disturbances.

“Our study confirmed that a large percentage of midlife women are using cannabis for symptoms that overlap with menopause, especially those women who reported more symptoms,” the study…s lead author said in a statement. “In addition, many of these women are claiming to get relief for their symptoms through the use of cannabis.”

Data from the United States, presented at last year…s conference, reported similar results. That study reported that some 27 percent of women living in California had experience using cannabis for menopause symptom management.

A press release summarizing the 2021 survey results is available online.

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Kansas City, MO: City Council Approves Measure Eliminating Pre-Employment Marijuana Testing for Most City Workers

Members of the Kansas City, Missouri city council approved a local ordinance that will prevent pre-employment marijuana testing for most prospective government employees.

Ordinance No. 210627, which was approved with an 11 to 1 vote, says, “It shall be unlawful for the City of Kansas City to require a prospective employee to submit to testing for the presence of marijuana in the prospective employee’s system as a condition of employment.”

Kansas City Mayor Quentin Lucas, who sponsored the measure, said, “Opportunities should not be foreclosed unnecessarily. Glad to see passage of our law eliminating pre-employment screening for marijuana at Kansas City government for most positions. One step of many in becoming a fairer city.”

Certain government positions would be excluded from the protections under this law, such as law enforcement; positions requiring a commercial drivers license; those caring for children, medical patients, disabled or other vulnerable individuals; and positions “where the employee could significantly impact the health or safety of other employees or members of the public.”

Members of the council approved a municipal ordinance last year repealing all local penalties specific to activities involving the personal possession of marijuana. The Kansas City Mayor’s Office has also launched an online system to facilitate the process of pardoning those with low-level marijuana convictions.

Kansas City’s measure is similar to other municipal laws that have recently been enacted in several other cities, including Philadelphia, Atlanta, New York, and Washington, DC, limiting employers’ abilities to drug test certain employees for off-the-job marijuana exposure.

Bill to End Marijuana Prohibition to Receive Committee Vote In US House

Last night, we sent you a message about the SAFE Banking Act passing the House of Representatives as part of the NDAA.

Today, we have an even better bit of news to share with you: The MORE Act, which repeals federal marijuana criminalization, is set to be voted on by members of the powerful House Judiciary Committee NEXT WEEK.

This is an all-hands-on-deck moment. We need to push as many members of Congress to co-sponsor and publicly support the advancement of this bill. That is why we need you to send your Representative a message NOW!

For those who need a refresher, here’s what you need to know about the MORE Act:

– It removes marijuana from the federal Controlled Substances Act – thereby eliminating the existing conflict between state and federal marijuana laws and providing states with the authority to be the primary arbiters of cannabis policy within their own jurisdictions.
– It facilitates the expungement of low-level federal marijuana convictions, and incentivizing state and local governments to take similar actions;
– It creates pathways for ownership opportunities in the emerging regulated industry as well as other sectors of the economy for local and diversely-reflective entrepreneurs who have been impacted under prohibition through the Small Business Administration grant eligibility;
– It allows veterans, for the first time, to obtain medical cannabis recommendations from their VA doctors;
– It removes the threat of deportation for immigrants accused of minor marijuana infractions or who are gainfully employed in the state-legal cannabis industry;
– It provides critical reinvestment grant opportunities for communities that have suffered disproportionate rates of marijuana-related enforcement actions.
During the last Congressional session, NORML members drove in hundreds of thousands of messages in support of the MORE Act. We cannot let up. We need you to send a message to your lawmakers now.

Thanks for showing up, standing up, and speaking out.

Next Week: House Judiciary Committee to Advance Historic MORE Act

Members of the House Judiciary Committee have scheduled a hearing next week to mark up HR 3617: The Marijuana, Opportunity, Reinvestment, and Expungement (MORE) Act of 2021. The Act repeals the long-standing federal prohibition of marijuana – thereby ending the existing state/federal conflict in cannabis policies and providing state governments with greater authority to regulate marijuana-related activities, including retail sales.

“We are excited to see Chairman Nadler and House Leadership move forward once again with passing the MORE Act. Public support and sound public policy demand the repeal of federal marijuana prohibition, Congressional action on this legislation is long overdue. The days of our failed federal policy of prohibition are numbered,” said NORML Political Director Justin Strekal.

