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by russellropeMedia, News April 19, 2022April 17, 2022No Comments

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Analysis: Adult-Use Cannabis Sales Generated Nearly $4 Billion in Tax Revenues in 2021

Washington, DC: Tax revenues derived from the licensed retail sale of state-legal, adult-use cannabis products grew by more than 30 percent between 2020 and 2021, totaling over $3.7 billion last year - according to an analysis provided by the Marijuana Policy Project.

MPP's figures do not include revenues derived from the sales of medical cannabis products and/or the collection of state-imposed regulatory fees.

Toi Hutchinson, president of MPP, said that the data provides "further evidence that ending cannabis prohibition offers tremendous financial benefits for state governments."

Adult-use sales generated the greatest amount of revenue in California ($1.3 billion), followed by Washington, Illinois, and Colorado.

Since 2014, retail sales of adult-use cannabis products have generated $11.2 billion dollars.

Full text of the report, "Cannabis Tax Revenues in States That Regulate Cannabis for Adult Use," is available online.

Study: Pain Patients Dramatically Reduce Opioid Intake Following Use of Various Cannabis Preparations

Potsdam, Germany: Chronic pain patients provided with cannabis-based interventions significantly reduce their daily intake of prescription opioids, according to longitudinal data published in the German medical journal Schmerz.

A team of German investigators assessed opioid use trends in a cohort of 178 chronic pain patients who were provided with either whole-plant cannabis extracts, nabiximols (a cannabis plant-derived oromucosal spray), or dronabinol (synthetic THC capsules) for an average period of 366 days. The majority of participants in the trial (65 percent) were older than 65 years of age.

Consistent with dozens of prior studies, patients significantly reduced their daily opioid intake over the course of the trial.

Investigators failed to identify any significant side effects due to the cannabis-based interventions.

Authors reported: "Patients daily opioid dosages were "significantly reduced in course of time by ... 50 percent. This reduction was independent on CAM [medical cannabinoids] dosage, age and gender."

They concluded: "Patients with chronic pain profit from long-term CAM which safely and significantly lower the consumption of co-medicated opioids, even at low dosages. ... Older patients benefit from CAM, and adverse effects do not limit the (chronic) use and prescription of CAM in the elderly."

Those who consume cannabis medicinally are most likely to report doing so to address chronic pain symptoms. Studies further report that pain patients typically reduce or eliminate their use of opioids following their initiation of cannabis therapy.

Full text of the study, "Cannabinoids reduce opioid use in older patients with pain: A retrospective three-year analysis of data from a general practice," appears in Schmerz.

Poll: Over Half of US Adults Have Tried Cannabis

Washington, DC: More than half of Americans ages 18 and older acknowledge having consumed cannabis, according to nationwide survey data provided by YouGov.com.

Fifty-two percent of respondents admitted having tried marijuana during their lifetimes, including 63 percent of those between the ages of 45 and 64.

By contrast, those respondents between the ages of 18 and 29 years old were among those least likely to report having had prior experience with cannabis (37 percent).

Consistent with prior surveys, smoking was the most common way adults consumed cannabis.

Two-thirds of those with a history of cannabis use said that their experiences were "very or somewhat positive."

The data is consistent with 2021 survey data provided by Gallup reporting that an estimated 50 percent of US adults have consumed cannabis at some point in their lives.

Additional polling information is available from YouGov.com.

Study: Adult-Use Marijuana Laws Associated with Reduction in Foster Care Admissions

Oxford, MS: Adult-use marijuana legalization laws are correlated with a reduction in foster care placements, according to data published in the journal Economic Inquiry.

A pair of economists with the University of Mississippi assessed foster care admission trends in states pre and post-legalization.

Authors reported: "Legalization may impact foster-care admissions directly by changing the welfare of children or indirectly by changing policies and attitudes towards marijuana use in the home. Direct effects may arise because marijuana use itself causes behaviors that affect child welfare, or because it changes the likelihood of using other drugs."

They added, "We also find that placements due to physical abuse, parental neglect, and parental incarceration decrease after legalization, providing evidence that legalization reduces substantive threats to child welfare, although the precise mechanism behind these effects is unclear."

Authors concluded: "We estimate that legalization decreases foster-care placements by at least 10 percent, with larger effects in years after legalization, and for admissions for reasons of parental drug and alcohol abuse, physical abuse, neglect, and parental incarceration. Our findings imply that legalization may have important consequences for child welfare, and that substitution toward marijuana from other substances can be an important part of how legalization affects admissions."

Full text of the study, "Recreational marijuana legalization and admissions to the foster care system," appears in Economic Inquiry.

Survey: Most Oncology Trainees Say They're "Insufficiently Informed" About Cannabis

Boston, MA: The majority of oncologists in training acknowledge knowing little about the use of cannabis in cancer care treatment, according to national survey data published in the journal JCO Oncology Practice.

A team of researchers affiliated with Harvard Medical School surveyed 462 oncology trainees from 25 states. Consistent with prior surveys of health professionals, most respondents (76 percent) said that they had received no "formal training regarding medical cannabis." Most respondents also said that they "considered themselves insufficiently informed to make cannabis-related medical recommendations."

Cancer is a qualifying condition in every state where medical cannabis access is provided, and the use of synthetic THC has been FDA-approved as an anti-nausea agent and as an appetite stimulant for cancer patients for several decades.

Survey data finds that an estimated one-in-eight cancer patients consume cannabis for symptom management and that nearly ten percent of cancer survivors identify as current marijuana users.

Full text of the study, "Oncology fellows' clinical discussions, perceived knowledge, and formal training regarding medical cannabis use: A national survey study," appears in JCO Oncology Practice.

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by russellropeMedia, News April 12, 2022April 12, 2022No Comments

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Congressional Chamber Advances Bill Allowing Scientists to Access State-Legal Marijuana Products in Clinical Trials

Washington, DC: Members of the US House of Representatives have approved legislation, HR 5657: The Medical Marijuana Research Act, facilitating clinical cannabis research by establishing a process whereby authorized scientists may access flowers and other products manufactured in accordance with state-approved marijuana programs.

The bill also expedites the timeline during which federal officials must either approve or reject applicants seeking licensure to conduct clinical trials using cannabis products, and it also seeks to increase the total number of federally licensed marijuana growers. For decades, scientists wishing to work with marijuana have complained that it often takes years before their research protocols are approved by the US Drug Enforcement Administration, and that the quality of cannabis provided by the University of Mississippi's cultivation program is of inferior quality and that it is not representative of the products available in legal state markets.

NORML's Deputy Director Paul Armentano said: "These common-sense regulatory changes are necessary and long overdue. Currently, the limited variety of cannabis cultivars accessible to federally licensed researchers does not represent the type or quality of cannabis products currently available in legal, statewide markets. The reality that nearly one-half of US adults have legal access to these multitude of cannabis products, but our nation's top scientists do not, is the height of absurdity and it is an indictment of the current system."

House members voted 343 to 75 in favor of the bill. All members voting against the bill were Republicans.

House lawmakers previously passed a version of the Act in 2020 in the final days of the 116th Congress. The bill was never taken up in the Senate.

Last month, Senate lawmakers unanimously approved separate legislation, Senate Bill 253: The Cannabidiol and Marihuana Research Expansion Act, which also seeks to streamline the federal approval process. However, this proposal continues to limit scientists' access only to marijuana products produced by those possessing a federal license.

