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by russellropeMedia, News April 11, 2023April 8, 2023No Comments

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Survey: IBD Patients Frequently Report Using Medical Cannabis for Symptom Relief

San Juan, Puerto Rico: Nearly one in four patients with inflammatory bowel diseases (e.g., ulcerative colitis or Crohn’s disease) report using medical cannabis, according to survey data published in the International Journal of Environmental Research and Public Health.

A team of investigators from Puerto Rico and the United States surveyed 162 IBD patients regarding their attitudes toward cannabis.

Twenty-three percent of respondents said that they consumed cannabis products specifically to address symptoms of IBD, such as pain, decreased appetite, insomnia, and anxiety. Over 85 percent of respondents who consumed cannabis for therapeutic purposes said that it improved their symptoms.

The findings are consistent with those of other surveys showing that a significant percentage of IBD patients acknowledged using cannabis and gaining relief from it.

“The use of medical cannabis to relieve symptoms is frequent in patients with IBD, although knowledge about cannabis among patients and physicians is limited,” the study’s authors concluded. “Our study supports the need for more investigation in this area, as well as an increase in educational programs for patients and physicians.”

Observational trials have previously documented that cannabis use by IBD patients is associated with fewer ER visits. In a randomized placebo-controlled trial involving 21 patients with refractory Crohn’s disease, nearly half achieved disease remission following their use of herbal cannabis.

Full text of the study, “A survey of cannabis use among patients with inflammatory bowel disease (IBD) appears in the International Journal of Environmental Research and Public Health.

Study: Daily Use of CBD Tinctures Associated with Decreased Daytime Drowsiness, No Increased Risk of Liver Disease

Chicago, IL: Adults who consume CBD daily experience less daytime drowsiness and are not at an increased risk of suffering from either low testosterone or liver abnormalities, according to data published in the journal Medical Cannabis and Cannabinoids.

Researchers affiliated with the University of Chicago and with Tarleton University in Texas assessed the daily use of CBD in a cohort of over 1,000 adults. Most of the study’s participants reported having consumed full-spectrum CBD tinctures for at least one year.

Investigators concluded: “In this large-sample study, self-dosing [with] CBD was not associated with an increased prevalence of elevation of LT [liver tests] or low levels of TT [total testosterone] in men. Furthermore, CBD administration decreased DD [daytime drowsiness] and was associated with a lower prevalence of low testosterone levels in older men as compared to age-adjusted population norms. ... [I]n those over 45 years of age, the prevalence of type 2 diabetes was significantly lower than that of the general population.”

Several population-based studies have reported that cannabis consumers typically possess lower BMI and other favorable indices related to diabetic control. Observational studies have also shown that the past use of cannabis is significantly associated with lower odds of diabetes in adults.

Data published in 2021 similarly determined that the repeated use of oral CBD products is not associated with liver abnormalities, such as the elevated production of the enzyme alanine transaminase.

Full text of the study, “The effects of long-term self-dosing of cannabidiol on drowsiness, testosterone levels, and liver function,” appears in Medical Cannabis and Cannabinoids.

Montana: Lawmakers Table Legislation That Sought to Eliminate Adult-Use Cannabis Sales

Helena, MT: Senators on the Business, Labor, and Economic Affairs Committee voted to halt any further consideration of legislation, Senate Bill 546, to repeal much of the state’s voters-approved marijuana legalization law.

The proposed legislation sought to shut down all licensed adult-use cannabis retailers and imposed a one-plant limit upon those who home-cultivate marijuana. It also sought to dramatically increase the taxes imposed on the sale of medical cannabis products, while capping the THC potency of those products at 10 percent.

Voters approved a pair of complementary citizen-initiated ballot measures in 2020 legalizing the personal possession, commercial production, and retail sales of marijuana. Licensed retailers began legally selling marijuana products to those ages 21 and older on January 1, 2022. (Voters on two prior occasions had approved medical cannabis access initiatives.)

Twenty-one states have approved legislation regulating the adult-use cannabis market. No state has ever rolled back or repealed an adult-use legalization law.

Kentucky: Lawmakers Fail to Advance Senate-Backed THC Per Se Law

Frankfort, KY: House lawmakers failed to advance Senate-backed legislation, Senate Bill 228, that sought to impose new criminal penalties for any motorist who operates a vehicle with the presence of THC in their blood above 5ng/ml.

Senators passed the measure in March, but House members failed to move it out of committee before the session’s adjournment.

Numerous scientific studies have concluded that the presence of THC in blood is an unreliable predictor of either recent cannabis exposure or impairment of performance. A report by the Congressional Research Service similarly concludes: “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.”

Six states -- Illinois, Montana, Nevada, Ohio, Pennsylvania, and Washington -- impose various per se limits for the presence of specific amounts of THC in blood while 11 states (Arizona, Delaware, Georgia, Illinois, Iowa, Michigan, Oklahoma, Rhode Island, South Dakota Utah, and Wisconsin) impose zero tolerant per se standards. In those states, it is a criminal violation of the traffic safety laws to operate a motor vehicle with any detectable levels of THC in blood. Colorado law infers driver impairment in instances where THC is detected in blood at levels of 5ng/ml or higher.

In 2021, lawmakers in Indiana and Nevada repealed their per se traffic safety limits for the presence of THC in blood.

Literature Review: CBD Beneficial for Treating Insomnia

Decorah, Iowa: The administration of plant-derived CBD is associated with improvements in patients suffering from insomnia, according to a review of human trials published in the journal Cannabis and Cannabinoid Research.

Investigators affiliated with Luther College in Iowa and with the Mayo Clinic in Rochester, Minnesota reviewed data from 34 human trials assessing the use of CBD on insomnia symptoms.

“All studies reported improvement in the insomnia symptoms of at least a portion of their participants,” authors reported.

They concluded, “The results of our systematic review suggest that CBD alone or with equal quantities of THC may be beneficial in alleviating the symptoms of insomnia.”