While House members deliberate over the MORE Act, members of the Upper Chamber continue to review public comments regarding The Cannabis Administration and Opportunity Act, introduced by Senators Cory Booker, Ron Wyden, and Majority Leader Chuck Schumer.

What the MORE Act Does: The legislation’s provisions remove marijuana from the federal Controlled Substances Act – thereby eliminating the existing conflict between state and federal marijuana laws and providing states with the authority to be the primary arbiters of cannabis policy within their own jurisdictions.

FURTHER: The MORE Act would also make several other important changes to federal marijuana policy, including:

– Facilitating the expungement of low-level federal marijuana convictions, and incentivizing state and local governments to take similar actions;
– Creating pathways for ownership opportunities in the emerging regulated industry as well as other sectors of the economy for local and diversely-reflective entrepreneurs who have been impacted under prohibition through the Small Business Administration grant eligibility;
– Allowing veterans, for the first time, to obtain medical cannabis recommendations from their VA doctors;
Removing the threat of deportation for immigrants accused of minor marijuana infractions or who are gainfully employed in the state-legal cannabis industry;
– Providing critical reinvestment grant opportunities for communities that have suffered disproportionate rates of marijuana-related enforcement actions.

Following action by the House Judiciary Committee, the MORE Act would require further consideration or waiver by the various jurisdictional committees before receiving a floor vote.

Key Facts Underscoring Marijuana Policy Reform Efforts:

According to the FBI UCR, over 545,000 Americans were arrested for marijuana-related crimes in 2019 alone. Over 90% of those arrested were charged with mere possession.

According to a recent report by the ACLU, Black Americans are 3.6 times more likely to be arrested for cannabis-related crimes than white Americans.
The state-legal cannabis industry employs over 321,000 full-time workers; that is over six times the number of jobs specific to the coal industry.
While the substance is not without harm, cannabis is objectively less harmful than legal and regulated alcohol and tobacco.

National Polling

Quinnipiac University, April 2021

Question: Do you think that the use of marijuana should be made legal in the United States, or not?

– Overall: 69% Yes – 25% No
– Democrat: 78% Yes – 17% No
– Republicans: 62% Yes – 32% No
– Independents: 67% Yes – 28% No
– Gallup Polling, Nov. 2020

Question: Do you think the use of marijuana should be made legal, or not?

– Overall: 68% Yes – 32% No
– Democrat: 83% Yes – 16% No
– Republicans: 48% Yes – 52% No
– Independents: 72% Yes – 27% No

Pew Research Center, April 2021

Question: Which comes closer to your view about the use of marijuana by adults?

– 60% It should be legal for medical AND recreational use
– 31% It should be legal for medical use ONLY
– 8% It should NOT be legal


– 12% of Republicans say marijuana should NOT be legal
– 5% of Democrats say marijuana should NOT be legal

History of the MORE Act:

On December 4th of 2020, Members of the House of Representatives voted to approve the MORE Act, HR 3884, by a margin of 228 to 164. However, under the leadership of then-Majority Leader Mitch McConnell (K-KY), the full Senate did not consider the legislation prior to the close of the 116th Congressional session.

HR 3884 was carried in the 116th Congress by House Judiciary Committee Chairman Jerry Nadler and in the Senate by Vice President Kamala Harris.

House Judiciary Committee Chairman Jerry Nadler, along with Cannabis Caucus co-chairs Earl Blumenauer and Barbara Lee, Judiciary Crime Subcommittee Chairwoman Sheila Jackson Lee, House Democratic Caucus Chairman Hakeem Jeffries, and Small Business Committee Chairwoman Nydia Velรกzquez reintroduced the 2021 version of the bill in May.

Kamala Harris is now Vice President of the United States and is unable to reintroduce companion legislation. In July, Senate Majority Leader Schumer, along with Finance Committee Chairman Ron Wyden and Judiciary Committee’s Senator Cory Booker introduced a discussion draft for public comment of forthcoming legislation, The Cannabis Administration and Opportunity Act, that seeks to similarly remove cannabis from the Controlled Substances Act.