Representative Earl Blumenauer, a co-sponsor of HR 5657, said: "The cannabis laws in this country are broken, including those that deal with the medical research of marijuana. ... I am prepared to work with my friends in the Senate to reconcile differences between this legislation and the Senate-passed Cannabidiol and Marihuana Research Expansion Act."

Under current regulations, the DEA is primarily tasked with reviewing and licensing marijuana cultivators, as well as granting Schedule I licenses to scientists wishing to study cannabis in clinical settings. In 2016, the agency announced that it would expand the pool of federally licensed growers beyond just the University of Mississippi (which was initially granted a federal cannabis cultivation license in 1968). In May, the agency for the first time ever announced that it had reached agreements with a handful of third-party applicants to allow them to grow cannabis for use in federally approved clinical trials.

NORML has long advocated for amending federal regulations so that federally-licensed scientists can directly access and assess the wide variety of retail cannabis products available in medical-use and adult-use state markets.

"Rather than compelling scientists to access marijuana products of questionable quality that are manufactured by a limited number of federally licensed producers, NORML believes that federal regulators should allow investigators to access the cannabis that is currently being produced by the multitude of state-sanctioned producers and retailers throughout the country," NORML's Deputy Director Paul Armentano said. "Doing so will not only facilitate and expedite clinical cannabis research in the United States, but it will also bring about a long overdue end to decades of DEA stonewalling and interference with respect to the advancement of our scientific understanding of the cannabis plant."

Analysis: Statewide Legalization Laws Not Associated with Any Uptick in Marijuana-Related Treatment Admissions

Farmington, CT: The enactment of laws legalizing adult-use marijuana possession and sales is not associated with any increase in the proportion of marijuana-related substance use treatment admissions, according to data published in The American Journal of Addictions.

A pair of researchers affiliated with the University of Connecticut and with the Veterans Administration New England Mental Illness, Research, Education, and Clinical Center assessed marijuana-use related admission trends in legal states and in states where marijuana remained criminalized.

Authors determined, "[O]ur findings failed to find evidence that legalization of commercial marijuana was associated with any significant change in entry into marijuana‐related treatment services or that greater numbers of years of marijuana legalization was associated with increased admissions to treatment."

They concluded, "It appears that, in the future, the proportion of marijuana‐related treatment service use may remain unchanged even as more states intend to legalize marijuana use fully or partially."

A separate study published in 2021 reported that the enactment of statewide marijuana legalization laws in Colorado and Washington was not associated with any increase in the number of teens or young adults seeking drug abuse treatment for the use of other controlled substances, including opioids, cocaine, or methamphetamine. Data from 2020 reported that the percentage of teens admitted to substance use treatment facilities for cannabis declined significantly in Colorado and Washington following the adoption of adult-use legalization.

Other studies have reported a dramatic and consistent decline in the prevalence of so-called cannabis use disorder over the better part of the past two decades. Self-reported use of marijuana by young people has also declined both nationally and in legal marijuana states.

Full text of the study, "Admissions to substance use treatment facilities for cannabis use disorder: Does legalization matter," appears in The American Journal of Addictions.

Study: Adult-Use Legalization Laws Associated with Declining Prices for Cannabis Flower

Waterloo, Canada: Cannabis consumers typically pay lower prices for cannabis flower in states with legal marijuana retail markets than they do in jurisdictions without them, according to data published in the journal Cannabis and Cannabinoid Research.

A team of researchers affiliated with the University of Waterloo in Canada and with the RAND Corporation in Santa Monica, California assessed cannabis prices and purchasing trends in states with and without licensed adult-use retailers.

They reported that consumers residing in states with mature retail markets rarely solicited the unregulated market in order to obtain cannabis flower. They also determined that retail prices declined over time in state-legal markets and that the average price of cannabis flower in states with legal retail outlets was lower than it was in states without retailers.

"Consumers paid more for dried flower in illegal, medical, and recreational states without stores, than [they did in] recreational states with stores," authors concluded. They added: "Among recreational states with stores, consumers reported purchasing [approximately] 80 percent of dried flower from legal sources in the past 12 months. Substantial differences were observed across states, with higher levels of legal purchases in states with retail stores compared with those without. For example, in Washington and Colorado, where recreational stores were open in 2014, consumers reported purchasing close to 90 percent of dried flower from legal sources."

Full text of the study, "Prices and purchase sources for dried cannabis flower in the United States, 2019-2020," appears in Cannabis and Cannabinoid Research.

Poll: Plurality of Americans Oppose Workplace Testing for Marijuana in States Where Cannabis Is Legal

Washington, DC: A plurality of Americans oppose workplace policies that permit employers to drug test employees for cannabis in states where its off-the-job use is legal, according to nationwide polling data provided by YouGov.com.

Forty-four percent of respondents said that they opposed "allowing employers to test workers for marijuana in states where [it] is legal." Thirty-six percent of respondents supported the policy and 20 percent were undecided.

In recent months, several states - such as Nevada, New Jersey, New York, and Montana - have enacted legislation limiting employers' ability to either pre-screen applicants for past marijuana exposure or refuse to hire them. New York's policy further limits employers' ability to sanction current employees for their off-hours marijuana use absent evidence of "articulable symptoms of cannabis impairment."

City officials in several metropolitan areas - such as Atlanta, Baltimore, Philadelphia, and St. Louis - have also recently adopted local laws prohibiting marijuana-specific pre-employment and random drug screenings for public employees in non-safety sensitive positions.

Urinalysis, the primary form of workplace drug testing, detects the presence of inactive marijuana byproducts that may be present for as many as 100 days post-abstinence. The detection of these products only indicates that a particular substance is present in the test subject's body. It does not indicate either recency of use or impairment.

According to data provided in March by the US Bureau of Labor Statistics, the percentage of private worksites engaged in drug screening has fallen by nearly half since the mid-1990s. Industries related to transportation, utilities, construction, and manufacturing are among those most likely to engage in drug screening.

Arizona: Appellate Court Rules Prenatal Cannabis Exposure Does Not Constitute Child Neglect

Phoenix, AZ: Judges on the Arizona Court of Appeals have determined that child welfare officials acted inappropriately when they placed a woman on state registry for using medical cannabis while pregnant.

Justices unanimously ruled that the prenatal exposure in this case did not constitute "neglect" because the mother was qualified to access medical cannabis under the law.

The Court determined: "The evidence shows that [the plaintiff] was certified under AMMA [the Arizona Medical Marijuana Act] to use marijuana medically to treat chronic nausea. The doctor who certified [the plaintiff's] eligibility for using medical marijuana knew that she was pregnant. Because the use of marijuana under AMMA 'must be considered the equivalent of the use of any other medication under the direction of a physician,' A.R.S. § 36-2813(C), the exposure of [the plaintiff's] infant to marijuana resulted from medical treatment and did not constitute neglect under A.R.S. § 8-201(25)(c)."

The Appellate Court's ruling overturns a decision by the state Department of Child Safety's director and a ruling by a trial court judge.

Last month, members of the Alabama Senate approved legislation requiring women of childbearing age to show proof of a negative pregnancy test before they could apply to obtain medical cannabis. The bill has not been advanced in the House.

Oklahoma regulators considered imposing a similar requirement on women seeking to obtain medical cannabis, but ultimately repealed the rule.

Data provides inconsistent results with respect to whether or not prenatal cannabis exposure is associated with adverse neonatal outcomes, such as the risk of preterm birth.

