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Survey: Consumers Frequently Turn to Cannabis To Relieve Pain and Anxiety

Los Angeles, CA: One in four consumers say that their “main goal when using cannabis” is to achieve pain relief, according to survey data provided by the company NuggMD.

The company, which offers physician referrals in several states, surveyed more than 6,500 consumers. Twenty-five percent of respondents said that they use cannabis to mitigate pain. A nearly equal percentage (23 percent) said that they consume cannabis products to relieve anxiety.

Only 13 percent of respondents defined their cannabis use strictly as “recreational.”

The survey’s findings are consistent with those of others reporting that consumers frequently self-medicate with cannabis to assuage pain, anxiety, depression, or problems sleeping.

Data published last year in the journal JAMA Network Open reported that nearly one in four pain patients residing in states where medical cannabis access is legal self-identify as marijuana consumers.

Another study, published in 2023 in the journal Cannabis and Cannabinoid Research, determined that patients who use authorized medical cannabis products experience sustained, “clinically significant improvements in pain interference and tiredness, anxiety, and well-being.”

Study: Cannabis Metabolite at Least Equipotent to THC

Saskatchewan, Canada: The cannabis metabolite 11-hydroxy-THC (11-OH-THC) possesses psychoactive properties that are equal to or greater than those of THC, according to preclinical data published in The Journal of Pharmacology and Experimental Therapeutics.

Canadian investigators compared the activity of THC and 11-hydroxy-THC in mice. They reported that 11-hydroxy-THC “displayed equal or greater activity than the parent compound THC.”

The study’s authors concluded: “The THC metabolite 11-OH-THC likely plays a critical role in the bioactivity of cannabis. … These data provide critical insight … that will inform the interpretation of future cannabinoid research and represent a model for how THC consumption and metabolism may affect cannabis use in humans.”

11-hydroxy-THC is one of two primary metabolites formed following cannabis consumption. It is distinct from 11-nor-9-carboxy-THC, which is not psychoactive and may remain detectable in blood or urine for extended periods. Greater quantities of 11-hydroxy-THC are produced following oral cannabis ingestion than by smoking cannabis flower, which is among the reasons why cannabis-infused edible products are often associated with greater psychoactive effects as compared to herbal cannabis.

Full text of the study, “The intoxication equivalency of 11-hydroxy-delta-9-tetrahydrocannabinol (11-OH-THC) relative to delta-9-tetrahydrocannabinol,” appears in The Journal of Pharmacology and Experimental Therapeutics.

Texas: Judge Rejects AG’s Effort To Nullify Austin’s Voter-Approved Marijuana Depenalization Ordinance

Austin, TX: A Travis County district judge has dismissed a lawsuit filed by the state’s Attorney General that sought to overturn the city’s voter-approved marijuana depenalization ordinance.

Austin is one of several Texas cities that has approved a municipal initiative prohibiting local law enforcement from making low-level marijuana-related arrests. Voters in Denton, Elgin, Harker Heights, Killeen, and San Marcos have approved similar measures.

In February, AG Ken Paxton filed suit against the cities of Austin, San Marcos, Killeen, Elgin, and Denton, stating, “I will not stand idly by as cities run by pro-crime extremists deliberately violate Texas law and promote the use of illicit drugs that harm our communities.” Paxton’s office has announced they will appeal the district court’s decision.

The activist group Ground Game Texas seeks to place similar initiatives on the ballot in Dallas and Lockhart this November.

State law defines marijuana possession as a criminal misdemeanor, punishable by up to 180 days in jail, a $2,000 fine, and a criminal record. According to data compiled by Texas NORML, police made an estimated 219,000 marijuana-related arrests between 2017 and 2021. Ninety-seven percent of those arrested were charged with possession only. Fifty-six percent of those arrested were under 25 years of age.

Colorado: Fewer Teens Say It’s “Easy” To Get Marijuana Following Adult-Use Legalization

Denver, CO: The regulation of the adult-use cannabis market in Colorado coincides with declining rates of teen marijuana use, according to data provided by the Department of Public Health.

Data compiled in the latest biannual Healthy Kids Colorado Survey finds that the percentage of high-school students reporting past-month cannabis use fell 37 percent between 2013 and 2023. The percentage of teens who perceive that cannabis is “easy” to obtain cannabis fell by 27 percent during this same period.

Colorado was among the first states to legalize cannabis possession and sales for adults. The state legalized marijuana possession in 2012 and initiated retail sales of cannabis products in 2014.

According to data provided by the Centers for Disease Control and Prevention, the percentage of high schoolers nationwide who use marijuana has fallen an estimated 30 percent over the better part of the past decade. Compliance check data from California, Colorado, Nevada, and other legal marijuana states show that licensed marijuana retailers do not sell products to underage patrons.

In 2021, Dr. Nora Volkow, Director of the US National Institute on Drug Abuse, publicly acknowledged that the enactment of statewide laws regulating the adult-use cannabis market has not led to an increase in the percentage of young people experimenting with the substance.

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Survey: Nearly All Patients Report Improvements After Using Medical Cannabis

Sydney, Australia: Adults who consume cannabis to treat a medical condition overwhelmingly say that it improves their symptoms, according to survey data published in the Harm Reduction Journal.

Researchers surveyed over 3,300 Australian adults who self-identified as medical cannabis consumers. Seventy-three percent of respondents said that they primarily consumed prescription cannabis products. (Australian law permits physicians to prescribe cannabis products to patients unresponsive to conventional treatments.) Twenty-seven percent of respondents acknowledged accessing cannabis, primarily from the unregulated market.

Survey participants predominantly consumed either cannabis flower or oral extracts. Patients typically used cannabis to address pain, mood disorders, or sleep disorders.

Ninety-seven percent of those surveyed said that their condition “was a little, much, or very much better since starting medical cannabis,” – a finding that is consistent with the results of prior surveys and observational trials.

Those respondents who used authorized cannabis products were more likely to be aware of the percentage of THC and other cannabinoids in their products. They were also more likely to either vaporize cannabis or consume oral extracts.

The most frequently reported side effects from cannabis were dry mouth, increased appetite, and drowsiness.

The study’s authors reported: “The results … further underline the dramatic recent increase in the proportion of people using legally prescribed rather than illicitly sourced medical cannabis. … Among these dual-users, respondents were far more likely to prefer prescribed medical cannabis for its consistency of dose, ease of getting supplies, effectiveness in treating their condition, better side-effects profile, and reduced risk of legal issues. This highlights the benefits to patients of being able to access medical cannabis of known potency through legal channels rather than having to obtain it from illicit sources.”

They concluded: “Both prescribed and illicit users overwhelmingly endorsed the effectiveness of their medical cannabis in treating their main health condition. … Further high-quality clinical trials and stronger research evidence is required to establish the role of different medical cannabis preparations in treating the wide array of conditions for which medical cannabis is being used.”