Randomized, placebo-controlled trial data published in December reported that the short-term use of plant-derived cannabis extracts is well-tolerated and effective in patients diagnosed with insomnia. Patients in the study were administered either extracts containing 10mg of THC and 15mg of CBD or placebo for two weeks. Those receiving cannabis extracts experienced improved sleep quality by up to 80 percent and “60 percent of participants no longer classified as clinical insomniacs at the end of the two-week intervention period.”

Full text of the study, “Use of cannabidiol in the management of insomnia: A systematic Review,” appears in Cannabis and Cannabinoid Research.

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by russellropeMedia, News April 4, 2023April 1, 2023No Comments

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Clinical Trial: CBD/THC Combination Controls Blood Sugar, Lowers Cholesterol in Type 2 Diabetics

Tehran, Iran: Diabetic patients administered a sublingual spray containing CBD and THC show improvements in their blood sugar and cholesterol levels, according to placebo-controlled data published in the Iranian Journal of Pharmaceutical Research.

A team of Iranian investigators evaluated the efficacy of a proprietary formulation of plant-derived CBD/THC compared to placebo in a cohort of 50 patients with type 2 diabetes. Patients utilized the spray twice daily for eight weeks. The sublingual formulation contained a ten-to-one ratio of CBD to THC.

Compared to placebo, cannabinoid therapy was associated with a “statistically significant decline in total cholesterol, triglycerides, LDL-C, FBS [fasting blood glucose levels], Hb [hemoglobin] A1C, and insulin secretion … at the end of the 8-week treatment period. ... [T]here were no statistically significant differences in reported adverse effects between the two groups.”

Researchers concluded: “In the present study, we demonstrated that sublingual administration of [a CBD/THC] spray, ... twice daily through an eight-week treatment period could effectively improve the patient’s lipid profile and glucose tolerance. ... Based on these observations, the combination of CBD/Delta9-THC regimen could be a new therapeutic regimen for controlling the lipid profile and glycemic state of DM [type 2 diabetic] patients.”

Clinical trial data has previously shown that the administration of the cannabinoid THCV (tetrahydrocannabivarin) decreases fasting glucose levels in type 2 diabetics.

Population-based studies have reported that cannabis consumers typically possess lower BMI and other favorable indices related to diabetic control. Observational studies have also shown that the past use of cannabis is significantly associated with lower odds of diabetes in adults.

Full text of the study, “A phase I randomized, placebo-controlled study on efficacy and safety profile of a sublingually administered cannabidiol/delta-9-tetrahydrocannabinol (10: 1) regimen in diabetes Type 2 patients,” appears in the Iranian Journal of Pharmaceutical Research.

Fewer Federal Offenders Charged with Marijuana-Related Offenses in 2022

Washington, DC: Federal officials in 2022 charged fewer people with marijuana-related offenses than they had in previous years, according to data compiled by the US Sentencing Commission in its latest Sourcebook of Federal Sentencing Statistics.

Just over 800 people were charged with violating federal marijuana laws in 2022. Ninety-nine percent of those charged were indicted for drug trafficking. Overall, those charged for marijuana-related violations comprised just four percent of all federal drug offenders.

Those totals represent a significant decrease from a decade ago, when federal officials charged nearly 7,000 people for violating federal marijuana laws. At that time, more people were federally indicted for marijuana offenses than for any other drug-related offense. However, since 2012, the number of people federally prosecuted for marijuana-related violations has fallen steadily.

In total, 32 percent of all people federally prosecuted in 2022 were charged with drug law violations.

Full text of the 2022 Sourcebook of Federal Sentencing Statistics is available from the United States Sentencing Commission.

Survey: One in Ten Veterans Acknowledges Using Cannabis

Fort Worth, Texas: An estimated one in ten US military veterans report having consumed cannabis within the past year, according to data published in the journal Substance Use & Misuse.

A pair of researchers affiliated with the University of North Texas and the University of Illinois assessed cannabis use trends among a nationally representative cohort of over 16,000 veterans over the years 2013 to 2019.

Investigators reported that ten percent of those sampled acknowledged past-year cannabis use. Consumers were most likely to define their consumption as medical-only if they were age 65 or older.

Only a minority of the study’s respondents acknowledged having received an authorization to use cannabis from a healthcare provider. This is likely because federal law prohibits providers affiliated with the Department of Veterans Affairs from issuing recommendations, even in states where the medical use of cannabis is legal.

The study’s authors concluded: “Our findings, taken in context with current federal policy, point toward a need for enhanced care coordination among veterans who may benefit from marijuana, but are unable to access it through the VA. ... Additional research is needed to better understand veterans’ use of a marijuana in the context of federal VA restrictions, including the examination of how veterans obtain marijuana, what affect this has on their care coordination and health outcomes, and whether or not marijuana can play a role in reducing other drug use and drug-related harms among veterans.”

According to nationwide survey data compiled by the group Iraq and Afghanistan Veterans of America, 75 percent of military veterans “would be interested in using cannabis or cannabinoid products as a treatment option if it were available.”

Full text of the study, “National trends in past-year marijuana use among veterans in the United States, 2013-2019,” appears in Substance Use & Misuse.

Utah: Governor Signs Bill Establishing State-Sponsored Cannabis Research Program

Salt Lake City, UT: Republican Gov. Spencer Cox has signed legislation into law establishing a cannabis-specific medical research center within the University of Utah.

House Bill 230 appropriates $650,000 in funding for the creation of the Center for Medicinal Cannabis Research. The Center “shall facilitate and support funding for research related to the efficacy and potential health effects of various cannabis delivery methods, including vaporizing, ingesting, topical application, and combustion; shall support researchers in applying for and securing federal and private research grant funding for expanding medical cannabis research; shall review current and future cannabis research literature, clinical studies, and clinical trials; [and] shall educate medical providers, lawmakers, and the public about medical cannabis research advances.”