The case is Ridgell v Arizona Department of Public Safety.

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by russellropeMedia, News April 5, 2022April 5, 2022No Comments

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Poll: Super-Majority of Voters Favor Federal Repeal of Marijuana Prohibition

Washington, DC: Majorities of Democrat, Republican, and Independent voters support repealing the federal criminalization of marijuana, according to national polling provided by the group, Coalition for Cannabis Policy, Education and Regulation (CPEAR).

Seventy percent of registered voters support the repeal of federal prohibition, the survey found. Support was strongest (83 percent) among Democrats and those between the ages of 30 to 44. Seventy percent of Independents and 58 percent of Republicans endorsed federal reform.

Multiple pieces of legislation pending before Congress, including the Marijuana Opportunity, Reinvestment, and Expungement (MORE) Act, remove cannabis from the US Controlled Substances Act - thereby repealing federal prohibition and providing states with the authority to regulate marijuana absent federal interference.

The survey data is consistent with dozens of other recent national polls showing that over 60 percent of Americans believe that the adult use of cannabis ought to be legal.

Senate Unanimously Approves Legislation Providing Attorney General with Greater Say in Cannabis Research Decisions

Washington, DC: Legislation unanimously passed last week by members of the US Senate empowers the US Attorney General to facilitate clinical research trials involving cannabis. The action represents one of the very few occasions that members of the Senate have ever advanced a marijuana-related reform bill.

Senate Bill 253: The Cannabidiol and Marihuana Research Expansion Act provides the office of the US Attorney General, rather than the Drug Enforcement Administration, the discretion to license scientists to engage in clinical trials involving the use of cannabis by human subjects. Under this proposal, the AG is also provided with the ability to authorize increases in the total number of federally approved marijuana cultivators. The Attorney General is provided with a 60-day timeline to either affirm or reject applicants for licensure.

Under current regulations, the US Drug Enforcement Administration is primarily tasked with reviewing and licensing marijuana cultivators, as well as granting Schedule I licenses to scientists wishing to study cannabis in clinical settings. In 2016, the agency announced that it would expand the pool of federally licensed growers beyond just the University of Mississippi (which was initially granted a federal cannabis cultivation license in 1968). In May, the agency for the first time ever announced that it had reached agreements with a handful of third-party applicants to allow them to grow cannabis for use in federally approved clinical trials.

For decades, scientists wishing to work with marijuana have complained that it often takes years before their research protocols are approved by the DEA, and that the quality of cannabis provided by the University of Mississippi's cultivation program is of inferior quality and that it is not representative of the products available in state-legal markets.

Senate members in 2020 passed a similar version of S. 253 in the final weeks of the legislative session. Their action came days after House members passed more expansive legislation, The Medical Marijuana Research Act, which sought to facilitate clinical cannabis research by permitting authorized scientists to access flowers and other products manufactured in accordance with state-approved marijuana programs - thereby bypassing the need for researchers to access marijuana grown by DEA license-holders. A new version of this Act, House Bill 5657, is pending in the US House of Representatives, but it has not yet been advanced out of committee.

NORML has long advocated for amending federal regulations so that federally-licensed scientists can directly access and assess the wide variety of cannabis products readily available in medical-use and adult-use state markets.

The full text of S. 253 is online.

Analysis: Legal Cannabis Sales Projected to Top $72 Billion by 2030

Washington, DC: Retail sales of cannabis in states where it is legal for either medical or adult use are estimated to top $72 billion annually by 2030, according to projections provided by the analytics firm New Frontier Data.

Their analysis predicts that several additional states - including Florida, Missouri, and Ohio - will regulate adult use markets in the coming years, while as many as nine other states will legalize medical use. Missouri and Ohio are among a number of states where voters are anticipated to decide on the issue of legalizing marijuana this election.

In 2021, analysts estimated that state-licensed retailers sold nearly $27 billion in cannabis products and that 428,000 workers were employed full-time in the marijuana industry.

Full text of the New Frontier Data's economic analysis is online.

US Senate Excludes SAFE Banking Language from America COMPETES Act

Washington, DC: Members of the US Senate have advanced an amended version of HR 4521: the American COMPETES Act. The Senate version of the bill, unlike the House version, does not include provisions of the Secure and Fair Enforcement (SAFE) Banking Act.

Members of the House voted in February to include SAFE Banking provisions in HR 4521. That marked the sixth time that House members had advanced SAFE Banking to the Senate as either an amendment or as a stand-alone piece of legislation. In December, Senate lawmakers similarly removed the language from a House-backed version of the National Defense Authorization Act (NDAA).

The Senate's decision to strike the language from HR 4521 means that the fate of SAFE Banking will be decided in Conference Committee - when leaders from both chambers and from both parties negotiate on finalizing the bill's language. Some powerful Republican Senators, like Minority Leader Mitch McConnell publicly criticized the inclusion of the banking language as a "poison pill."

NORML's Political Director Morgan Fox urged members of the conference committee to prioritize the inclusion of SAFE Banking provisions in the bill. "It is imperative for the interests of public safety, transparency, and the economic viability of small cannabis businesses that this legislation is approved as soon as possible," he said. "Continued inaction by the Senate on this popular bipartisan reform puts workers and customers at risk of violence, makes it harder for regulators to accurately track cannabis revenue, and perpetuates the high costs and lack of access to capital that are increasingly widening the gap between large and small businesses in the cannabis space when it comes to their chances to succeed."

Morgan reminded lawmakers that a growing number of cannabis retailers have been recent victims of armed robberies because it is well known that these establishments are required to maintain large quantities of cash on hand.

According to the most recent financial information provided by the US Treasury Department, only about ten percent of all banks and only about four percent of all credit unions provide services to licensed cannabis-related businesses.

Utah: Governor Signs Bills Expanding Access, Legal Protections for Medical Cannabis Patients

Salt Lake City, UT: Republican Gov. Spencer Cox has signed a pair of bills into law expanding legal protections for registered medical cannabis patients.

Senate Bill 46 limits state employers from taking punitive actions against employees who consume cannabis products at home in compliance with the state's medical marijuana access law. The legislation does not extend these protections to those who work for private employers, nor does it allow for employees to arrive to work under the influence of marijuana.

The measure also forbids judges and juries from discriminating against medical cannabis patients in the course of a judicial proceeding.

The bill's chief sponsor said that the bill's enactment further clarifies lawmakers' intent to treat the medicinal use of cannabis in a manner that is similar to the use of other physician-authorized medicines.

Governor Cox also signed SB 195, which expands the ability of doctors to recommend medical cannabis products to patients suffering from chronic pain, particularly for those for whom they would otherwise prescribe opioids.

Other provisions in SB 195 place limitations on the way retailers can market or advertise medical cannabis products.

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by russellropeMedia, News March 29, 2022March 28, 2022No Comments

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US Sentencing Commission: Fewer Federal Offenders Charged with Marijuana-Related Crimes in 2021

Washington, DC: Federal officials charged fewer people with marijuana-related crimes in 2021 as compared to previous years, according to data compiled by the US Sentencing Commission in its 2021 Annual Report.

Just under 1,000 people were charged federally with violating marijuana laws in 2021. They comprised less than six percent of those charged with violating federal drug laws that year.

By contrast, federal officials charged nearly 7,000 people in 2012 with marijuana offenses. That was greater than the number of people charged with any other drug violation. By 2016, that total fell to fewer than 3,500 people. The total has continued to fall steadily since then.