Full text of the study, “Medical cannabis use in Australia seven years after legalization: Findings from the online Cannabis as Medicine Survey 2022-2023 (CAMS-22),” appears in the Harm Reduction Journal.

South Africa: Legislation Becomes Law Regulating Personal Cannabis Use

Johannesburg, South Africa: South African President Cyril Ramaphosa has signed legislation (the Cannabis for Private Purposes Act) into law, codifying the personal use of cannabis by adults.

The new law removes cannabis from the federal Drugs and Drug Trafficking Act and recognizes the rights of adults to possess and grow personal use quantities of cannabis in private. It also establishes a process so that those with criminal records for certain marijuana-related offenses can have their convictions expunged.

The law does not establish rules for the commercial production or retail sales of cannabis products. Such activities remain prohibited.

Passage of the law comes years after the nation’s highest court determined that the private use of marijuana by adults is constitutionally protected behavior.

South African lawmakers initially criminalized the use of marijuana in 1908.

In March, German lawmakers passed similar legislation permitting the personal possession and home cultivation of limited amounts of cannabis. Lawmakers in the European nations of Luxembourg and Malta have also recently enacted personal use laws.

The text of the Cannabis for Private Purposes Act is available from the Parliament of the Republic of South Africa.

Mississippi: Governor Signs Legislation Establishing State-Sponsored Cannabis Research Program

Jackson, MS: Republican Gov. Tate Reeves has signed legislation into law establishing a state-sponsored cannabis research program at the University of Mississippi.

Senate Bill 2888 seeks to facilitate and fund medical cannabis research, including “research related to the efficacy and potential health effects of various cannabis delivery methods, including vaporizing, ingesting, topical application, and combustion.”

The University has been licensed by the federal government since 1968 to engage in federally approved cannabis cultivation and research.

MIssissippi lawmakers in 2022 approved a medical cannabis access program for qualified patients. Over 40,000 residents are registered with the program to access cannabis products.

Several states – including California, Colorado, Florida, Kentucky, Pennsylvania, and Utah – have similarly established state-sponsored institutions to study the safety and efficacy of cannabis. Those programs have conducted several FDA-approved clinical trials documenting cannabis’ efficacy in various patient populations.

Preclinical Study: Cannabis Terpenes Produce Potent Analgesic Effects

Tucson, AZ: The administration of select cannabis plant terpenes produces analgesic effects comparable to morphine, according to preclinical data published in The Journal of the Association for the Study of Pain.

Researchers affiliated with the University of Arizona and the National Institutes of Health assessed the pain-relieving effects of various cannabis terpenes – geraniol, linalool, β-pinene, α-humulene, and β-caryophyllene – in a mouse model of chemotherapy-induced peripheral neuropathy.

They reported that each of the selected terpenes “produced roughly equal antinociception to 10 mg/kg of morphine.” The co-administration of low doses of terpenes and morphine produced “enhanced” analgesic effects.

“Together these studies identify cannabis terpenes as potential therapeutics for chronic neuropathic pain,” investigators concluded.

A 2018 clinical trial by researchers at Columbia University previously demonstrated that the co-administration of inhaled cannabis and sub-therapeutic doses of oxycodone produces heightened pain-relieving effects in humans. The results of another clinical trial similarly determined that vaporized cannabis interacts synergistically with opioids and “may allow for opioid treatment at lower doses with fewer side effects.” Observational studies consistently show that patients who consume cannabis reduce or eliminate their use of prescription opioids over time.

Other recent studies have also shown that terpenes can modulate the effects of various cannabinoids. For example, a preclinical study published in April reported that the coadministration of CBD and β-caryophyllene produces enhanced anti-inflammatory effects. Additionally, clinical data published in March determined the co-administration of THC and the terpene D-limonene is associated with reduced feelings of THC-induced anxiety.

The results of a 2023 study found that patients are more likely to report greater symptom relief after consuming cannabis flowers that contain elevated levels of terpenes.

Full text of the study, “Terpenes from cannabis sativa induce antinociception in a mouse model of chronic neuropathic pain via activation of adenosine A2a receptors,” appears in The Journal of the Association for the Study of Pain.

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Study: Frequent Cannabis Consumers Exhibit No Significant Changes in Driving Performance Following Use of THC-Infused Edibles

Toronto, Canada: Subjects display few changes in simulated driving performance following the ingestion of THC-infused edible products, according to data published in the Journal of Cannabis Research.

Investigators affiliated with the University of Toronto assessed simulated driving behavior in 22 subjects prior to and following the ingestion of THC-infused edibles. Edibles contained, on average, 7.3 mg of THC. Subjects’ driving performance was assessed at two, four, and six hours. Study participants were primarily “frequent users of cannabis for recreational purposes.”

Researchers reported: “Compared to [baseline], cannabis edibles produced a decrease in mean speed 2 hours after consumption. ... No changes in standard deviation of lateral position (SDLP; ‘weaving’), maximum speed, standard deviation of speed or reaction time were found at any time point.” Some participants expressed a lesser willingness to drive following cannabis ingestion.

Researchers theorized that the absence of any significant performance changes may “reflect [subjects’] tolerance to the effects of cannabis” – a phenomenon that has been reported in prior studies. According to one literature review, “Patients who take cannabinoids at a constant dosage over an extensive period of time often develop tolerance to the impairment of psychomotor impairment, so they can drive vehicles safely.”

The study’s authors concluded: “This is the first study of the impact of cannabis edibles on simulated driving. ... Future studies will need to control for age and determine any age-related impacts on the effects of cannabis on driving. This is especially important given that participants over the age of 50 years have been overlooked in studies of the effects of cannabis on driving and related outcomes.”

Full text of the study, “The effect of cannabis edibles on driving and blood THC,” appears in the Journal of Cannabis Research.

Clinical Trial: No Next-Day Impairment Associated With Nighttime Use of Cannabis Oil

Sydney, Australia: Insomnia patients exhibit no next-day impairment following the nighttime use of plant-derived cannabis extracts, according to the results of a randomized, placebo-controlled clinical trial published in the journal Psychopharmacology.

Australian researchers assessed next-day cognitive and psychomotor performance in a cohort of patients diagnosed with insomnia. Subjects in the study consumed either an oral cannabis extract containing 10 mg THC and 200 mg CBD or a placebo.

Investigators identified no differences among those who consumed cannabis or placebo in 27 of 28 performance tests. There were “no impairing effects” on simulated driving performance post-treatment.

The study’s authors concluded: “We found a lack of notable next day impairment to cognitive and psychomotor function and simulated driving performance following evening use of 10 mg oral THC, in combination with 200 mg CBD, in an insomnia population who infrequently use cannabis. ... These findings confirm and extend on prior work by employing a randomized controlled trial design, a patient population that infrequently uses cannabis and who are, on average, older than participants in previous studies, and the use of a regulated product containing a higher ratio of CBD to THC.”

Clinical and observational trial data have reported that the use of cannabis products is associated with improved sleep quality in patients with insomnia.