House Advances SAFE Banking Act as Part of the Must-Pass NDAA

NORML Supports Swift Enactment; Stresses Need for Further Federal Reforms

Washington, DC: The NDAA funding package passed by the US House of Representatives includes the provisions of the Secure and Fair Enforcement (SAFE) Banking Act, which allows state-licensed marijuana-related businesses to engage freely in relationships with banks and other financial institutions. The language was offered as an amendment to the bill by Representatives Ed Perlmutter (D), Earl Blumenauer (D), Barbara Lee (D), Nydia Velazquez (D), David Joyce (R), and Steve Stivers (R).

This vote marks the fifth time that House members have advanced SAFE Banking legislation in recent years. House members last approved the measure in April as a stand-alone bill by a vote of 321 to 101. At that time, all Democrats and just over half of Republicans in the House voted for the bill.

“Enactment of the SAFE Banking Act would improve public safety and business efficiency in the 36 states that currently permit some form of retail marijuana sales,” said NORML Political Director Justin Strekal, “The Senate should ensure this provision remains in the final version of this funding package and approve it swiftly.”

Strekal added: “The SAFE Banking Act is only the first step toward making sure that state-legal marijuana markets operate safely and efficiently. The sad reality is that those who own or patronize these currently unbanked businesses would still be recognized as criminals in the eyes of the federal government and by federal law. This situation can only be rectified by removing marijuana from the list of controlled substances.”

Currently, thousands of state-licensed cannabis businesses are unable to partner with the banking industry due to federal restrictions. They are unable to accept credit cards, deposit revenues, access loans, or write checks to meet payroll or pay taxes. This situation is untenable. No industry can operate safely, transparently, or effectively without access to banks or other financial institutions. Congress must move to change federal policy so that this growing number of state-compliant businesses, and their consumers, may operate in a manner that is similar to other legal commercial entities.

For these reasons, NORML has long advocated that federal lawmakers vote “Yes” on The SAFE Banking Act.

The NDAA now advances to the Senate for consideration.

In an exchange on Tuesday with Politico reporter Natalie Fertig, Republican Senate co-lead of the SAFE Banking Act Senator Kevin Cramer said “(I)f it’s a vehicle that can carry it, I think it’d be fine. … Any vehicle’s good that gets it to pass it.”

Analysis: Growing Number of States Allow Reimbursement of Medical Cannabis Costs by Workers’ Compensation Insurance

Medical Marijuana
A limited but growing number of states permit eligible patients to be reimbursed for their medical cannabis-related costs through their workers’ compensation insurance (WCI) plans, according to a just-published analysis of state policies conducted by the National Institute for Occupational Safety and Health.

NORML’s Deputy Director Paul Armentano said that these policy changes are further evidence of the legitimacy and social acceptance of medical cannabis. “For millions of patients, cannabis is a legitimate therapeutic option. More and more, our laws and regulations are recognizing this fact and evolving their policies accordingly.”

Researchers affiliated with the federal agency assessed rules and regulations in 36 states permitting medical cannabis access. They identified six states – Connecticut, Minnesota, New Hampshire, New Jersey, New Mexico, and New York – that explicitly allow for employees to have their medical cannabis expenses reimbursed. In three of those states – New Hampshire, New Jersey, and New York – reimbursements were ordered as a result of state Supreme Court rulings issued earlier this year.

By contrast, authors identified six states where workers’ compensation insurance is expressly prohibited from reimbursing medical marijuana-related costs: Maine, Massachusetts, Florida, North Dakota, Ohio, and Washington.

In all other jurisdictions, the law is either silent on the issue or states that insurers are “not required” to reimburse employees who are injured on the job for the costs related to their use of medical cannabis.

Authors said that they expected the number of states permitting marijuana-related compensation to increase in the coming years “as more workers petition state courts and administrative agencies for cannabis WCI reimbursement.”

An abstract of the study, “Review of cannabis reimbursement by workers’ compensation insurance in the US and Canada,” appears in the American Journal of Industrial Medicine.

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Study: Cannabis Use Not Associated with Adverse Outcomes for Couples Undergoing IVF

Montreal, Canada: A history of marijuana use among men and women is not associated with compromised effects on IVF (in vitro fertilization) outcomes, according to data published in the Journal of Cannabis Research.