Commenting on the latest federal figures, NORML's Deputy Director Paul Armentano said: "Although Congress has failed to amend federal cannabis laws, clearly the attitudes and priorities of federal prosecutors have shifted in the era of state-level marijuana legalization. Now it's time for federal lawmakers to codify these changes in priorities by descheduling marijuana."

NORML's Political Director Morgan Fox added: "Despite this downward trend in federal marijuana prosecutions, America's outdated federal laws are still having a significant and unnecessary impact on people's lives. Congress has the opportunity to change that. Lawmakers must continue to build momentum to end our failed marijuana prohibition policies and help those who have been unjustly hurt by them. We urge House Speaker Nancy Pelosi to hold a floor vote on the Marijuana Opportunity, Reinvestment, and Expunge Act immediately, and sincerely hope that Senate Majority Leader Chuck Schumer sticks to his planned April introduction of the Cannabis Administration and Opportunity Act."

Overall, 31 percent of all federal offenders in 2021 were charged with drug violations, up from about 26 percent in 2020. Just under half of all people charged with federal drug offenses in 2021 were prosecuted for trafficking methamphetamine.

The 2021 Sourcebook of Federal Sentencing Statistics is available online.

Study: Arthritis Patients Significantly Reduce Their Opioid Use Following Cannabis Therapy

Philadelphia, PA: Patients suffering from arthritic pain reduce their use of prescription opioids and report improvements in their condition following medical cannabis treatment, according to longitudinal data presented at the annual meeting of the American Academy of Orthopedic Surgeons.

Investigators affiliated with the Rothman Opioid Foundation at Thomas Jefferson University in Philadelphia evaluated opioid consumption patterns in a cohort of 40 patients with chronic arthritis pain during the six-months immediately prior to and immediately following their enrollment in the state's medical cannabis access program.

Consistent with prior studies, patients reduced their daily intake of opioids over the course of the trial. On average, subjects' daily morphine milligram equivalents fell by nearly half, from 18.2 to 9.8 MME. Over one-third of the study's subject ceased using prescription opioids altogether.

Separate data provided by the same team of investigators reported similar results in patients with chronic back pain. That data was previously published in February in the journal Cureus.

"One of the biggest central problems with opioids is both addiction and the need for higher dosages to achieve the same results," said Dr. Asif Ilyas, the studies' lead researcher. "Based on our current understanding of medical cannabis, you do not need increasing doses to achieve the same results and we're not yet seeing any addictive qualities to it."

Survey: Cannabis Use Common Among Patients with Alopecia Areata

Boston, MA: Patients diagnosed with alopecia areata (AA) – an autoimmune disorder that results in unpredictable, patchy hair loss – frequently report consuming cannabis to alleviate symptoms of stress, anxiety, and depression, according to survey data published in the International Journal of Trichology.

A team of investigators affiliated with Boston's Brigham and Women's Hospital, Department of Dermatology surveyed nearly 1,100 patients with AA. One-third of subjects acknowledged engaging in the current use of cannabis. More than two-thirds of those users said that cannabis mitigated their feelings of stress, anxiety, sadness, and depression.

Authors concluded: "A significant proportion of patients with AA use cannabis, oftentimes seeking relief from psychosocial symptoms related to their hair loss. These findings build on existing literature suggesting that patients are seeking alternative methods to address the emotional impact of AA that traditional solutions have been unable to achieve."

Full text of the study, "Cannabis use among patients with alopecia areata: A cross-sectional survey study," appears in the International Journal of Trichology.

Report Highlights Marijuana Penalties In States That Still Maintain Criminalization

Washington, DC: Americans in 19 states continue to face arrest, criminal prosecution, and incarceration for minor marijuana possession offenses, according to a comprehensive report issued by the Marijuana Policy Project.

Those arrested in these jurisdictions are disproportionately African American. Consistent with other analyses, MPP reported, "In each of the states that have not yet decriminalized cannabis - and in every state nationwide - Black people are more likely than their white counterparts to be arrested for cannabis possession, despite similar use rates."

For example, African Americans in Kentucky were arrested for marijuana possession offenses at more than nine times the rate of whites. In Iowa and Wisconsin, Black people were arrested for possession at more than seven times the rate of whites. Black people were arrested for cannabis possession in Kansas, South Dakota, and Utah at roughly five times the rate of whites.

Overall, several hundred thousand Americans are still arrested for violating states' marijuana laws. Over nine in ten of those arrested are charged with low-level marijuana possession offenses, not sales or trafficking.

Majority support for legalizing marijuana exists in every state where cannabis possession remains criminalized.

"It is long past time for these states to start taking a more just, commonsense, and fiscally responsible approach to cannabis policy," authors concluded. "Short of legalization, states should stop needlessly ensnaring thousands of their residents in the criminal justice system each year. Now is the time for the remaining 19 states that still criminalize to reclassify possession of one ounce or less of cannabis as a civil infraction, replacing the criminal offense with a small civil fine and wiping away the criminal records of offenders convicted under the old, overly harsh laws."

Full text of the report, "Behind The Times: The 19 States Where a Joint Can Still Land You in Jail," is available for download.

South Dakota: Governor Signs Legislation Preserving Limited Home Grow Rights for Patients

Pierre, SD: Republican Gov. Kristi Noem has signed legislation (SB 24) into law preserving the ability of qualified patients to home cultivate limited quantities of cannabis.

Voters in November 2020 overwhelmingly decided in favor of a ballot initiative (Measure 26) permitting qualified patients to possess, grow, and purchase medical cannabis - a measure which Gov. Noem opposed. Since that time, on two occasions, House lawmakers have voted in favor of legislation to eliminate patients' home cultivation rights.

"Permitting limited home cultivation provides patients with the ability to have reliable, affordable, and consistent access to their medicine," NORML's Deputy Director Paul Armentano said. "Seventy percent of voters approved this right at the ballot box and it is reassuring to see that a majority of lawmakers, and the Governor, ultimately decided to respect the voters' decision."

Senate Bill 24, as amended in conference committee, permits registered patients to cultivate a total of four marijuana plants (two mature, two immature) and to legally possess the harvest from those plants.

NORML has long supported home grow rights for patients, opining that "the inclusion of legislative provisions protecting the non-commercial home cultivation of cannabis serves as leverage to assure that the product available at retail outlets is high quality, safe, and affordable." Allowing patients the ability to grow cannabis at home further ensures that they "will have an uninterrupted and cost-effective supply of the medicine that is best suited to their own particular therapeutic needs."

Other cannabis-related bills signed by Governor Noem this session include Senate Bill 6, which protects medical cardholders from discrimination by either school administrators or by landlords, SB 7, which mandates that "no person may be denied custody of, visitation rights with, or parenting time with a minor solely because the person is a cardholder," and SB 15, which protects cardholders from the loss of any professional licensure due solely to their medical cannabis patient status.

Additional information on pending legislation is available from NORML's 'Take Action Center.'

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by russellropeMedia, News March 22, 2022March 22, 2022No Comments

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Federal Report: Fewer Private Sector Employers Engaging in Drug Testing

Washington, DC: A diminishing number of private sector employers are testing their workers for the use of controlled substances, according to survey data provided by US Bureau of Labor Statistics.

Researchers reported that the percentage of private worksites engaged in drug screening fell by nearly half since 1996, the last time the agency probed the issue. In the latest survey, about 16 percent of respondents said that they drug tested their employees.