Full text of the study, “Evaluating possible ‘next day’ impairment in insomnia patients administered an oral medicinal cannabis product by night: A pilot randomized controlled trial,” appears inPsychopharmacology.

Analysis: Proximity to Medical Cannabis Facilities Associated With Perceived Mental Health Improvements in Older Adults

Pittsburgh, PA: Older adults who reside within a 30-minute drive of a licensed medical cannabis dispensary report experiencing fewer days of poor mental health, according to data published by the National Bureau of Economic Research.

Researchers affiliated with the University of Pittsburgh and with John Hopkins University in Baltimore assessed whether proximity to medical cannabis dispensaries was associated with self-reported changes in adult’s mental health.

They reported that local dispensaries were associated with “considerable mental health benefits for older adults.” Specifically, they determined, “[M]edical cannabis availability affected a 3.48 percentage point decrease in persons aged 65 and above reporting having any past-month poor mental health days, a nearly 10 percent decrease from a baseline of 36.3 percent.”

The study’s authors suggested that older adults are likely using cannabis for pain relief and that its analgesic efficacy is also influencing their overall mental health. Data published last year in the Journal of the American Medical Association (JAMA) Network Open reported that nearly one in three patients with chronic pain use cannabis as an analgesic agent and that many of them substitute it in place of opioids.

Researchers did not identify similarly significant effects on mental health among any other subgroups.

Full text of the study, “Medical cannabis availability and mental health: Evidence from New York’s medical cannabis program,” is available online from the National Bureau of Economic Research.

Ohio: Dispensaries May Begin Applying To Serve the Adult-Use Cannabis Market

Columbus, OH: Regulators on Friday will have applications available for those retailers who wish to engage in the licensed sales of cannabis products to adults. Lawmakers last month gave final approval to allow for the expedited sale of adult-use cannabis products by existing medical cannabis dispensaries.

Some retailers with dual licensure are anticipated to begin engaging in adult-use sales before the end of the month. However, most businesses will likely require additional time before they open their doors to the adult-use market.

Dispensaries with dual licensure will need to ensure that they have adequate inventory to serve both medical patients and adults consistently.

Adult-use marijuana sales will be subject to a ten percent excise tax in addition to an existing 5.75 percent sales tax. Sales are anticipated to generate between $276.2 million and $403.6 million in annual cannabis tax dollars within five years.

Voters in November approved a citizens-initiated measure (Issue 2) legalizing the possession, home cultivation, and retail sale of cannabis for those age 21 or older. Provisions in the initiative called upon regulators to begin issuing retail licenses by late 2024.

Following the vote, several of the state’s leading Republicans moved to pass legislation gutting many of the initiative’s key provisions. Those efforts stalled after NORML and other organizations generated thousands of communications urging legislators to enact Issue 2 as written.

Maryland: Frederick County Ceases Pre-Employment Testing for Cannabis

Frederick, MD: City officials in Frederick County, Maryland (population: 287,000) have removed pre-employment drug screening requirements for most public employees.

Under the updated plan, only those seeking jobs in certain “safety-sensitive” positions, such as law enforcement, are required to undergo pre-employment testing for cannabis and other controlled substances. The county employs approximately 3,400 people.

State lawmakers last year approved legislation legalizing the production, sale, and use of cannabis. However, that legislation does not provide explicit workplace protections for those who consume cannabis while away from the job.

Separate legislation introduced this year limiting employers’ abilities to sanction workers who test positive for their past use of marijuana died in committee.

Frederick County Executive Jessica Fitzwater said that pre-employment drug testing requirements “created an unnecessary barrier to employment.”

Numerous other municipalities and counties nationwide -- including Atlanta, Cleveland, the District of Columbia, Philadelphia, and St. Louis – have similarly ended pre-employment marijuana screening for most public employees. Lawmakers in Michigan, Nevada, and Washington have passed legislation halting pre-employment marijuana testing statewide. Several other states -- including California, Connecticut, Minnesota, Montana, New Jersey, New York, and Rhode Island — have enacted broader workplace protections limiting employers’ ability to either test or sanction employees for the use of cannabis use while off the job.

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Clinical Trial: CBD-Infused Gel Relieves Osteoarthritic Hand Pain

Sydney, Australia: The daily application of a transdermal gel containing CBD relieves pain and improves the quality of life of patients with hand osteoarthritis (OA), according to open-label trial data published in the journal Nature: Scientific Reports.

Australian researchers evaluated the self-reported efficacy of transdermal CBD in a cohort of 15 OA patients. Study participants applied CBD-infused gelatin three times a day for four weeks. Self-reported measures were assessed at baseline and throughout the trial via smartphone technology.

CBD application was associated with self-reported improvements in pain, grip strength, fatigue, muscle stiffness, and anxiety.

“Pain, grip strength and QoL [quality of life] measures … were shown to improve over time following transdermal CBD application suggesting feasibility of this intervention in relieving osteoarthritic hand pain,” the study’s authors concluded. “Proof of efficacy, however, requires further confirmation in a placebo-controlled randomized trial.”

The transdermal delivery of CBD has previously been associated with reduced levels of lower back and leg pain in patients with spinal stenosis.

Full text of the study, “An open-label feasibility trial of transdermal cannabidiol for hand osteoarthritis,” appears in Nature: Scientific Reports.

Study: History of Cannabis Use Associated With Lower Risk of Prostate Cancer

Farmington, CT: Lifetime cannabis use is associated with lower rates of prostate cancer, according to observational data published in the journal Biomedicines.

Researchers affiliated with the University of Connecticut School of Medicine and the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida assessed the relationship between cannabis consumption and prostate cancer in a nationally representative cohort of 2,503 participants.

Investigators reported that subjects between the ages of 50 and 64 who identified as either current or former cannabis consumers possessed a significantly lower risk of prostate cancer diagnoses. Scientists suggested that this finding provides “biological support for the anti-cancer effects of the constituents of marijuana.” Numerous preclinical trials have documented the ability of cannabinoids to inhibit cancer cell growth.

The study’s authors reported: “In this cross-sectional study of 2503 participants from the USA using the NSDUH [National Survey on Drug Use and Health] from 2002 to 2020, we observed that individuals who were former marijuana users had a significantly lower rate of self-reports of having PC [prostate cancer]. Additionally, the current marijuana users also trended towards lower self-reports of PC. … Specifically, among participants aged greater than 65 years, former marijuana use was linked to reduced self-reports of PC compared to never using.”

They concluded, “Our findings provide corroborative data from a large national, population-based survey to strengthen the existing body of evidence suggesting a potentially protective role of marijuana against the development of PC … [and] our findings can serve as hypothesis-generating for future prospective studies to further evaluate the role of cannabinoids (using medical marijuana) in PC prevention.”

Separate case-control studies have similarly suggested that a history of cannabis use may provide protection against certain types of cancers, including lung cancer and head and neck cancers.

Full text of the study, “Marijuana use may be associated with reduced prevalence of prostate cancer: A National Survey on Drug Use and Health study from the United States of America,” appears in Biomedicines.