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

Utah lawmakers enacted legislation permitting for the limited use and distribution of cannabis and cannabis products in 2018.

South Dakota: Governor Signs Bills into Law Amending Medical Cannabis Access Rules

Pierre, South Dakota: Republican Gov. Kristi Noem has signed several bills into law amending the state’s medical cannabis regulations.

Senate Bill 1 expands the pool of patients eligible to receive medical cannabis authorizations to include those diagnosed with AIDS/HIV, ALS (aka Lou Gehrig’s disease), multiple sclerosis, cancer (or who are undergoing chemotherapy), Crohn’s disease, epilepsy, and/or post-traumatic stress. However, the legislation repeals provisions that previously provided patients and others the ability to petition health department officials to add additional qualifying conditions. Going forward, lawmakers will have the sole discretion to add new qualifying conditions.

Another bill, House Bill 1053, prohibits health practitioners from providing patients with an authorization to access medical cannabis if they are either pregnant or breastfeeding. No other state explicitly imposes similar restrictions. NORML opposed HB 1053 on the grounds that it unduly interferes with doctor/patient relations.

Governor Noem signed a third bill into law, House Bill 1154, which prohibits recommending physicians from offering discounts or other financial incentives in exchange for their services.

The Governor also vetoed legislation, House Bill 1209, which sought to increase the amount allowable THC levels in state-legal hemp products.

South Dakotans approved a citizens’ initiative legalizing cannabis for medical purposes in 2020. At that time, Gov. Noem campaigned against the initiative effort.

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by russellropeMedia, News March 28, 2023March 26, 2023No Comments

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Analysis: Drivers in Traffic Collisions More Likely to Test Positive for High Levels of Alcohol Than THC

Drivers treated for traffic-related injuries are more likely to test positive for high levels of alcohol (BAC ≥ 0.08 percent) than they are likely to test positive for elevated levels of THC (THC in blood ≥ 5 ng/mL), according to data published in the journal Addiction.

Canadian investigators quantified and reviewed alcohol and THC concentrations in a cohort of nearly 7,000 injured drivers.

They reported, “In this sample, there were over three times as many drivers with BAC ≥ 0.08% (12.6 percent) than with THC ≥ 5 ng/mL (3.5 percent), suggesting that alcohol remains a greater threat to road safety.”

Authors also acknowledged that drivers who tested positive for high levels of alcohol were more likely to be involved in single vehicle accidents as well as in motor vehicle accidents resulting in serious injuries.

Because THC can remain present in blood for extended periods of time, the study’s authors emphasized that at least some subjects who tested positive for cannabis may not necessarily have had recent exposure to it. They further emphasized that subjects testing positive for the presence of THC at levels below 5 ng/ml are typically not under the influence and likely do not possess a significantly increased risk of being involved in a motor vehicle accident.

Driving simulator studies generally report that cannabis administration is associated with compensatory driving behavior, such as decreased mean speed and increased mean following distance, whereas alcohol administration is associated with more aggressive driving behavior. Nevertheless, cannabis exposure can influence certain psychomotor skills necessary for safe driving, such as reaction time and drivers’ ability to maintain lane positioning.

A study conducted by the US National Highway Traffic Safety Administration reported that drivers who test positive for any amount of THC possess, on average, a far lower risk of being involved in a traffic collision than do drivers who test positive for alcohol at or near legal limits.

By contrast, drivers who test positive for the presence of both THC and alcohol in their system tend to possess significantly higher odds of being involved in a motor vehicle accident than do those who test positive for either substance alone.

Full text of the study, “A comparison of cannabis and alcohol use in drivers presenting to hospital after a vehicular collision,” appears in Addiction.

Study: Short-Term Use of Prescription Medication Containing THC and CBD Not Associated with Cardiovascular Complications in High-Risk Patients

Genova, Italy: Patients with a history of stroke are not at an increased risk of cardiovascular complications following the use of nabiximols (a/k/a Sativex – an oromucosal spray containing a balanced ratio of plant-derived THC and CBD), according to clinical trial data published in the journal Frontiers in Cardiovascular Medicine. Nabiximols is available by prescription in various countries, but not in the United States, for patients suffering from symptoms of multiple sclerosis.

Italian researchers compared the cardiovascular impact of nabiximols versus placebo in a cohort of 34 stroke survivors. Subjects in the study suffered from symptoms of spasticity. Patients in the study took either nabiximols or placebo in addition to their standard medications for a period of one-month.

Investigators reported: “No … adverse drug effects emerged during nabiximols treatment, namely no significant fluctuation of blood pressure and heart rate, nor ischemic or hemorrhagic events occurred. During nabiximols treatment, self-assessed blood pressure and heart rate did not change compared to the baseline condition. No patients showed significant acceleration or decrease in heart rate or change in rhythm and none required an additional ECG or cardiological evaluation during the study.”

Authors concluded: “The present study is the first to evaluate the effects of a cannabinoid drug (nabiximols) in patients with post-stroke spasticity. … This ancillary study adds evidence that, in patients who already underwent a cerebrovascular accident, nabiximols does not determine significant blood pressure and heart rate variation or cardiovascular complications. These data support the cardiovascular safety of nabiximols, encouraging more extensive studies involving cannabinoids characterized by slow absorption rates.”

Numerous studies demonstrate the ability of cannabinoids to influence blood pressure and other cardiovascular responses. However, data is inconsistent with respect to whether the frequent use of cannabis may increase one’s risk of stroke, heart attack, or other adverse cardiovascular events. While some studies report an increased risk of stroke and other cardiovascular diseases among marijuana consumers, others report either no risk or provide evidence of possible cardioprotection. A 2021 literature review of 67 studies published in The American Journal of Medicine concluded, “[M]arijuana itself does not appear to be independently associated with excessive cardiovascular risk factors.” Authors did caution, however, that “it can be associated with other unhealthy behaviors such as alcohol use and tobacco smoking that can be detrimental” to cardiovascular health.