Industries related to transportation, utilities, construction, and manufacturing were among those most likely to engage in drug screening. Companies employing larger numbers of people (100+ employees) were also far more likely to drug test than were smaller employers.

Employers were least likely to engage in drug testing if they resided in a state that has legalized the adult use of marijuana. Several of these states limit certain employers' ability to drug test either prospective or current employees for past cannabis exposure. By contrast, none of the ten states with the highest rates of drug testing have legalized marijuana for recreational purposes.

Separate survey data provided in 2021 by the Manpower Group reported that an estimated nine percent of employers had recently "eliminated job screenings or drug tests" as a way to either attract or keep their employees.

Last year, representatives of the Amazon corporation announced that the company would no longer engage in pre-employment marijuana screenings for its new hires, except for those in federally regulated positions (that mandate drug testing). The Amazon corporation is the second-largest employer in the United States.

Additional information is available from NORML's fact sheet, 'Marijuana Legalization and Impact on the Workplace.'

Study: Tourette Patients Respond Favorably to Cannabis

Tel Aviv, Israel: Patients with Tourette syndrome (TS) experience reductions in tic severity and improvements in their overall quality of life following cannabis treatment, according to trial results published in the journal Behavioral Neurology.

Israeli researchers assessed the use of medical cannabis products in 15 patients with Tourette syndrome over a 12-week period.

Subjects experienced, on average, a 38 percent reduction in their tic severity – as assessed by the Yale Global Tic Severity Scale. A significant percentage of study participants also reported improvements in mood, sleep, and sexual function.

Patients were most responsive to formulations high in THC and low in CBD and they favored inhaling cannabis flowers over consuming sublingual oil extracts.

The most commonly reported side-effects from cannabis were dry-mouth, fatigue, and dizziness.

Authors concluded: "From our data, it is suggested that MC [medical cannabis] might be a treatment option for resistant TS patients, and MC has a significant effect on tics, premonitory urges, and patients' overall quality of life."

Separate trials have similarly reported that the administration of either whole-plant cannabis or oral THC mitigate symptoms in patients with TS, including those with treatment-resistant forms of the disease.

Full text of the study, "Medical cannabis for Gilles de la Tourette syndrome: An open-label prospective study," appears in Behavioral Neurology.

Survey: Gender Influences Patients' Cannabis Product Preferences

Los Angeles, CA: Women are more likely than men to express a preference for edible medical cannabis products, and for products with explicit ratios of THC to CBD, according to survey data compiled by the healthcare technology company Veriheal.

Researchers analyzed survey responses from a convenience sample of medical cannabis patients in the Veriheal database. Data was obtained from patients throughout the United States over a one-year period. Patients ranged in age from 18 to 85, with a majority of subjects falling between the ages of 25 and 29.

Female survey respondents were more likely to express interest in trying edible formulations of cannabis. According to the survey's results, 71 percent of women expressed a preference for edible products. By contrast, 81 percent of men expressed a preference for cannabis flower.

More women than men also expressed interest in products containing both THC and CBD. While one-third of female respondents said that they preferred products with specific THC/CBD ratios, only around one-quarter of male respondents did so.

Men and women were nearly equally likely to seek out cannabis in order to improve sleep and reduce chronic pain. Women were nearly twice as likely as men to report using cannabis to mitigate symptoms of nausea.

"This study demonstrates the complexity of decisions made by medical patients when choosing a route of administration for cannabis products. The preference for cannabis edibles in women is evident, and the factors contributing to this preference are varied," authors concluded. "Societal stigmas which influence women in their cannabis consumption choices may become outdated as society begins to accept cannabis as medicine. An increased use of cannabis as medicine is likely to lead to more oral formulations as a parallel to or part of the pharmaceutical industry. While oral consumption may have stark differences from smoking, its popularity seems to be increasing, and women are apt to support their growth in the adult use market."

Full text of the survey, "Veriheal's Annual Medical Cannabis Preference Report," is available.

Study: Cannabis Self-Administration Associated with Nausea Relief

Albuquerque, NM: Over 90 percent of nausea patients who self-medicate with cannabis products report that it is effective at relieving their symptoms, according to data published in the Journal of Clinical Gastroenterology.

A team of researchers affiliated with the University of New Mexico, College of Pharmacy assessed the effects of cannabis on nausea symptom intensity in 886 subjects over a three-year period. Study participants self-administered cannabis at home and reported symptom changes in real time on a mobile software application.

Ninety-six percent of subjects reported symptom relief following cannabis administration. Participants, on average, experienced a reduction in their symptom intensity of -3.85 points on a 0 to 10 visual analog scale. Most participants began experiencing statistically significant relief within five minutes of cannabis inhalation. Flower preparations containing higher percentages of THC and lower percentages of CBD were rated most efficacious.

"The findings suggest that the vast majority of patients self-selecting into cannabis use for treatment of nausea likely experience relief within a relative short duration of time," investigators concluded. "Future research should focus on longer term symptom relief, including nausea-free intervals and dosing frequency; the risks of consumption of medical cannabis, especially among high-risk populations, such as pregnant women and children; and potential interactions between cannabis, conventional antiemetics, other medications, food, tobacco, alcohol, and street drugs among specific patient populations."

Oral THC, in the form of dronabinol, has been FDA-approved as an anti-emetic agent since the mid-1980s.

Using similar methods, UNM researchers have previously reported that cannabis exposure is associated with real-time reductions in migraine symptoms, pain intensity, stress, depressive symptoms, as well as improvements in sleep.

Full text of the study, "The effectiveness of common cannabis products for treatment of nausea," appears in the Journal of Clinical Gastroenterology.

Survey: Cannabis Use Associated with 50 Percent Reduction in Pain Scores

Hempstead, NY: Chronic pain patients report significant reductions in their pain scores following the use of cannabis, according to survey data published in the Open Journal of Anesthesiology.

Investigators affiliated with Hofstra University in New York and the Elson S. Floyd College of Medicine in Spokane surveyed patients receiving care in a pain clinic setting.

Respondents' average pain scores fell from 8.4 prior to using medical cannabis to 4.275 afterward. Participants also reported improvements in sleep and overall daily functioning.

The study's authors reported: "Medical marijuana offers numerous benefits such as better management of pain as demonstrated by the participants of this study. The responses in this study showed a 50 percent reduction in pain levels after use of medical marijuana. Other benefits that we observed include decreased levels of anxiety, increased appetite, decreased migraines, reduced swelling, improvement in mood as well as an increased quality of life as reported on the surveys."

They concluded, "[This] survey shows that medical marijuana is efficacious in chronic pain patients and further studies need to be done and access to the medication needs to be improved so as to benefit more patients."

Full text of the study, "Medical marijuana efficacy: A survey," appears in the Open Journal of Anesthesiology.

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by russellropeMedia, News March 15, 2022March 12, 2022No Comments

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Federal Agency Proposes Oral Fluid Testing for Transportation Industry

Washington, DC: The U.S. Department of Transportation has proposed changes to existing federal drug testing guidelines that would allow for the use of oral fluid testing as an alternative to urinalysis for those working in the transportation industry.

The agency proposed the rule change in the February 28, 2022 edition of the Federal Register, opining, “This will give employers a choice that will help combat employee cheating on urine drug tests and provide a more economical, less intrusive means of achieving the safety goals of the program.”