Federal: House Committee Approves Amendment Barring Production of Hemp-Derived Intoxicating Products

Washington, DC: Members of the House Committee on Agriculture have approved an amendment to federally criminalize hemp-derived products containing mood-altering cannabinoids.

The amendment revises section 297A of the 2018 Farm Bill, which expanded the definition of hemp to include “any part of the plant, including …. extracts [or] cannabinoids that do not possess greater than 0.3 percent THC on a dry weight basis.” The Farm Bill is up for reauthorization.

The amendment, sponsored by Rep. Mary Miller (R-IL), excludes products from the federal definition of hemp if they contain cannabinoids that “are not capable of being naturally produced” by the hemp plant or if they are the result of a chemical synthesis.

In recent years, unregulated manufacturers have engaged in synthesizing hemp-derived CBD into a variety of novel intoxicating products, including delta-8-THC, HHC, and THC-O. This synthetic conversion process often involves the use of potentially dangerous household products. Lab analyses of unregulated products containing delta-8 and similar compounds have consistently found them to contain lower levels of cannabinoids than what is advertised on the products’ labels. Some products also possess heavy metal contaminants and unlabeled cutting agents. Other novel compounds, like THC-O, have not been tested for safety in human trials.

Studies have reported that consumers are far more likely to seek out and use these products in jurisdictions where cannabis remains criminalized.

In 2021, NORML published a paper cautioning consumers about the unregulated nature of these products.

Further debate on the Farm Bill is anticipated to take place in the coming months.

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Study: Cannabis Use Not Linked To Sedentary Behavior

Toronto, Canada: Young and middle-aged adults who consume cannabis are no less likely than non-users to engage in daily physical activity, according to data published in the journal Cannabis and Cannabinoid Research.

Canadian researchers assessed physical activity in a cohort of 4,666 US adults ages 18 to 59 years old. Subjects wore a portable accelerometer that tracked participant’s daily activity levels. Researchers collected data for a minimum of four days.

Investigators reported that cannabis consumers were slightly more likely than non-users to engage in light physical activity. Researchers reported no differences between the two groups with respect to median daily sedentary time, time spent engaging in vigorous physical exercise, or sleeping.

“Recent cannabis use in young to midlife adults was not associated with accelerometer-measured sedentary or MVPA [moderate-to-vigorous physical activity] time, but it was associated with a marginal increase in LPA [light physical activity] time,” the study’s authors concluded. “Our findings provide evidence against existing concerns that cannabis use independently promotes sedentary behavior and decreases physical activity.

“This study provides useful insight into the association between cannabis use and physical activity, which may help inform clinicians and prescribers with patient counseling, patients and their lifestyle choices, as well as policy makers around public health resource allocations.”

The findings are consistent with those of several prior studies “challenging the stereotype that marijuana … users are less active than their non-using counterparts.” Among those age 60 and older, marijuana use has been associated with increased exercise frequency.

Full text of the study, “Recent cannabis use and accelerometer-measured physical activity and sedentary behavior among young-to-midlife adults: An analysis of the National Health and Nutrition Examination Survey from 2011 to 2014,” appears in Cannabis and Cannabinoid Research.

Canada: No Increase in Hospitalizations Following Adult-Use Legalization

Toronto, Canada: Policies legalizing the use and sale of cannabis products have not led to an increase in marijuana-related hospitalizations, according to data published in the Journal of Addictive Diseases.

Canadian investigators tracked rates of cannabis-related hospitalizations in Alberta in the years prior to and following legalization. Canadian lawmakers legalized the use and sale of cannabis flowers for those ages 18 and older in October 2018. Retailers began engaging in the sales of cannabis concentrates and edible products in 2020.

Researchers identified an increase in hospitalizations among those ages 18 to 24 in the period immediately prior to legalization, but they acknowledged that there were no increases in hospitalizations following legalization among representatives of any age group.

“Legalization was not significantly associated with immediate or ongoing changes in hospitalization rates … for either younger or older adults,” the study’s authors concluded.

Separate Canadian analyses have failed to identify an increase in either traffic-related hospitalizations or ER visits attributable to cannabis-related psychosis following legalization.

Full text of the study, “Cannabis legalization and hospitalizations in Alberta: Interrupted time series analysis by age and sex,” appears in the Journal of Addictive Diseases.

Analysis: Growing Number of Native American Tribes Engaging in Cannabis Sales

Minneapolis, MN: A growing number of Native American tribes are operating marijuana retail businesses, according to data published in the trade publication Marijuana Business Daily.

Nationwide, nearly 60 cannabis retailers are tribally owned – an increase of nearly 25 percent since 2023. Currently, tribes are operating businesses in nine states: California, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, South Dakota, and Washington. About three-quarters of tribes engaging in marijuana sales also own and operate casinos.

The greatest number of tribal-owned retailers is in Minnesota. State lawmakers legalized the adult-use marijuana market last year, but regulators have yet to begin licensing retail establishments.

In April, members of the North Carolina Eastern Band of Cherokee Indians opened a medical cannabis dispensary on tribal lands. Tribal leaders are anticipated to approve a separate ordinance to expand sales to adults. Marijuana is not yet legal for either medical use or adult use in the state.

The federal government recognizes 574 Native American tribes, and roughly 350 are in the contiguous 48 states.

The full text of the column, “Tribally owned marijuana store numbers up 25% since 2023,” is available from MJBizDaily.

California: State Assembly Overwhelmingly Approves Bill Permitting Cannabis Retailers To Hold Live Events

Sacramento, CA: Lawmakers in the State Assembly have overwhelmingly voted in favor of legislation, Assembly Bill 1775, permitting cannabis retailers to expand their operations to include serving food and beverages and holding live events.

Lawmakers voted 56 to 6 to advance the bill to the Senate.

The measure authorizes eligible retailers to hold musical and other live performances on their premises. It also permits them to serve non-cannabis infused food and beverages to patrons.

State law already permits authorized facilities to engage in on-site cannabis use.

Lawmakers in both chambers advanced similar legislation last year, but the bill was ultimately vetoed by Democratic Gov. Gavin Newsom.

NORML’s action alert in support of AB 1775 is available in the Take Action Center.

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Analysis: Adult-Use Cannabis Markets Generate Over $20 Billion in State Tax Revenue

Washington, DC: Taxes derived from the licensed sale of state-regulated cannabis products totaled more than $4 billion in 2023, according to an analysis provided by the Marijuana Policy Project.

MPP’s estimates do not include revenues derived from the sale of medical cannabis products or from the collection of state-imposed regulatory fees.

Cannabis sales generated the greatest amount of tax revenue in California (nearly $1.1 billion), followed by Illinois, Washington, and Michigan.

Since 2014, retail sales of adult-use cannabis products have generated more than $20 billion in state tax revenue.