Full text of the study, “Nabiximols effect on blood pressure and heart rate in post-stroke patients: A randomized controlled study,” appears in Frontiers in Cardiovascular Medicine.

Mississippi: Bill Amending Medical Cannabis Access Regulations Advanced to Governor

Jackson, MS: Lawmakers have approved legislation, House Bill 1158, amending provisions of the state’s medical cannabis access law.

Proposed changes to the law will make it easier for qualified patients to register for the program and for physicians to participate in it. Language in the bill also expedites the timeline during which officials must approve patients’ registry applications. Other proposed changes require designated caregivers to undergo criminal background checks.

The measure now goes to Republican Gov. Tate Reeves for final approval.

State-licensed dispensaries began selling medical cannabis to qualified patients in January, nearly one year after legislators passed comprehensive legislation regulating its production and dispensing.

Voters in 2020 had initially decided in favor of a citizens’ initiative legalizing medical cannabis use. However, the state Supreme Court later struck down the state’s initiative process, thereby nullifying the election result.

Tourette Syndrome Patients Report Quality of Life Improvements Following Cannabis Therapy

Tel Aviv, Israel: Tourette Syndrome (TS) patients report improvements in their quality of life and reductions in their use of prescription medications following cannabis therapy, according to data published in the journal Cannabis and Cannabinoid Research.

Israeli investigators surveyed patients prior to and six-months following cannabis treatment. Subjects in the study consumed products containing roughly twice as much THC as CBD.

Participants reported statistically significant improvements in their quality of life and employment status following cannabis treatment. Most subjects also reported reduced symptoms of anxiety and obsessive-compulsive tendencies. Patients reduced their use of prescription medicines.

By contrast, subjects did not report statistically significant improvements in their frequency of either vocal or motor tics during the study period.

Authors concluded: “Subjective reports from TS patients suggest that medical cannabis may improve their quality of life and comorbidities. More studies are needed to evaluate the efficacy and safety of medical cannabis.”

A limited number of clinical trials have shown both oral THC and inhaled cannabis to be associated with symptom improvements in TS patients, including decreased tic severity and reductions in obsessive-compulsive behaviors. The results of a randomized, placebo-controlled trial published last month in the journal Psychiatry Research reported that patients with more severe TS symptoms experienced symptomatic improvements following the consumption of a balanced formulation of oral THC and CBD.

Full text of the study, “Using medical cannabis in patients with Gilles de la Tourette’s Syndrome in a real-world setting” appears in Cannabis and Cannabinoid Research.

CBD Administration Mitigates Opioid Cravings in Animals

Portland, OR: The administration of plant-derived CBD significantly reduces opioid cravings in animals, according to preclinical data published in the journal Addiction Neuroscience.

Investigators affiliated with Washington State University in Spokane and with the Legacy Research Institute in Portland assessed the efficacy and safety profile of vaporized CBD in a cohort of female rats.

They reported that rats provided with CBD were less likely to self-administer morphine.

“[T]he ability of WPE [whole-plant cannabis extract] to reduce opioid reward and drug seeking behavior appears quite robust and of great clinical utility,” authors concluded. “Additional systematic research is required to fully evaluate the potential for CBD to serve as an adjunct treatment for opioid use disorder.”

A limited number of clinical trials have previously demonstrated the ability of CBD to mitigate subjects’ cravings for various substances, including heroin, tobacco, and cannabis. Other studies indicate that CBD may also play a role in mitigating symptoms of opioid withdrawal. According to a 2020 review paper, “[E]vidence … demonstrates the potential [of] cannabis to ease opioid withdrawal symptoms, reduce opioid consumption, ameliorate opioid cravings, prevent opioid relapse, improve OUD treatment retention, and reduce overdose deaths.”

Full text of the study, “High-CBD cannabis vapor attenuates opioid reward and partially modulates nociception in female rats,” appears in Addiction Neuroscience.

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by russellropeMedia, News March 21, 2023March 20, 2023No Comments

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Study: Plant-Derived Cannabis Oils Effective for Symptom Management in Older Patients with Treatment-Resistant Neurological Diseases

Sydney, Australia: The use of plant-derived cannabis oils containing balanced ratios of THC and CBD is generally safe and effective for patients suffering from neurological diseases, according to observational trial data published in the Journal of Clinical Medicine.

Australian researchers assessed the sustained use of cannabis extracts in 157 patients with treatment-resistant neurological, musculoskeletal, autoimmune, or anti-inflammatory disorders. (Under Australian law, physicians may only authorize medical cannabis to patients that have been unresponsive to conventional prescription treatments.)

Investigators reported that patients age 65 or older and/or those suffering from neurological disorders, such as Parkinson’s disease, peripheral neuropathy, and multiple sclerosis, perceived the greatest overall benefits from cannabis therapy. Their findings are consistent with those of several other studies reporting health-related quality of life benefits among older patients who consume cannabis.

Subjects were most likely to report cannabis to be effective for improving sleep and for reducing pain – findings that are consistent with other studies. By contrast, patients suffering from spondylosis were least likely to perceive benefits from cannabis therapy.

Authors concluded: “This retrospective medical record review describes the population characteristics of patients using medicinal cannabis at a clinic in Sydney, Australia and provides data on the effectiveness and safety of medicinal cannabis treatment on patient conditions and indications. … [Its findings] indicate that medicinal cannabis, in a balanced formulation, may address a variety of non-cancer conditions and indications concurrently and can be safely prescribed by a medical doctor.”

Full text of the study, “A retrospective medical record review of adults with non-cancer diagnoses prescribed medical cannabis,” appears in the Journal of Clinical Medicine.

Analysis: No Uptick in Traffic-Related Hospitalizations Following Marijuana Legalization

Toronto, Canada: The implementation of adult-use marijuana sales in Canada is not associated with any increase in traffic injury-related hospitalizations, according to data published in the journal Addiction.