Oral fluid tests typically detect either THC or its metabolite for a period of one to two days post-exposure – a timetable that is significantly shorter than that associated with urinalysis. The latter may detect the presence of carboxy-THC for weeks or even months following abstinence.

Federal law mandates commercial drivers to routinely undergo marijuana urinalysis testing. In recent months, federal statistics have identified the suspension of over 72,000 truck drivers as a result of failed drug tests. Over half of those failed tests were for the past use of marijuana.

In 2020, the US Department of Health and Human Services proposed in the Federal Register expanding federal drug testing guidelines to include the use of hair follicle testing. To date, however, that proposed rule change has not been finalized.

NORML has long called for the use of performance testing technology, rather than drug detection technology, to determine whether someone may be impaired while on the job.

Full text of the proposed rules is available from the US Federal Register.

Study: Recent Cannabis Use Associated with Lower Resting Heart Rate

San Francisco, CA: Current cannabis use is associated with lower resting heart rate, according to data published in The American Journal of Medicine.

A team of researchers from Switzerland and the United States assessed the relationship between cannabis exposure and heart rate in a cohort of middle-aged adults. Subjects in the study were participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study – which is a multi-decade assessment of cardiovascular health. Previous findings from the CARDIA sample have failed to link the use of cannabis – even long-term – with an elevated risk of either atherosclerosis, high blood pressure, ECG abnormalities, or other serious cardiovascular events at middle age.

Researchers reported that subjects who occasionally consumed cannabis (defined as five times or more per month) possessed a lower resting heart rate than did non-users, including those who were former marijuana consumers.

“Current cannabis use was associated with lower resting heart rate, but cumulative cannabis exposure was not,” they reported. “Our findings align with epidemiological research on thousands of participants from Europe and the USA that found no association between cannabis and cardiovascular disease, mortality, or surrogate outcomes.”

Authors concluded: “Current cannabis use was associated with lower resting heart rate, which supports findings from experimental studies. … Past cumulative exposure to cannabis was not associated with heart rate, indicating the effects of cannabis exposure on heart rate are transient. Our findings add to the growing body of evidence suggesting a lack of deleterious association of cannabis use at a level typical of the general population on surrogate outcomes of cardiovascular disease.”

Full text of the study, “Association between current and cumulative cannabis use and heart rate: The Coronary Artery Risk Development in Young Adults (CARDIA) Study,” appears in The American Journal of Medicine.

Review: Influence of Cannabis on Driving Performance Less Significant Than Alcohol

Alberta, Canada: The magnitude of cannabis’ influence on driving performance is far less than that of alcohol, according to a systematic review and meta-analysis published in the journal Addiction.

Canadian researchers analyzed data from 57 studies assessing the influence of cannabis and alcohol on driving behavior and crash risk.

They acknowledged that cannabis exposure was typically associated with deviation in drivers’ lateral positioning (lane weaving) and a decrease in their average speed. Cannabis use was “not associated with an increase in crashes in experimental studies.” Authors also found “no compelling evidence” that cannabis influenced hazard response time, headway variability, time out of lane, speed variability, speed exceedance, or time speeding.

They concluded, “Specifically, for the measures reported here, there are no instances where the average effect of cannabis is equal to or greater than the driving performance decrements associated with BAC concentration ranging from 0.04 to 0.06 percent.”

Consistent with other studies, authors acknowledged that the combined use of cannabis and alcohol “is generally more detrimental to driving performance relative to non-intoxication or to either drug in isolation.”

NORML has long acknowledged that acute cannabis intoxication can influence driving performance, particularly if consumed with alcohol, and has opined that anyone inhaling cannabis “should refrain from driving for a period of several hours.”

Full text of the study, “Effects of cannabis and alcohol on driving performance and driver behavior: A systematic review and meta-analysis,” appears in Addiction.

Survey: Most Internal Medicine Residents Lack Adequate Knowledge About Cannabis

New York, NY: The majority of internists in training possess little or no knowledge about the use of cannabis for medicinal purposes, according to survey data published in the journal BMJ Primary Care.

A team of investigators with the Icahn School of Medicine at Mount Sinai in New York surveyed a group of internal medicine residents regarding their knowledge about the medical use of marijuana.

Ninety-three percent of respondents said that they lacked adequate knowledge about cannabis’ overall effects, and 97 percent said that they lacked sufficient knowledge regarding which indications it could address. Eighty-three percent of participants said that they were “unsure where to find pertinent information,” and 92 percent agreed that education regarding cannabis should be included in their training.

Authors concluded: “To the best of our knowledge, this is the first study to observe a critical lack of knowledge in MM [medical marijuana] in in-training IM [internal medicine] residents. Hence, it is worth implementing a curriculum for resident physicians that includes indications, medication interactions, and side effects of MM use.”

The findings are consistent with those of surveys of other medical professionals – including nurses, pharmacists, clinicians, and other health care practitioners – all of whom report possessing insufficient training in matters specific to medical cannabis. Separate survey data published in 2020 reported that fewer than one-in-five patients believe that their primary care providers are sufficiently knowledgeable about cannabis-specific health-related issues.

Full text of the study, “Medical marijuana knowledge and attitudes amongst internal medicine residents,” appears in BMJ Primary Care.

Study: Pain Patients’ Use of Cannabis Oils Associated with Cessation of Opioids

Milan, Italy: The long-term use of plant-derived cannabis extracts by patients with chronic pain is associated with reduced reliance on prescription opioids, according to data published in the European Review for Medical and Pharmacological Sciences.

A team of Italian researchers assessed the use of prescription opioids and other medicines in a cohort of chronic patients in the six months immediately prior to and immediately following their initiation of medical cannabis.

Authors reported that a significant percentage of subjects ceased their use of prescription opioids by the conclusion of the trial. They concluded, “Analyses by subgroups showed a statistically significant difference in the proportion of female opioid non-users before and after cannabis-based oil treatment (34.1 percent to 56.1 percent), as well as in the proportion of under-65 years old opioid non-users before and after cannabis-based oil treatment (32.5 percent to 55 percent), in the proportion of opioid non-users with non-severe comorbidity (33.3 percent to 54.2 percent), and … in the proportion of opioid non-users with a chronic pain condition (32.6 percent to 59.2 percent).”

The findings are consistent with dozens of other studies showing that pain patients typically reduce or eliminate their use of prescription opioids following the use of cannabis. Inconsistent with prior studies, authors did not identify an association between medical cannabis use and a significant reduction in patients’ use of other prescription drugs, including benzodiazepines.

Full text of the study, “Long-term cannabis-based oil therapy and pain medications prescribing patterns: An Italian observational study,” appears in European Review for Medical and Pharmacological Sciences.

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by russellropeMedia, News March 8, 2022March 6, 2022No Comments

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Study: Osteoarthritis Patients Reduce Their Opioid Use Following Use of Medical Cannabis

Philadelphia, PA: Osteoarthritis patients significantly decrease their daily opioid intake and experience improvements in their overall quality of life following the initiation of medical cannabis therapy, according to longitudinal data published in the journal Cureus.

Investigators affiliated with Thomas Jefferson University in Philadelphia evaluated opioid consumption patterns in a cohort of 40 patients with osteoarthritis during the six-months immediately prior to and immediately following their enrollment in the state's medical cannabis access program.

On average, subjects nearly halved their daily opioid intake by the end of the trial period. Nearly 40 percent of participants ceased using opioids altogether. Patients also reported reductions in pain and overall improvements in their quality of life.