A team of researchers from Canada and Israel assessed IVF treatment outcomes among male-female, non-donor IVF patients that were either cannabis users or non-users.

Authors reported: “Our study did not show any detrimental impact of current cannabis use on any of the measured IVF outcomes. … All the reproductive outcomes of cannabis users and non-users in our study were comparable. These parameters included measures of ovarian response, sperm quality, efficiency of fertilization, early embryonic development, and implantation. In fact, the ongoing pregnancy rate per cycle start trended higher for the group of cannabis users (35.2 percent vs. 29.1 percent). This could partially relate to the female participants in the user group being younger than the non-user counterparts.”

They concluded, “The results of this study are in line with the newer studies suggesting that the use of cannabis is not associated with a compromised outcome for couples undergoing IVF.”

Other recently published studies have affirmed that a history of cannabis use does not negatively impact fertility rates in either men or women, nor does it adversely impact overall reproductive health in men.

Full text of the study, “The relationship between cannabis use and IVF outcome โ€“ a cohort study,” appears in the Journal of Cannabis Research.

Canada: Marijuana Legalization Not Associated with Upticks in Vehicular Accidents Resulting in Emergency Room Visits

Toronto, Canada: The enactment of adult-use marijuana sales in Canada is not associated with any increase in motor vehicle injuries requiring hospitalization, according to data published in the journal Drug and Alcohol Dependence.

A team of investigators affiliated with the Centre for Addiction and Mental Health and with University of British Columbia assessed emergency department records in two provinces (Alberta and Ontario) to determine trends in traffic-injury emergency department visits in the months immediately prior to and immediately after legalization.

Authors reported: “The current study found no evidence that the implementation of the Cannabis Act was associated with significant changes in post-legalization patterns of all drivers’ traffic-injury ED visits or, more specifically, youth-driver traffic-injury ED presentations. … Given that Canada’s Cannabis Act mandated that the Canadian Parliament review the public health consequences of the Act no later than 2023, the findings of the current study can provide empirical data not only for the Canadian evaluation of the calculus of harms and benefits, but also for other international jurisdictions weighing the merits and drawbacks of cannabis legalization policies.”

The Canadian data is consistent with prior studies from the United States also showing no significant changes in traffic safety in the months immediately following the enactment of adult-use legalization. However, separate assessments evaluating longer-term trends in traffic safety following legalization have yielded mixed results.

Full text of the study, “Canada’s cannabis legalization and drivers’ traffic-injury presentations to emergency departments in Ontario and Alberta, 2015-2019,” appears in Drug and Alcohol Dependence.

Delaware: Supreme Court Says Marijuana Odor Isn’t Grounds for a Warrantless Arrest

Dover, DE: Police officers may not make a warrantless arrest of a person based solely upon the odor of marijuana emanating from them, according to a ruling by the state’s Supreme Court.

In a 4-1 decision, the court determined that the smell of marijuana alone does not provide police with “reasonable grounds to believe” that either a felony has been committed or that a suspect “has committed a misdemeanor … in the officer’s presence.” Under state law, a warrantless arrest is only permissible in those two instances, or if the suspect is under 18 years of age. The possession of up to one ounce of cannabis is a civil violation in Delaware, regardless of the age of the person possessing it.

The majority of the court ruled that there was no possibility that the arresting officer could have reasonably presumed the suspect’s age at the time of the arrest or that the suspect possessed felony quantities of marijuana. The court further found no evidence that the defendant committed a crime while in the arresting officer’s presence.

The court’s ruling reverses a lower court decision and suppresses all further evidence of drug law violations that were identified following the defendant’s arrest.

The case is Juliano v. Delaware.

Survey: Patients Report Benefits of Cannabinoids for Blistering Skin Condition

Groningen, The Netherlands: The use of various preparations of whole-plant cannabinoids is associated with perceived benefits among patients with the painful skin disease epidermolysis bullosa (EB), according to survey data published in the Orphanet Journal of Rare Diseases. Epidermolysis bullosa is a rare genetic condition that results in blistering skin.