Investigators assessed nationwide rates of emergency department visits and hospitalizations in the years before and immediately following legalization.

Authors concluded, “Overall, there is no clear evidence that RCL [recreational cannabis laws] had any effect on rates of ED visits and hospitalizations for either motor vehicle or pedestrian/cyclist injury across Canada.”

The findings are consistent with those of a 2021 Canadian study that similarly “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.”

Several studies from the United States also found no significant changes in traffic safety in the years immediately following the enactment of adult-use legalization. However, other assessments evaluating longer-term trends in traffic safety following legalization have yielded inconsistent results.

Full text of the study, “The effect of recreational cannabis legalization on rates of traffic injury in Canada,” appears in Addiction.

North Dakota: Lawmakers Advance Bill Increasing THC Limits for Qualified Patients

Bismarck, ND: Members of the state House and Senate have approved legislation (Senate Bill 2068) increasing the quantity of THC-containing products that patients may legally possess at any one time.

House members advanced the bill by a vote of 77 to 16. Members of the Senate passed it by a vote of 34 to 14. The measure now awaits action from Republican Gov. Doug Burgum.

Under the state’s medical cannabis access law, registered patients are not permitted to either purchase or possess a supply of THC-infused products totaling more than 4,000 milligrams in any 30-day period. The pending legislation raises this 30-day cap to 6,000 milligrams.

According to the state’s Department of Health & Human Services website, over 9,000 residents are currently registered to obtain medical cannabis products at state-licensed dispensaries.

South Dakota: Mixed Bag of Cannabis Bills Advance to Governor’s Desk

Pierre, SD: A pair of medical cannabis reform bills have been advanced by the legislature and await action from Republican Gov. Kristi Noem.

The first bill, Senate Bill 1, expands the pool of patients eligible to receive medical cannabis authorizations to include those explicitly diagnosed with AIDS/HIV, ALS, multiple sclerosis, cancer (or who are undergoing chemotherapy), Crohn’s disease, epilepsy, and/or post-traumatic stress. However, the legislation repeals provisions providing patients and others the ability to petition health department officials to add additional qualifying conditions in the future. Going forward, lawmakers will have the sole discretion to add new qualifying conditions.

The second bill, House Bill 1053, prohibits health practitioners from providing patients with an authorization to access medical cannabis if they are either pregnant or breastfeeding. No other state explicitly imposes similar restrictions. (Last year, members of the Alabama Senate approved similar legislation requiring women of childbearing age to show proof of a negative pregnancy test before they could apply to obtain medical cannabis; however, that bill eventually failed in the House.)

In January, the Arizona Supreme Court held that a mother’s authorized use of medical cannabis to treat symptoms of morning sickness did not constitute child neglect under the state’s child welfare laws.

According to survey data published last year, a small percentage of patients acknowledge having used cannabis to treat symptoms of Hyperemesis Gravidarum (HG). However, among those that do, most say that it is more effective than prescription medications at reducing severe nausea and vomiting.

NORML opposes HB 1053 because it unduly interferes with doctor/patient relations. For information on additional legislation, please visit NORML’s ‘Take Action Center.’

Study: Clinicians More Likely to Order Drug Tests for Black Newborns

Ann Arbor, MI: Black newborns are more likely to undergo drug testing than are other babies, according to data published in the journal JAMA (Journal of the American Medical Association) Network Open.

Researchers affiliated with the University of Michigan assessed rates of infant drug testing in a cohort of over 26,000 newborn children. They reported that clinicians ordered drug tests to be performed on Black newborns at nearly four times the rate of other children.

“This study [finds] racial disparities in newborn drug testing unrelated to obstetrical risk,” authors determined. “Our findings strongly suggest that changes in policies regarding drug testing and reporting at the hospital and state level and improvement measures focused on the health, well-being, and dignity of Black birthing people are needed to reduce health inequity for Black parents and their newborns.”

The findings are consistent with those of prior studies reporting that Black patients and their newborns are more likely to be drug tested for cannabis and other substances than those of other ethnicities.

For example, a study published earlier this month in the journal Hospital Pediatrics reported that patients selected to undergo marijuana-specific drug screening during the labor and delivery process are disproportionately Hispanic or African American.

Data assessing the relationship between in utero cannabis exposure and various neonatal outcomes, such as birth weight, is inconsistent. However, longitudinal data indicates that cannabis exposure is rarely independently linked with adverse neurodevelopmental consequences, finding, “Although there is a theoretical potential for cannabis to interfere with neurodevelopment, human data drawn from four prospective cohorts have not identified any long-term or long lasting meaningful differences between children exposed in utero to cannabis and those not.”

Nonetheless, in some states, such as in Oklahoma and Alabama, mothers have been arrested and criminally prosecuted for the use of cannabis during their pregnancy. In total, 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes and three consider it grounds for civil commitment, according to data provided by The Guttmacher Policy Institute.

Full text of the study, “Incidences of newborn drug testing and variations by birthing parent race and ethnicity before and after recreational cannabis legalization,” appears in JAMA Network Open.

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by russellropeMedia, News March 14, 2023March 12, 2023No Comments

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Study: Cannabis Products Improve Health-Related Quality of Life in Patients with Chronic Illnesses

London, United Kingdom: Patients’ consumption of medical cannabis products is well-tolerated and is associated with significant improvements in their health-related quality of life, according to observational data published in the journal Expert Review of Clinical Pharmacology.

British investigators assessed the safety and efficacy of cannabis-derived products in 2,833 patients enrolled in the UK Medical Cannabis Registry. All of the participants possessed a doctor’s authorization to access cannabis products. (Since 2018, specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.)

Patients enrolled in the registry suffered from a variety of disorders, including chronic pain, anxiety, post-traumatic stress, depression, migraine, inflammatory bowel disease, and other afflictions. Study participants consumed cannabis by either vaporizing marijuana flowers or by ingesting plant-derived extracts containing both THC and CBD. Researchers assessed subjects’ symptoms compared to baseline at one, three, six, and twelve months.