Authors concluded: "Our findings indicate that providing access to MC [medical cannabis], helps patients with chronic pain due to OA [osteoarthritis] reduce their levels of opioid usage in addition to improving pain and QoL [quality of life]. Furthermore, a majority of patients did not feel intoxicated or high from MC, and of those who did, only a small percentage said it interfered with their daily activities. ... Our findings support the literature in that MC reduces the use of opioids for the treatment of chronic pain."

Separate findings published by the same team similarly reported that patients with chronic back pain reduce their daily opioid intake following their enrollment in the state's medical access program. That finding is consistent with those of dozens of other studies documenting patients' tapering of opioids and other prescription medications subsequent to their use of medical cannabis.

Full text of the study, "Medical cannabis use reduces opioid prescriptions in patients with osteoarthritis," appears in Cureus.

Treasury Report: Uptick in Total Number of Financial Institutions Banking with Licensed Marijuana Providers

Washington, DC: Over 700 banks and credit unions have filed paperwork with the US government acknowledging their relationships with licensed cannabis businesses, according to quarterly data provided by the US Treasury Department.

The total is an uptick from the first quarter of 2021, but it remains shy of the totals reported in the first quarter of 2020. In all, the agency identified 553 banks (about 11 percent of all US banks) and 202 credit unions (about 4 percent of all US credit unions) that are "actively providing banking services to marijuana-related businesses."

Federal law discourages banks and other financial institutions from maintaining relationships with marijuana businesses because the plant remains classified as a Schedule I controlled substance. On six occasions, members of the US House of Representatives have passed legislation, The SAFE Banking Act, to explicitly permit banks and other institutions to engage in relationships with marijuana businesses without running afoul of federal law. House members most recently did so last month, attaching the measure as an amendment to The America COMPETES Act of 2022. The Act is currently awaiting action by the US Senate.

According to survey data compiled earlier this year by Whitney Economics, over 70 percent of participating cannabis businesses said that the "lack of access to banking or investment capital" is their top challenge. By comparison, only 42 percent of respondents cited "state regulations" as the most significant burden facing the industry, and only 39 percent cited the "influence of the illicit market."

Arizona: Retail Marijuana Sales Top $1 Billion in 2021

Phoenix, AZ: Retail sales of cannabis products topped over $1.35 billion in 2021, according to data provided by the Arizona Department of Revenue.

Slightly more than half of those sales were generated from products sold by medical cannabis dispensaries, while nearly $600,000,000 was generated from the newly initiated adult-use market. Adult use sales first began in mid-January. By November, monthly sales of adult-use products exceeded those of medical cannabis.

Total tax revenues from marijuana in 2021 exceeded $200,000 million.

Since the establishment of the first adult-use retail markets in 2014, sales of marijuana products have generated more than $10 billion in new tax revenues, according to a recent analysis published by the Marijuana Policy Project.

Study: Frequent Cannabis Consumers Exhibit Short-Term Changes in Psychomotor Performance Following Marijuana Ingestion

Boulder, CO: Frequent cannabis consumers exhibit changes in psychomotor performance in the 60-minute period following their use of either marijuana flowers or concentrates, according to data published in the journal Cannabis and Cannabinoid Research.

A team of investigators affiliated with the University of Colorado, the University of Washington, and Tufts University in Boston assessed the influence of cannabis on psychomotor performance as measured by the DRUID mobile app. Prior studies have demonstrated DRUID to be more sensitive to marijuana-induced changes in performance than Field Sobriety Tests. Participants in the study were frequent users of cannabis and were instructed to inhale ad libitum high-potency cannabis flowers or concentrates. Subjects' performance after inhalation was measured against their individual baseline performance.

Researchers reported that subjects' changes in performance "peaked shortly after acute use and decreased over the next hour" – a finding that is consistent with prior research. Participants exhibited similar degrees of impairment regardless of whether they consumed flowers or concentrates. Changes in performance were most pronounced with respect to balance, reaction time, and in subjects' abilities to properly process multiple pieces of information at one time (divided attention).

Authors concluded, "This study demonstrated that regular cannabis users show a decrease in performance on the DRUID app immediately after cannabis ingestion but appear to ‘recover' almost back to baseline levels 1-hour post-use." They added: "At present, there is a great need for a well-supported brief and mobile method for determining acute cannabis-related impairment, but no such tool exists. Considerable further validation and development are needed to determine whether a testing battery like DRUID may have individual or other applications as a driving impairment test."

NORML has long acknowledged that acute cannabis intoxication can influence driving performance, particularly with respect to decreases in driving speed and changes in lateral control, and has opined that anyone inhaling cannabis "should refrain from driving for a period of several hours." More pronounced changes in driving performance are typically present when cannabis is consumed in combination with alcohol.

NORML has also expressed longstanding opposition to the imposition of either per se or zero-tolerant per se traffic safety limits for THC or its metabolites because their presence is not consistently associated with impairment of psychomotor performance. NORML has opined in favor of the use of performance testing technology as a more reliable indicator of cannabis-induced impairment.

Full text of the study, "Effects of high-potency cannabis on psychomotor performance in frequent cannabis users," appears in Cannabis and Cannabinoid Research.

Study: Frequent Use of the Cannabis-Based Prescription Drug Associated with Opioid-Sparing Effects

Oslo, Norway: Prescription opioid users who frequently consume the cannabis plant-derived extract medication Sativex (nabiximols) substantially reduce their opioid intake over time, according to data published in the journal Basic & Clinical Pharmacology & Technology.

Sativex is an oromucosal cannabis spray containing nearly equal portions of plant-derived THC and CBD. It is available by prescription in numerous countries, but it is not FDA-approved in the United States.

A team of researchers affiliated with the Norwegian Institute of Public Health assessed the relationship between the use of Sativex and opioids over a one-year period in a cohort of patients prescribed both substances.

They reported that those who filled their Sativex prescriptions three times or more during the study period decreased their use of prescription opioids. This decrease "was even more evident among those filling five or more prescriptions." By contrast, an inverse relationship was identified among those infrequently engaged in the use of Sativex.

Authors concluded: "This is one of a few studies investigating the impact of medicinal cannabis use on individual level opioid use. ... Looking at all those filling a prescription for Sativex, opioid use was only marginally lowered in the follow-up period. Some Sativex users, however, filled more prescriptions for Sativex and were able to reduce their opioid use substantially. Further studies are needed to elucidate more details on these patients, so as to know who can benefit from such cannabis-based extracts in reducing their opioid use."

Numerous studies have previously identified a relationship between patients' consumption of medical cannabis and a reduction in their use of opioids and other prescription drugs.

Full text of the study, "Possible opioid-saving effect of cannabis-based medicine using individual-based data from the Norwegian Prescription Database," appears in Basic & Clinical Pharmacology & Toxicology.

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by russellropeMedia, News March 2, 2022March 2, 2022No Comments

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Study: Older Patients Experience Improvements in Their Quality of Life Following Medical Cannabis Treatment

Tel Aviv, Israel: The use of medical cannabis products by older patients is associated with improvements in subjects' quality of life and reductions in their use of concomitant medications, according to data published in the journal Frontiers in Medicine.