“In many states with legal, adult-use cannabis sales, tax revenues are allocated for social services and programs,” the report’s authors acknowledged. “This includes funding education, school construction, early literacy, public libraries, bullying prevention, behavioral health, alcohol and drug treatment, veterans’ services, conservation, job training, conviction expungement expenses, and reinvestment in communities that have been disproportionately affected by the war on cannabis, among many others.”

Separate economic data published in April reported that the state-licensed cannabis industry added over 23,000 new jobs in 2023 and employs over 440,000 full-time workers.

Full text of the report, “Cannabis Tax Revenue in States that Regulate Cannabis for Adult Use,” is available from MPP.

Study: Patients With Multiple Sclerosis Report Quality of Life Improvements Following Cannabis Therapy

London, United Kingdom: Multiple sclerosis (MS) patients report improvements in their health-related quality of life following the use of medical cannabis preparations, according to observational data published in the journal Multiple Sclerosis and Related Disorders.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) consisting of either flower or oil extracts in 141 MS patients enrolled in the UK Medical Cannabis Registry. (Since 2018, British specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Researchers assessed changes in patient-reported outcomes measures at one month, three months, and six months.

Patients reported sustained improvements in their physical and mental health following cannabis therapy. They reported few serious adverse health effects during treatment.

“This case series demonstrates a potential association between [the] initiation of CBMPs and improved patient reported outcomes in sleep, anxiety and general HRQoL [health-related quality of life] measures, over six months,” the study’s authors concluded. “Additional measures for HRQoL, including various physical and mental health subdomains, also exhibit improvements up to six months when compared to baseline.”

A prescription cannabis spray (nabiximols aka Sativex) consisting of specific ratios of THC and CBD is currently available in several countries, including Canada, France, Germany, Spain, and the United Kingdom. The drug is not approved in the United States for treatment of any condition.

Full text of the study, “Clinical outcome analysis of patients with multiple sclerosis – Analysis from the UK Medical Cannabis Registry,” appears in Multiple Sclerosis and Related Disorders.

Minnesota: State Officials Expunge Nearly 60,000 Cannabis Convictions

St. Paul, MN: State officials have reviewed and expunged more than 57,000 low-level marijuana-related convictions, according to data provided this week by the Department of Public Safety, Bureau of Criminal Apprehension.

Legislation passed last year regulating the adult-use cannabis market called for the automatic review and expungement of records for those previously convicted of misdemeanor marijuana-related violations.

“The Bureau of Criminal Apprehension has expunged (also referred to as sealing) 57,780 records in CHS [the Minnesota Criminal History System] almost three months ahead of schedule,” the agency posted Monday on its website.

A separate process will be undertaken to review marijuana-related felony records, some of which may also be eligible for expungement relief.

“These actions together will have a lasting and significant equity impact on communities throughout the state of Minnesota,” James Rowader, Executive Director of the state’s Cannabis Expungement Board, said in a press release.

Twenty-five states have enacted laws facilitating the sealing of eligible marijuana-related convictions. Publicly available data compiled by NORML finds that state courts have sealed the records of an estimated 2.2 million marijuana-related convictions since 2018.

Ohio: Officials Finalize Plans for Retail Marijuana Sales Launch

Columbus, OH: Members of a legislative panel have given final approval to regulations permitting the expedited sale of cannabis products to those age 21 and older.

Under the plan, proposed by the Department of Cannabis Control in April and approved on Monday by the Joint Committee on Agency Rule Review, existing medical dispensaries may apply for dual licensure. (State lawmakers approved medical cannabis access in 2016.) Regulators are anticipated to begin accepting applications on June 7th. Facilities may begin engaging in adult-use cannabis sales immediately following approval.

“The sooner consumers have market access to cannabis products, the more quickly we will begin to see disruptions to the unregulated marketplace,” NORML’s Deputy Director Paul Armentano said. “Retailers provide consumers with the option of obtaining lab-tested products in a safe, regulated environment.”

While state law permits localities to ban the establishment of new adult-use retailers, it does not permit municipalities with existing dispensaries to prohibit them from selling cannabis products to adults.

Adult-use marijuana sales will be subject to a ten percent excise tax in addition to an existing 5.75 percent sales tax. Sales are anticipated to generate between $276.2 million and $403.6 million in annual cannabis tax dollars within five years.

Voters in November approved a citizens-initiated measure (Issue 2) legalizing the possession, home cultivation, and retail sale of cannabis for those age 21 or older. Provisions in the initiative called upon regulators to begin issuing retail licenses by late 2024.

Following the vote, several of the state’s leading Republicans moved to pass legislation gutting many of the initiative’s key provisions. Those efforts stalled after NORML and others generated thousands of communications urging legislators to enact Issue 2 as written.

Twenty-four states have legalized the adult-use marijuana market. Ohio was the 14th to do so by a public vote.

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Study: Cannabis Extracts Reduce Disease Burden In Chronic Pain Patients

Haifa, Israel: Patients’ use of cannabis oil extracts is associated with long-term improvements in their pain intensity and related symptoms, according to data published in the journal Pain Reports.

Israeli researchers assessed the safety and efficacy of cannabis extracts in a cohort of 218 middle-aged chronic pain patients (mean age: 54) over six months. Patients consumed sublingual extracts containing standardized THC and CBD concentrations.

Cannabis treatment was associated with sustained reductions in pain intensity, opioid use, anxiety, depression, and sleep deprivation. Though some subjects did report “mild to moderate” side effects from cannabis, these events did not interrupt their “continuous use” of marijuana extracts throughout the study period.

“Cannabis seems to have an impact on the ‘disease burden’ of chronic pain,” the study’s authors concluded. “It also has a positive effect on functioning and health-related quality of life.”

The researchers’ findings are consistent with those of other larger observational studies involving thousands of pain patients enrolled in medical cannabis access programs.

Full text of the study, “Cannabis oil extracts for chronic pain: What else can be learned from another structured prospective cohort,” appears in Pain Reports.

Senate Leadership Reintroduces Legislation Repealing Federal Cannabis Prohibition

Washington, DC: Senators Cory Booker (D-NJ), Senate Majority Leader Chuck Schumer (D-NY), Finance Committee Chair Ron Wyden (D-OR), and 15 other Democrats have reintroduced legislation, S. 4226: The Cannabis Administration and Opportunity Act (aka CAOA), to remove cannabis from the Controlled Substances Act – thereby empowering states to regulate marijuana primarily as they see fit.

NORML’s Political Director Morgan Fox said: “NORML is pleased to once again support this comprehensive bill that deschedules cannabis federally and emphasizes repairing the harm and injustices caused by decades of prohibitionist policies. We strongly encourage senators on both sides of the aisle to support and cosponsor this legislation so that Congress can finally bring about an end to the conflict between state and federal marijuana laws and to the ongoing damage being done to communities across the nation because of cannabis criminalization.”

Said Leader Schumer in a prepared statement: “It’s past time for the federal government to catch up to the attitudes of the American people when it comes to cannabis. That’s why we’re reintroducing the Cannabis Administration and Opportunity Act, legislation that would finally end the federal prohibition on cannabis while prioritizing safety, research, workers’ rights and restorative justice.”