Authors reported that the majority of patients experienced sustained improvements following cannabis therapy. Adverse events associated with cannabis were typically mild, with the most frequently reported side-effects being dry mouth and fatigue.

They concluded: “This observational study suggests that initiating treatment with CBMPs [cannabis-based medicinal products] is associated with an improvement in general HRQoL [health-related quality of life], as well as sleep- and anxiety-specific symptoms up to 12 months in patients with chronic illness. … Most patients tolerated the treatment well, however, the risk of AEs [adverse events] should be considered before initiating CBMPs. In particular, female and cannabis-naïve patients are at increased likelihood of experiencing adverse events. These findings may help to inform current clinical practice, but most importantly, highlights the need for further clinical trials to determine causality and generate guidelines to optimize therapy with CBMPs.”

Full text of the study, “An observational study of safety and clinical outcome measures across patient groups in the United Kingdom Medical Cannabis Registry,” appears in Expert Review of Clinical Pharmacology.

Justice Department Appealing Federal Ruling That Struck Down Gun Ban for Cannabis Consumers

Washington, DC: The Justice Department is appealing a ruling issued by a federal judge last month that struck down a longstanding federal law prohibiting marijuana users from possessing firearms.

In early February, a federal judge for the US District Court for the Western District of Oklahoma determined that the 1968 law was unconstitutional. The judge determined: “[T]he mere use of marijuana carries none of the characteristics that the Nation’s history and tradition of firearms regulation supports. The use of marijuana — which can be bought legally (under state law) at more than 2,000 ordinary store fronts in Oklahoma — is not in and of itself a violent, forceful, or threatening act. It is not a ‘crime of violence.’ Nor does it involve ‘the actual use or threatened use of force.’”

On Friday, the Justice Department announced that it was appealing the ruling in the U.S. Court of Appeals for the Tenth Circuit.

In 2016, a three-judge panel of the Ninth Circuit Court of Appeals upheld the federal government’s interpretation of the law. Justices opined that the ban “furthers the Government’s interest in preventing gun violence” because marijuana users “are more likely to be involved in violent crimes.”

The case is United States of America v. James Michael Harrison.

Adult-Use Marijuana Legalization Legislation Advances in Three States

Washington, DC: Legislation legalizing the possession of marijuana by those age 21 and older continues to advance in three states.

Lawmakers in Hawaii advanced Senate Bill 669 on Tuesday by a vote of 22 to 3. The bill legalizes marijuana use, production, and retail sales for adults. It now awaits action in the House, where it faces an uncertain future. Specifically, House Speaker Scott Saiki has expressed reluctance to move the bill this year, instead calling for the issue to be further assessed in a summer study session.

In Delaware, House members voted 28 to 13 in support of HB 1, which removes criminal and civil penalties for adults who possess personal use quantities of cannabis. Complimentary legislation (HB 2) providing regulations for the adult-use cannabis retail market is pending in the chamber. Last year legislation similar to SB 1 was passed by lawmakers, but vetoed by Democratic Gov. John Carney, who opined, “I do not believe that promoting or expanding the use of recreational marijuana is in the best interests of the state of Delaware, especially our young people.”

Finally, in Minnesota, a pair of bills (HF 100 | SB 73) legalizing the adult-use cannabis market have passed multiple committees and are anticipated to receive floor votes in the coming weeks. The bills have the support of Democratic Gov. Tim Walz, who publicly predicted that the state would pass legalization by May.

Analysis: Black and Hispanic Patients Disproportionately Screened for Perinatal Cannabis Use

Boston, MA: Patients selected to undergo marijuana-specific drug screening during the labor and delivery process are disproportionately Hispanic or African American and they are also likely to be on subsidized health insurance plans, according to data published in the journal Hospital Pediatrics.

Researchers affiliated with Harvard Medical School assessed characteristics of 1,924 patients who underwent peripartum toxicology testing between 2016 and 2020 at five birthing hospitals in Massachusetts.

Consistent with prior studies, those singled out for testing were disproportionately Black or Hispanic and many were publicly insured. Specifically, Hispanic patients were twice as likely to be mandated to undergo testing and Black patients were four times as likely to be ordered to do so. Those on public health care plans were more than twice as likely to be tested for past cannabis exposure.

However, doctors seldom took any follow up action or made changes to patients’ clinical management after they tested positive for cannabis.

The study’s authors concluded, “Toxicology testing of patients for a sole indication of cannabis use, without other risk factors, may be of limited utility in elucidating other substance use and may exacerbate existing disparities in perinatal outcomes.”

Nonetheless, in some states, such as in Oklahoma and Alabama, mothers have been arrested and criminally prosecuted for the use of cannabis during their pregnancy. In total, 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and three consider it grounds for civil commitment, according to data provided by the Guttmacher Policy Review.

Full text of the study, “Limited utility of toxicology testing at delivery for perinatal cannabis use,” appears in Hospital Pediatrics.

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by russellropeMedia, News March 7, 2023March 4, 2023No Comments

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Study: THC/CBD Combination Therapy Reduces Seizure Frequency in Children with Treatment-Resistant Epilepsy

London, United Kingdom: The daily administration of cannabis products is associated with reductions in seizure frequency among children with treatment-resistant epilepsy (TRE), according to observational trial data published in the journal Neuropediatrics.

British investigators assessed the safety and efficacy of cannabis-derived products in 35 patients diagnosed with pediatric epilepsy. Study subjects were participants in the UK Medical Cannabis Registry, and each of them possessed a doctor’s authorization to consume cannabis. Study participants consumed either CBD-dominant extract oils or a combination therapy containing both CBD and THC.