A team of investigators from the Netherlands and from the United States surveyed EB patients on five continents who reported using cannabis preparations to treat their illness. Patients reported using cannabinoids as topical agents in addition to inhaling cannabis flowers and consuming marijuana-infused edible products.

Authors reported that cannabis preparations improved subjects “perception of pain, pruritus, wound-healing, and well-being … and reduced concomitant medication use.” They concluded, “Future prospective controlled clinical studies are warranted to elucidate the potential role of CBMs (cannabis-based medicines) in EB treatment.”

Case reports have previously documented the efficacy of both topical and oral cannabinoid preparations for the treatment of EB symptoms. Other case reports have also documented the use of cannabinoids in patients with intractable leg ulcers and pruritus.

Full text of the study, “Cannabinoid use and effects in patients with epidermolysis bullosa: An international cross-sectional survey study,” appears in the Orphanet Journal of Rare Diseases.

Clinical Trial: CBD Administration Associated with Short-Term Improvements in Verbal Recall

Basel, Switzerland: The administration of CBD is associated with short-term improvements in verbal recall in healthy subjects, according to randomized trial data published in the Journal of Psychiatric Research.

A team of Swiss researchers compared the effects of vaporized CBD versus placebo on verbal episodic memory performance in a cohort of 34 young adult subjects (ages 18 to 30).

They reported that those provided CBD exhibited better verbal recall than those provided with a placebo.

Investigators determined: “The present study revealed an average increase of recalled words 20โ€ฏminutes after vaping CBD compared to placebo condition by 10 percent. Importantly, we did not detect medication effects on attention or working memory performance, suggesting that CBD has no negative impact on these basic cognitive functions.”

They concluded: “CBD might prove useful to enhance disease-related memory impairments being present in psychiatric disorders, neurodegenerative disorders, as well as in stress and stress-related exhaustion related to episodic memory deficits. … [W]hile further research is needed to identify dose-response and time-response relationships, our results show that CBD can improve episodic memory, a drug effect with possible therapeutic potential.”

Full text of the study, “Cannabidiol enhances verbal episodic memory in healthy young participants: A randomized clinical trial,” appears in the Journal of Psychiatric Research.

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Study: No Rise in Youth Marijuana Use Following Legalization

Bozeman, MT: Neither the enactment of medical marijuana or adult-use legalization laws have led to an uptick in young people’s consumption of cannabis, according to data published in the Journal of the American Medical Association.

A team of researchers analyzed data compiled from the Youth Risk Behavior Survey for the years 1993 to 2017.

They reported that the adoption of medical cannabis access laws was associated with slight reductions in self-reported marijuana use by young people. The enactment of adult-use legalization laws was associated with no statistically significant changes in youth use patterns.

Authors concluded, “Consistent with estimates from prior studies, there [is] little evidence that RMLs [recreational marijuana laws] or MMLs [medical marijuana laws] encourage youth marijuana use.”

To date, dozens of federal and state-specific surveys have failed to identify any independent link between the legalization of cannabis for either adult-use or medical purposes and any rise in the percentage of teens using it. Moreover, data published in 2019 in the journal JAMA Pediatrics reported that the enactment of laws regulating the use of cannabis by adults is associated with declines in self-reported marijuana use by young people. Separate data compiled by the US Centers for Disease Control has reported that the number of adolescents admitted to drug treatment programs for marijuana-related issues has fallen precipitously in states that have legalized and regulated the adult-use market.

In a recent interview, Nora Volkow, Director of the US National Institute on Drug Abuse similarly acknowledged that statewide legalization laws have not led to an increase in the prevalence of adolescents consuming cannabis.

Full text of the study, “Association of marijuana legalization with marijuana use among US high school students, 1993-2019,” appears in JAMA Open Network.

Analysis: Medical Cannabis Provides Benefits to Migraine Patients

Miami, FL: The inhalation of medical cannabis is associated with decreases in migraine frequency and in migraine-related pain, according to a literature review published in the journal Cureus.

A team of investigators affiliated with Larkin Community Hospital in Miami reviewed 34 scientific papers assessing the use of cannabis for migraine management.