Added Sen. Wyden: “Our comprehensive Cannabis Administration and Opportunity Act doesn’t tell states what to do – but it provides them with the tools to effectively implement the laws their voters and legislators choose. Public health, public safety, opportunity, and social justice must be at the core of any cannabis reform proposal, and it is crucial stakeholders continue to have a seat at the table. I look forward to working with my colleagues and advocates across the country to make these priorities a reality.”

A previous version of CAOA was introduced in the 117th Congress. That version of the bill only gained four co-sponsors and it failed to receive a hearing.

Additional information on The Cannabis Administration and Opportunity Act is available from Senator Booker.

Analysis: THC Dosing Associated With Increased Survival Time In Palliative Cancer Patients

Berlin, Germany: The daily use of 5mg of oral THC is associated with increased survival times in palliative cancer patients, according to data published in the journal Medical Cannabis and Cannabinoids.

German researchers evaluated the impact of THC dosing in a cohort of 9,419 advanced cancer patients enrolled in Specialized Palliative Outpatient Care (SAPC). SAPC offers team-based home care for patients with advanced and progressive diseases whose life expectancies are limited to days, weeks, or months.

Researchers reported that patients’ daily use of 4.7mg of THC was associated with significantly increased survival time, whereas lower doses were not.

The study’s authors concluded: “The data … show a significant impact of THC on survival in ambulatory palliative care patients [who] … use more than 4.7 mg/day. Median survival time was prolonged by 15 days – from survival time of 25 days without THC therapy to 40 days with a daily THC dose higher than 4.7 mg per day. This prolongation by more than two weeks can be considered substantial. In addition to mere survival, patients [treated] with THC become more mentally and physically active. … The increased activity and improved quality of life might enable the patients to renew social contact with relatives and friends and to settle essential affairs before dying.”

The study’s findings are consistent with data published in 2021 that similarly reported that THC was associated with increased survival times in German hospice patients, particularly among women ages 75 and older.

Full text of the study, “The use of tetrahydrocannabinol is associated with an increase in survival time in palliative cancer patients: A retrospective multicenter cohort study,” appears in Medical Cannabis and Cannabinoids.

Florida: Republican Party To Formally Oppose Marijuana Legalization Initiative

Orlando, FL: The Republican Party of Florida is calling upon voters to reject Amendment 3, a proposed constitutional initiative legalizing adult-use marijuana sales. Voters will decide on the amendment this November.

Members of the Party’s Executive Board voted to formally oppose the amendment at its quarterly meeting, resolving that it “[puts] children at risk and endanger[s] Florida’s family-friendly business and tourism climates.”

Republican Gov. Ron DeSantis has also committed to raising money to assist ‘counter-messaging’ efforts to defeat the amendment.

Speaking at a recent press conference, the Governor claimed that passing Amendment 3 would “reduce [Floridians’] quality of life.”

Amendment 3 amends the state Constitution to allow existing medical cannabis facilities to engage in adult-use marijuana sales. Under the proposal, those 21 and older may legally possess up to three ounces of cannabis, of which not more than five grams may be in the form of concentrate. Home cultivation of marijuana for one’s own personal use is not permitted. The majority of funding for the measure was provided by the multi-state cannabis company Trulieve.

Because the ballot proposal is in the form of a constitutional amendment, it requires approval from a supermajority of voters (60 percent) to become law.

Florida law defines the possession of more than 20 grams of marijuana as a felony offense, punishable by up to five years in prison. Those who possess lesser amounts are guilty of a criminal misdemeanor, punishable by a year in jail.

For the past several years, state agencies have failed to provide comprehensive marijuana-related arrest data to the FBI. Historically, Florida was among the leading states in the nation in marijuana-related arrests. Additional information on Amendment 3 is available from Smart & Safe Florida.

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Study: Osteoarthritis Patients Report Sustained Benefits From Cannabis

London, United Kingdom: Patients diagnosed with osteoarthritis report pain-specific improvements following their use of medical cannabis preparations, according to observational data published in the Journal of Pain & Palliative Care Pharmacotherapy.

British researchers assessed the use of cannabis-based medicinal products (CBMPs) consisting of either flower or oil extracts in a cohort of osteoarthritis patients enrolled in the UK Medical Cannabis Registry. (Since 2018, British specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Researchers assessed changes in patient-reported outcomes measures over a one-year period.

Patients reported symptom improvements at one-month, three-months, six-months, and at one-year.

“Commencement of CBMP treatment was associated with reductions in pain-specific PROMs [patient-reported outcome measures] at all time points in patients with osteoarthritis,” researchers reported. Patients also reported improved sleep. Contrary to the results of several other studies, patients prescribed opioids did not decrease their opioid intake following their initiation of medical cannabis.

Investigators documented few serious side-effects associated with cannabis. “AEs [adverse events] were mainly mild or moderate in severity,” they wrote. “Fatigue was the most common AE in this study.”

The study’s authors concluded: “These results suggest an improvement in pain-related outcomes for patients with osteoarthritis following the initiation of CBMP treatment. Furthermore, there was an improvement in general HRQoL [health-related quality of life] metrics across the follow-up period. CBMPs also appeared to be well-tolerated at 12-month follow-up. … Hence, this study supports the development of RCTs [randomized clinical trials] for CBMP use in osteoarthritis.”

Other studies assessing the use of cannabis products in patients enrolled in the UK Cannabis Registry have reported them to be effective for those suffering from chronic pain, anxiety, post-traumatic stress, depression, migraine, inflammatory bowel disease, and other afflictions.

Full text of the study, “Assessment of clinical outcomes in patients with osteoarthritis: Analysis from the UK Medical Cannabis Registry,” appears in theJournal of Pain & Palliative Care Pharmacotherapy.

Randomized Clinical Trial: CBD Effectively Treats Acute Dental Pain

Kilmarnock, Scotland: The administration of a purified formulation of plant-derived CBD (aka Epidiolex) provides significant short-term relief to patients suffering from acute toothaches, according to placebo-controlled clinical trial data published in the journal Evidence-Based Dentistry.

A pair of Scottish scientists assessed the use of Epidiolex versus placebo in 61 patients with moderate-to-severe dental pain. Forty patients received CBD in doses of either 10 or 20 mgs. Twenty-one subjects received a placebo. Patients’ pain was monitored for three hours following dosing.

Patients who consumed CBD, on average, experienced a greater than 50 percent reduction in their pain, investigators reported. By contrast, those receiving placebo experienced a 37.5 percent decrease in pain.

“Based on this randomized clinical trial, pure CBD drug Epidiolex demonstrates effective analgesia against acute toothache,” the study’s authors concluded.

The US Food & Drug Administration approved the prescription use of Epidiolex as an anti-epileptic drug in 2018. The DEA removed Epidiolex from the Controlled Substances Act in 2020.

Full text of the study, “Cannabidiol – an effective analgesic for toothache,” appears in Evidence-Based Dentistry.