Researchers reported that over 90 percent of subjects treated with the combination therapy experienced a ≥50 percent reduction in seizure frequency at six months, whereas fewer than one-third of patients receiving CBD-only products did so. Investigators said that cannabis products exhibited an acceptable short-term safety profile in this patient cohort.

"The results show a promising signal toward the effectiveness of CBMPs [cannabis-based medicinal products] in children with TRE, particularly in the cohort of patients treated with delta-9-THC," the authors concluded. They added: "The short term adverse effects appear well tolerated, but the long-term effects of CBMPs on neurodevelopment are still unknown. The results from this study could be utilized in the design of future phase II randomized controlled trials, particularly for dosing regimens."

Subjects enrolled in the UK Medical Cannabis Registry who were diagnosed with a variety of other conditions, including post-traumatic stress, depression, and inflammatory bowel disease, have also demonstrated symptomatic improvements following cannabis therapy.

Survey data from Canada estimates that as many as one-third of epileptic patients consume cannabis products therapeutically.

In 2018, regulators with the United States Food and Drug Administration granted market approval for the plant-derived CBD prescription drug Epidiolex in the treatment of two rare forms of pediatric epilepsy, Lennox-Gastaut syndrome, and Dravet syndrome. The drug is categorized as a Schedule V controlled substance. In 2020, FDA regulators expanded the prescription use of Epidiolex to patients with the genetic disorder tuberous sclerosis complex (TSC).

Full text of the study, "Clinical outcomes of children treated with cannabis based medicinal products for treatment resistant epilepsy: Analysis from the UK Medical Cannabis Registry," appears in Neuropediatrics.

Case Series: Cannabis Effective at Treating Borderline Personality Disorder

London, United Kingdom: The use of cannabis products containing THC and CBD are safe and effective in mitigating symptoms in patients diagnosed with emotionally unstable personality disorder (EUPD), according to a case series reported in the journal Brain Sciences. Emotionally unstable personality disorder (a/k/a borderline personality disorder) is a common mental health disorder associated with a range of chronic and debilitating symptoms, including impaired social functioning, unstable mood, and risky, impulsive, or self-injurious behavior.

An international team of researchers assessed the use of cannabis products in a cohort of seven EUPD patients. Subjects consumed products containing both THC and CBD in varying ratios for one month.

Six of the seven participants reported "an improvement in symptoms," and "none of the participants reported any adverse side effects."

The study’s authors concluded: "To our knowledge, this case series represents the first medical evidence of the use of CBMPs [cannabis-based medicinal products] for the clinical management of patients with a diagnosis of EUPD. ... [O]ur results suggest that, when deployed in a rigorously controlled clinical environment, CBMPs can provide substantial improvement in symptoms associated with EUPD thus warranting the need for further research on this therapeutic strategy."

Full text of the study, "Cannabis based medicinal products in the management of emotionally unstable personality disorder: A narrative review and case series," appears in Brain Sciences.

Study: Cannabis Use History Not Associated with Increased Risk of Hypertension

Chicago, IL: Neither current nor past cannabis use is associated with an elevated risk of high blood pressure, according to data published in the Journal of Clinical Hypertension.

Investigators with Northwestern University’s Feinberg School of Medicine in Chicago assessed the relationship between cannabis use and blood pressure in a cohort of 4,565 adults.

They found no correlation between cannabis consumption and the likelihood of receiving a medical diagnosis for hypertension. They reported: "When compared with non-users, respondents who indicated sustained use of cannabis were not found to have an increased likelihood of developing hypertension. Among cannabis users, the frequency of use was not associated with increased odds of hypertension diagnosis. The age that an individual first began regularly using cannabis was also not found to have an association with the odds of hypertension diagnosis. Current users were not more likely than past users to have hypertension."

The authors concluded: "The findings of this study indicate that neither past nor current cannabis use are associated with the likelihood of having clinical hypertension. … Prospective clinical trials are needed to further determine the effects of cannabis on developing or perhaps even mitigating hypertension, particularly regarding long-term outcomes."

The findings are similar to those of a 2021 study, which also reported, "After adjustment for all confounders, neither lifetime cannabis use, 12-month cannabis use nor 12-month cannabis use frequency [at least monthly use and less than monthly use] were associated above chance with the incidence of hypertension."

Cannabinoids may influence blood pressure and other cardiovascular responses, though these effects tend to be short-term in duration and can be inconsistent. Recently, Israeli data reported that elderly subjects with hypertension respond favorably to medical cannabis treatment. Investigators involved with that study concluded, "Cannabis treatment for three months was associated with a reduction in systolic and diastolic blood pressure, as well as heart rate."

Full text of the study, "Sustained cannabis use does not predispose clinical hypertension: Findings from a national survey," appears in the Journal of Clinical Hypertension.

Analysis: Long-Term Cannabis Use Not Significantly Detrimental to Overall Health

Barcelona, Spain: Adults who regularly consume cannabis products do not report significant differences in their overall health as compared to the general public, according to data published in the journal Cannabis and Cannabinoid Research.

Spanish investigators surveyed a representative sample of regular cannabis consumers on a variety of questions specific to their daily activities and perceived overall health. Their responses were compared to previously compiled data provided by the general public.

Cannabis consumers were more likely than members of the general public to report walking at least ten minutes per day (76 percent to 70 percent), and they were more likely to positively perceive their own health (88 percent to 82 percent). Consumers were also less likely to report having issues with their cholesterol and blood pressure. Consumers were more likely than those in the general population to report experiencing problems sleeping.

One in four respondents reported reducing their need for medical interventions since using cannabis, and nearly one-third acknowledged reducing their use of prescription medications -- a finding that is consistent with prior studies.

Authors reported: "In this study, long-term users of cannabis scored in a similar way as the general population on a list of health indicators. These results were obtained using validated health indicators, especially designed and used by several governments to assess population health and compare this information between countries or specific populations. There was only one indicator associated with poorer health among cannabis users: sleep problems."