Researchers reported “encouraging data on medicinal cannabis’ therapeutic effects on alleviating migraines in all of the studies reviewed.” They added: “Beneficial long-term and short-term effects of medicinal cannabis were reported. It was effective in decreasing daily analgesic intake, dependence, and level of pain intensity. Some patients experienced a prolonged and persistent improvement in their health and well-being (both physically and mentally) after long-term use of medicinal cannabis. Overall, patients reported more positive effects rather than adverse effects with medical cannabis use.”

Authors concluded: “[T]here is a consensus for the indication of medical marijuana therapy when first and second-line treatment fails. … Further research should be performed once cannabis becomes legalized to determine a favorable delivery method, dose, and strain for migraine and chronic headache management and possible long-term effects of medical cannabis use.”

Numerous surveys of patients report that those suffering from migraines often turn to cannabis for symptomatic relief, and many patients say that it is more effective than prescription medications.

Full text of the study, “Medical cannabis, headaches, and migraines: A review of the current literature,” appears in Cureus.

Case Series: Cannabis Plant Extracts Effective in Mitigating Chronic Pain

London, United Kingdom: The use of sublingual oils containing whole-plant cannabis extracts are safe and effective in patients diagnosed with chronic pain, according to clinical outcome data published in the Journal of Clinical Pharmacology.

British researchers affiliated with London’s Imperial College assessed the use of cannabis extracts over a six-month period in 110 subjects.

Investigators reported that the administration of cannabis oils was associated with “significant improvements” in patients’ pain conditions over the study period. Adverse events associated with the extracts were described as “being mild or moderate in intensity.”

They concluded: “Treatment of chronic pain with [whole-plant cannabis] oils was associated with an improvement in pain-specific outcomes, HRQoL [health-related quality of life] and self-reported sleep quality. Relative safety was demonstrated over medium-term prescribed use. Whilst these findings must be treated with caution considering the limitations of study design, they can inform future clinical trials.”

Several randomized, placebo-controlled trials have previously demonstrated the safety and efficacy in herbal cannabis in the treatment of chronic pain, particularly neuropathy. A 2017 review of over 10,000 peer-reviewed scientific papers by the National Academies of Sciences, Engineering, and Medicine acknowledged, “In adults with chronic pain, patients who [are] treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms. … There is conclusive or substantial evidence that cannabis is effective for the treatment of chronic pain in adults.”

Full text of the study, “Clinical outcome data of first cohort of chronic pain patients treated with cannabis-based sublingual oils in the United Kingdom โ€“ Analysis from the UK Medical Cannabis Registry,” appears in Journal of Clinical Pharmacology.

Survey: Most Physicians “Insufficiently Prepared” to Discuss Cannabis-Related Health Issues

Ann Arbor, MI: Physicians report possessing limited knowledge about cannabis, particularly with respect to advising patients on medical marijuana treatment plans, according to data published in the journal Cannabis and Cannabinoid Research.

A pair of researchers with the University of Michigan at Ann Arbor anonymously surveyed 244 practicing physicians. All of the participants practiced in a state where both the use of cannabis for medical and for recreational purposes was legal.

Consistent with prior surveys of health care professionals, the majority of respondents said that they possessed little or no formal knowledge about either cannabis or individual cannabinoids, and 64 percent said that they were “somewhat uncomfortable or very uncomfortable in integrating cannabis into their patients’ treatment regimens.”

Authors concluded: “We show that physicians from a university-affiliated health system in a state with legal recreational and medical cannabis have generally low levels of factual knowledge about medical cannabis. … Our results highlight the mismatch between physician knowledge and medical cannabis policy. Despite numerous long-standing medical cannabis laws (11 years in the state of the current study), physician training and education has insufficiently prepared physicians on cannabis-related knowledge. This is especially true for dosing, as most respondents were unsure about effective doses (in mg) of THC or CBD. … This lack of knowledge has contributed to general discomfort with integrating cannabis into medical practice. This discomfort likely pushes patients to turn to other sources to obtain cannabis-related knowledge, including the popular press, personal research, or from dispensary staff who receive little or no medical training. As such, more comprehensive training is necessary for physicians to bridge the gap between cannabis policy and clinical care.”

Full text of the study, “Assessing health care providers’ knowledge of medical cannabis,” appears in Cannabis and Cannabinoid Research.

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