Analysis: Fewer Young Adults Driving Impaired Following Marijuana Legalization

Seattle, WA: The legalization of marijuana in Washington state is not associated with any uptick in the percentage of young people driving under the influence of either cannabis or alcohol, according to data published in the journal Prevention Science.

A team of researchers with the University of Washington assessed DUI trends among young adults immediately prior to the adoption of adult-use sales and for the next five years.

Following legalization, fewer young people engaged in DUI alcohol. Among young people who used cannabis, fewer acknowledged driving under its influence.

“[These] trends may reflect some success in reducing DUI, but additional detection and prevention efforts are needed,” the study’s authors concluded.

The findings are similar to those of a 2022 study concluding, “The risk of self-reported DUIC [driving under the influence of cannabis] is lower in recreational and medical cannabis states compared to states without legal cannabis.”

Full text of the study, “Young adult alcohol and cannabis impaired driving after the opening of cannabis retail stores in Washington state,” appears in Prevention Medicine.

Review: Use Of Nicotine Products Typically Precedes Teens’ Use Of Cannabis

Phoenix, AZ: Teens’ use of cigarettes and other nicotine products is predictive of later cannabis use, according to data published in Substance Use & Misuse.

A team of investigators affiliated with the University of Arizona assessed data from 21 studies involving nearly 2.8 million adolescents.

They determined, “Nicotine-product use emerged as a significant factor associated with future cannabis use among adolescents.”

The study’s authors concluded, “Current evidence suggests an association between nicotine-product use and subsequent recreational cannabis use among adolescents.”

Longitudinal data published last year in the journal Drug and Alcohol Dependence similarly reported that young people typically try either alcohol or tobacco before ever experimenting with cannabis.

Full text of the study, “Nicotine and alcohol use as predictors of recreational cannabis use in adolescence: A systematic review and narrative synthesis,” appears in Substance Use & Misuse.

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Analysis: Elevated Levels Of Heavy Metals Identified In Some Commercially Available Rolling Papers

Marie, MI: Consumers’ use of certain brands of commercially available rolling papers may result in heavy metal exposure, according to data published in the journal of the American Chemical Society (ACS Omega).

Researchers affiliated with Lake Superior State University’s School of Chemistry analyzed metal concentrations in 53 brands of rolling papers and paper cones. Products were purchased from four Michigan retail outlets. They included brands that are available nationally and internationally.

Investigators identified elevated levels of certain metals – including copper, chromium, and vanadium – in about one-quarter of the products tested. Metals were most frequently identified in colored rolling paper products.

The study’s authors concluded: “Under the current regulatory scheme, rolling papers are virtually unregulated, except in a limited number of jurisdictions. … This general lack of regulation is of concern in light of their potential to substantially increase exposure to several potentially toxic elements, particularly copper. … Additional efforts by state regulatory agencies to reach a consensus on limits to toxic elements in cannabis and smoking papers are warranted based on our findings, as is additional research to determine exposures based on realistic use patterns.”

A 2020 analysis of 101 rolling paper products purchased in California similarly reported that some papers used by the manufacturers of pre-rolled cannabis cigarettes contain metal contaminants and pesticides.

Full text of the study, “Elemental composition of commercially available rolling papers,” appears in ACS Omega.

Study: Cannabis Use Seldom Associated With Cognitive Impairments In People With HIV

San Diego, CA: Neither the use of whole-plant cannabis or cannabis-based medicines (e.g., dronabinol) are associated with significant cognitive changes in people with HIV, according to the results of a meta-analysis published in the journal Current HIV/AIDS Reports.

Researchers affiliated with the University of California at San Diego reviewed data from 34 clinical studies. They reported, “Overall, the number of reported adverse effects were largely outnumbered by beneficial or null findings, providing insufficient support for the detrimental impact of CU [cannabis use] on cognition in PWH [people with HIV].”

They concluded, “[These results] suggest [that] cannabis and [cannabis-based] medications can be prescribed to PWH while posing little threat to cognitive function.”

Survey data shows that people with HIV frequently use cannabis for symptom relief. Studies have reported that cannabis use is associated with increased appetite, reduced inflammation, and greater levels of physical activity in patients with HIV.

In 1985, the US Food and Drug Administration approved synthetic oral THC capsules (dronabinol) for the treatment of HIV-induced cachexia.

Full text of the study, “The impact of cannabis use on cognition in people with HIV: Evidence of function-dependent effects and mechanisms from clinical and preclinical studies,” appears in Current HIV/AIDS Reports.

Survey: Patients Report Improvements, Few Serious Side-effects Following Use Of High-THC Flower

Hannover, Germany: Patients prescribed high-THC prescription-grade cannabis chemovars report them to be safe and effective, according to data published in the journal Pharmacopsychiatry.

An international team of investigators surveyed more than 1,000 German patients authorized to use medical cannabis. (Plant cannabis and cannabinoid treatments, such as dronabinol, were legalized by prescription use in Germany in 2017.) Survey respondents obtained lab-tested cannabis flower from regional pharmacies. Potency of the most frequently used chemovar was 22 percent.

The overwhelming majority of patients surveyed reported medical cannabis to be effective at treating their symptoms. Patients reported no significant differences between chemovars, most of which were dominant in THC and low in CBD content. The most commonly reported side effects were dry mouth, increased appetite, and somnolence.

“Patients self-reported very good efficacy and tolerability [to] medical cannabis,” the study’s authors concluded.

Pharmaceutical-grade cannabis flower in Europe, Israel, and elsewhere typically contain THC levels of 20 percent or greater.

The study’s findings push back against claims that cannabis strains higher in THC pose unique risks to health or that there is an absence of research supporting the efficacy of medical cannabis chemovars above 10 percent THC.

Full text of the study, “Medical use of different cannabis strains: results from a large prospective study in Germany,” appears in Pharmacopsychiatry.

Colorado: Most Voters Strongly Support State’s Decision To Legalize Marijuana

Denver, CO: Most Colorado voters are supportive of the state’s decision to legalize the adult-use cannabis market.

In 2010, Colorado and Washington became the first two states to legalize marijuana possession. Colorado was the first state to initiate state-licensed retail sales of cannabis products.

According to statewide polling data compiled by the Colorado Polling Institute, 67 percent of voters say that “allowing the regulation of marijuana” is a “good thing.” Separate survey data compiled by Public Policy Polling similarly finds that most voters believe, “Colorado’s regulated marijuana industry has had a positive impact on the state economy.”

Responding to the polling data, NORML’s Deputy Director Paul Armentano said: “There’s no ‘buyer’s remorse’ among the public when it comes to legalizing cannabis. That’s because these policies are largely working as intended and because voters prefer legalization and regulation over the failed policy of cannabis prohibition.”

Armentano emphasized this point in a new syndicated op-ed, highlighting that public support for legalization has grown in parallel with more states legalizing it.