They concluded: "[T]hese findings suggest that long-term cannabis use might not play a central role in terms of public health. … We suggest inclusion of cannabis-related items in national surveys of health as they would provide valuable data to support the progress of public debates regarding its regulation."

Full text of the study, "Cannabis and public health: A study assessing regular cannabis users through health indicators," appears in Cannabis and Cannabinoid Research.

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by russellropeMedia, News February 28, 2023February 24, 2023No Comments

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Analysis: Growing Percentage of Consumers Obtain Cannabis Products From the Legal Marketplace

Waterloo, Canada: Canadian cannabis consumers are steadily transitioning from the unregulated market to the legal market, according to data published in the Harm Reduction Journal.

Investigators affiliated with the University of Waterloo, School of Public Health surveyed over 15,000 cannabis consumers regarding where they obtained their products. Researchers evaluated data for the years 2019 to 2021. (Canada instituted licensed retail sales of cannabis products in October 2018.)

Authors reported that the percentage of respondents legally sourcing their cannabis products increased year over year. Respondents were most likely to purchase cannabis-infused drinks, oils, and capsules from the legal marketplace. About 55 percent of respondents said they obtained cannabis flower exclusively from legally licensed retailers.

In 2019, fewer than half of consumers acknowledged obtaining their cannabis products from legal sources. According to separate consumer survey data published last year, that percentage rose to nearly 70 percent in 2020.

“Legal sourcing of cannabis was greater in 2021 than 2020 for all ten cannabis products [surveyed]. In 2021, the percentage of consumers sourcing all their products legally in the past 12 months ranged from 49 percent of solid concentrate consumers in 2021 to 82 percent of cannabis drink consumers,” investigators reported. “Transitioning consumers of all cannabis products into the regulated market is important for public health and safety. Future studies should continue to examine cannabis product sourcing in Canada over time, as well as ways to displace the illegal market for all cannabis products without also promoting the use of high-potency cannabis products.”

Full text of the study, “Legal sourcing of ten cannabis products in the Canadian cannabis market, 2019-2021: A repeat cross-sectional study,” appears in the Harm Reduction Journal.

Survey: Cannabis Provides Relief, Less Need for Prescription Medications in Nerve Pain Patients

Scranton, PA: Patients suffering from Charcot-Marie-Tooth (CMT) disease, a genetic nerve pain disorder, frequently report that cannabis use mitigates their pain and decreases their need for prescription medications, according to data published in the American Journal of Hospice and Palliative Medicine.

A team of investigators affiliated with the Geisinger Commonwealth School of Medicine in Pennsylvania surveyed 56 patients with CMT.

Over 90 percent of respondents said that cannabis use reduced their average pain by at least half. Eighty percent of respondents reported using fewer opioids following the initiation of cannabis therapy. Sixty-nine percent of study participants reported reducing their use of sleep aids, and 50 percent reported using fewer anxiety/anti-depressants.

“The findings from this survey indicate that patients with CMT report substantial relief of pain symptoms from the use of cannabis,” the authors concluded. “These data support the need for prospective, randomized, controlled trials using standardized dosing protocols to further delineate and optimize the potential use of cannabis to treat pain related to CMT.”

The survey’s findings are consistent with those of numerous other studies documenting that patients frequently use cannabis for pain mitigation and that many patients either reduce or eliminate their consumption of opioids and other medications following the initiation of cannabis therapy.

Several placebo-controlled trials document the ability of either inhaled or vaporized herbal cannabis to significantly mitigate pain in various patient populations, including those suffering from HIV, diabetes, spinal cord injury, or severe treatment-resistant neuropathy (nerve pain). These positive results have been replicated in clinical trials utilizing relatively low doses of cannabis as well as in trials using plant-derived cannabis extracts.

Full text of the study, “Patient reported outcomes using medical cannabis for managing pain in Charcot-Marie-Tooth disease,” appears in the American Journal of Hospice and Palliative Medicine. Information on cannabis and pain management is available from NORML’s publication, Clinical Applications for Cannabis and Cannabinoids.

Survey: Cannabis Provides Relief, Less Need for Prescription Medications in Nerve Pain Patients

A team of investigators affiliated with the Geisinger Commonwealth School of Medicine in Pennsylvania surveyed 56 patients with CMT.

Clinical Trial: Topical CBD Treatment Accelerates Healing of ‘Canker Sores’

Bangkok, Thailand: The use of a topical agent containing trace levels of plant-derived CBD reduces ulcer size and promotes healing in subjects with recurrent aphthous ulcers (a/k/a canker sores), according to clinical trial data published in the journal BMC Complementary Medicine and Therapies.

A team of Thai researchers compared the use of a topical patch containing 0.1 percent CBD with a placebo in 100 healthy subjects with recurrent aphthous ulcers (RAU). The CBD ointment was applied three times per day for seven days. Ulcer size was measured on days zero, two, five, and seven.

Authors reported that topical CBD “reduced ulcer size and accelerated ulcer healing without side effects.”

They concluded: “This clinical study demonstrated that topical 0.1 percent CBD reduced ulcer size and accelerated ulcer healing without any reported local (signs of allergic and anaphylactic reactions) or systemic (vital sign and blood test alteration) side effects.

Furthermore, in the RCT [randomly controlled trial], topical CBD exerted an anti-inflammatory effect by reducing the erythematous border size in the early stage and decreasing pain intensity in the late stage of RAU. Thus, CBD may be appropriate for RAU patients who choose not to take topical steroids, except for cases where CBD is contraindicated.”

The findings are consistent with those of other trials and case reports finding that the topical application of CBD promotes wound healing in patients with scleroderma, refractory leg ulcers and with the rare skin blistering disease epidermolysis bullosa. The topical application of cannabinoids, and of CBD in particular, has demonstrated benefits in the treatment of a variety of skin-related conditions, including psoriasis, erythema, pruritis, and acne.

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by russellropeMedia, News February 21, 2023February 2, 2023No Comments