“After a century of failed policies and ‘canna-bigotry,’ the verdict is in,” he wrote. “Legalization is a success, and the end of cannabis prohibition can’t come soon enough.”

Hawaii: Senators Abruptly Reject Marijuana Decriminalization Legislation

Honolulu, HI: Senate members voted 15 to 9 to defeat legislation, SB 2487, which sought to reduce marijuana possession penalties.

The defeat marked a sudden about-face for Senate lawmakers. In April, Senators voted 24 to 1 in favor of the bill. Last week, they once again expressed support for the measure, agreeing to House-backed changes to the legislation.

State law defines the possession of more than three grams of cannabis as a criminal misdemeanor, punishable by up to 30 days in jail and a $1,000 fine. Those penalties would have been reduced to a $25 civil fine under the proposal.

In April, Senators voted 19 to 6 in favor of separate legislation, SB 3335, which sought to legalize and regulate the adult-use cannabis market. That legislation was ultimately tabled by the House.

Opponents of both measures alleged that liberalizing Hawaii’s cannabis laws would undermine tourism and send the wrong message to young people.

Nikos Leverenz, board president for the Drug Policy Forum of Hawaii, told Marijuana Moment: “Too many legislators this cycle have ceded to the histrionic arguments by many in the criminal legal lobby and others who want to ensure broad prohibition. Hopefully next year’s legislature will produce a bona fide recalibration of cannabis policy in Hawaii.”

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Report: Cannabis Industry Employs Over 440,000 Full-time Workers

Denver, CO: The state-licensed cannabis industry added over 23,000 new jobs in 2023 and now employs over 440,000 full-time workers, according to data compiled by Vangst and Whitney Economics.

Job growth increased more than five percent between 2022 and 2023, while retail cannabis sales grew over ten percent to $28.8 billion, authors reported. Year-over-year growth was especially strong in Michigan and more nascent adult-use markets such as Missouri, New Jersey, Connecticut, and Rhode Island.

By contrast, ten states experienced negative growth during the past year. The report’s authors suggested that market saturation and waning demands for cannabis tourism likely played a role in those markets’ contraction.

“Now more than ever, America’s cannabis industry is a state-by-state, region-by-region job market,” the study’s authors concluded. “Young markets in recently legalized states continue to expand and create employment opportunities, while labor demand in mature markets contracts along with revenue and profit margins.”

Between 2017 and 2022, the state-legal cannabis industry experienced year-over-year double-digit growth. Since then, industry growth has plateaued.

Survey: Fibromyalgia Patients Report Improved Symptoms Following Cannabis Use

Rochester, MN: Fibromyalgia (FM) patients frequently use cannabis therapeutically and most say that it improves their disease symptoms, according to survey data published in the journal Mayo Clinic Proceedings.

Researchers affiliated with the Mayo Clinic in Minnesota surveyed 1,336 patients with fibromyalgia. Half (49.5 percent) acknowledged using cannabis following their FM diagnosis.

Ninety-nine percent of consumers reported using cannabis for pain, and 94 percent reported using it to mitigate stress, anxiety, depression, and insomnia.

Eighty-two percent said that marijuana reduced their FM-related pain, and most respondents also rated cannabis as effective in mitigating other disease symptoms.

In an accompanying editorial, authors acknowledged that cannabis use among FM patients is “widespread” and that most patients perceive it to have a “favorable impact on pain, stress, and sleep disturbances.” The editorial’s authors described cannabis as a “promising” option for FM patients, but cautioned, “More research is needed to determine the best doses and composition for each symptom, long-term safety, and whether people might become dependent on MC [medical cannabis] when using it to manage FM.”

Recent observational trial data from Germany and the United Kingdom reports that FM patients typically reduce their use of other prescription medications following their use of cannabis products.

Full text of the study, “A cross-sectional survey study of cannabis use for fibromyalgia symptom management,” appears in Mayo Clinic Proceedings.

Kentucky: Lawmakers Advance Legislation Imposing New Restrictions Upon State’s Nascent Medical Cannabis Access Program

Frankfort, KY: Lawmakers in the House and Senate have approved legislation, Senate Bill 829, imposing new restrictions on patients’ ability to access medical cannabis products. The bill awaits action from Democratic Gov. Andy Beshear.

The legislation makes several amendments to the state’s nascent medical cannabis program, which lawmakers approved last year. Among the legislation’s more restrictive provisions, it subjects patients to criminal background checks prior to entering the state’s cannabis registry. Those patients with certain criminal records are disqualified from participating in the program. No other state imposes such patient restrictions.

Other provisions in the bill provide school administrators the discretion to prohibit students registered in the program from accessing medical cannabis products while on school grounds and mandate physicians to perform a complete intake of a patient’s prescription drug history prior to issuing a medical cannabis recommendation. Efforts to expand the pool of qualifying conditions for which doctors may recommend medical cannabis products were unsuccessful.

While separate provisions in the legislation seek to expedite the timeline for which state-licensed growers and others can begin their operations, representatives of Kentucky NORML remain opposed to the bill.

“House Bill 829 introduces burdensome provisions that will likely hinder patients’ ability to access medical cannabis,” Lauren Bratcher, Deputy Director of Kentucky NORML said. “These include background checks for patients, redundant regulations, and other requirements that will limit patients’ participation in the program. While expediting timelines may seem advantageous, the potential negatives embedded within the bill outweigh any perceived benefits. Patient access and rights must take precedence over expediency.”

She added: “As advocates for patient-centric cannabis reform, Kentucky NORML urges Gov. Beshear to veto HB 829 and protect patient access to medical cannabis in Kentucky. We stand ready to work collaboratively with lawmakers to develop legislation that prioritizes patient well-being and aligns with the principles of compassion and justice.”

Kentucky NORML representatives worked closely with lawmakers and the Governor to pass the 2023 medical law, which is set to take effect on January 1, 2025.

Hawaii: Despite Law, Few People Are Having Their Cannabis Convictions Expunged

Honolulu, HI: Few Hawaiians have had their marijuana-related convictions expunged, despite the intentions of a 2020 law.

Under the law, those with low-level (possession of less than three grams of cannabis) convictions can petition the courts to have their records expunged. Criminal justice experts have estimated that 12,000 Hawaiians are eligible for relief under the law. However, fewer than 60 people have had their convictions expunged, according to reporting by Hawaii Public Radio.

In March, House lawmakers approved legislation, HB 1595, facilitating state-initiated expungements for anyone with a marijuana misdemeanor conviction on their record. However, members of the Senate Judiciary Committee significantly amended the bill. As amended, the legislation calls upon the state Attorney General’s office to initiate a marijuana expungement pilot program in a single county (Hawaii County). The Senate approved the amended bill earlier this month.

Since 2018, 24 states have enacted laws explicitly providing pathways for expunging eligible marijuana convictions. As a result, state courts have either expunged or sealed the records of more than two million marijuana-related cases, according to publicly available data compiled by NORML.

The full text of the report, Marijuana Pardons and Expungements: By the Numbers, is available from NORML.

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