Israeli researchers assessed the use of federally authorized medical cannabis products over a six-month period in a cohort of approximately 10,000 qualified patients. Subjects in the study averaged 55 years of age and were most likely to be diagnosed with either cancer, pain, or post-traumatic stress. Under Israeli law, physicians can authorize qualified patients to access cannabis flowers and infused products from licensed retail providers.

Patients typically rated cannabis as highly effective in mitigating their symptoms. Among patients with post-traumatic stress, 91 percent reported cannabis treatment as successful, as did 84 percent of patients with inflammatory bowel disease, and 78 percent of patients with chronic pain.

Consistent with other studies, most subjects reported improvements in their overall quality of life during the trial. While only 13 percent of patients reported "good QOL" prior to treatment initiation, 70 percent reported good QOL at 6 months.

Many subjects also engaged in drug substitution - a finding that is also consistent with prior studies. Among patients who entered the study using opioids, nearly 40 percent ceased consuming them following cannabis treatment. Twenty-five percent of participants who consumed prescription antidepressants and anti-epileptic drugs at the onset of the trial stopped using their prescribed medications, as did 17 percent of patients who possessed prescriptions for anxiolytics.

Authors concluded: "In this prospective study, we describe the characteristics and outcomes of approximately 10,000 patients treated with medical cannabis. Results showed high adherence, high safety with a low incidence of adverse events, and a high rate of effectiveness in the prescribed treatment, as well as a decrease in pain levels, improvement in QOL, and a reduction in the consumption of concomitant medications."

Full text of the study, "Adherence, safety, and effectiveness of medical cannabis and epidemiological characteristics of the patient population: A prospective study," appears in Frontiers in Medicine.

Colorado: Retail Marijuana Sales Surpass $2.2 Billion in 2021

Denver, CO: State-licensed marijuana retailers sold over $2.2 billion worth of marijuana flower and related products in 2021 - the highest annual total ever, according to data released by the state's Department of Health.

Since 2014, when adult-use sales first became legal in Colorado, retail cannabis sales have grown each successive year. Over the past seven years, state regulators have collected over $2 billion in taxes and fee revenue from retail sales.

In all, state-authorized sales of retail marijuana products nationwide have yielded more than $10 billion in new tax revenues, according to an analysis compiled by the Marijuana Policy Project in January.

Much of this revenue has been used to fund various state-specific projects. In Colorado, over $470 million in cannabis-specific tax revenue has been applied toward public schools. In Washington, some $600 million in revenue has been directed toward public health initiatives, including a fund that provides health insurance to low-income families. In California, over $100 million in revenue has been provided to community investment programs and local nonprofit groups.

New York: Governor Signs Legislation Expediting Adult-Use Cannabis Production and Manufacturing

Albany, NY: Democratic Gov. Kathy Hochul signed legislation (A9283/S8084-A) into law this week authorizing state-licensed hemp growers to obtain temporary licenses to commercially cultivate and process cannabis for the state's forthcoming adult-use market.

Eligible applicants must possess a valid industrial hemp grower authorization from the Department of Agriculture and Markets as of December 31, 2021, be in good standing, and have grown and harvested hemp for at least two of the last four years. The law also requires that both cultivator and processor licensees participate in a social equity mentorship program as well as an environmental sustainability program. The licenses expire on June 30, 2024.

Majority Leader Crystal D. Peoples-Stokes, who sponsored the legislation in the Assembly, said that its passage was necessary in order to "help secure enough safe, regulated, and environmentally conscious cannabis products to meet the demand of the adult-use cannabis market when retail dispensaries open."

However, it remains unclear when that time will be. Nearly one-year following the passage of the state's Marijuana Regulation and Taxation Act (MRTA), regulators with the Office of Cannabis Management (OCM) have yet to promulgate rules governing the adult-use market. Once draft rules are promulgated, they will be subject to a five-month public comment period. Earlier this month, the Executive Director of the OCM speculated that the agency will begin accepting commercial licensing applications, including retail licenses "by the end of 2022" - far later than initially projected.

Case Reports: Cannabis Associated with Symptom Improvements in ADHD Patients

Saskatoon, Canada: The adjunctive use of cannabis is associated with symptom mitigation and improvements in ADHD patients' quality of life, according to case reports published in the journal Medical Cannabis and Cannabinoids.

Canadian researchers documented improvements in three male ADHD patients, ages 18, 22, and 23, following the integration of cannabis into their treatment regimen.

Following the use of cannabis, patients showed improvements in depression, anxiety, and in their ability to pay attention. Researchers said that the findings suggested that "cannabis played a complimentary role in the therapeutic regimen of these three patients."

Survey data published last year reported that ADHD patients often self-medicate with cannabis and that most report that it alleviates their symptoms. Clinical studies have reported that both inhaled cannabis as well as the administration of cannabis extracts mitigate ADHD symptoms in human subjects. Israeli data published in 2020 further reported that ADHD patients with legal access to medical cannabis products significantly reduce their use of prescription medications.

Full text of the study, "Cannabis for the treatment of Attention Deficit Hyperactivity Disorder: A report of 3 cases," appears inMedical Cannabis and Cannabinoids.

Case Reports: Cannabis Associated with Symptom Improvements in ADHD Patients

Canadian researchers documented improvements in three male ADHD patients, ages 18, 22, and 23, following the integration of cannabis into their treatment regimen.

Full text of the study, "Cannabis for the treatment of Attention Deficit Hyperactivity Disorder: A report of 3 cases," appears inMedical Cannabis and Cannabinoids.

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by russellropeMedia, News February 22, 2022February 20, 2022No Comments

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Review: Cannabinoids Effective for Mitigating Back Pain

Seattle, WA: The use of either whole-plant cannabis or synthetic cannabinoids is effective at mitigating back pain, according to a review of randomized controlled studies published in Global Spine Journal.

A team of investigators affiliated with the Swedish Neuroscience Institute in Seattle, Washington conducted a systematic review of the use of cannabinoids to treat nonsurgical back pain. In each of the studies identified by investigators, "[T]here was a quantifiable advantage of cannabis therapy for alleviating back pain." There were "no serious adverse effects reported" by patients in any of the studies.

Those who consume cannabis medicinally are most likely to report doing so to address chronic pain conditions. Dozens of studies further report that pain patients typically reduce or eliminate their use of opioids following their initiation of cannabis therapy. According to longitudinal data published earlier this month, patients with chronic musculoskeletal back pain who use medical cannabis for a period of at least six months experience decreased opioid use and improvements in pain scores and in their daily functions.

Full text of the study, "Efficacy of cannabis in reducing back pain: A systemic review," appears in Global Spine Journal.

Canada: Retail Cannabis Market Generates $11 Billion in Sales, More Than 90,000 Jobs

Ottawa, Canada: The adult-use marijuana market in Canada has generated some $11 billion in retail sales and sustained over 90,000 jobs annually, according to an economic analysis published by the consulting firm Deloitte Canada. Canadian lawmakers legalized the commercial production of cannabis products in June 2018 and retail sales began that October.

The report's authors estimated the economic contributions of the cannabis sector from 2018 to 2021. Analysts assessed cannabis-related revenues and expenditures associated with cannabis-sector operations and capital investments. They determined: "[T]he Canadian cannabis sector has made a significant economic contribution to both Canada and Ontario in the three short years since legalization. The industry has generated $11 billion in sales nationwide and made $29 billion in capital expenditures. ... Overall, the cannabis industry has contributed $43.5 billion to Canada's GDP – and $13.3 billion to Ontario's GDP – since legalization. Moreover, the industry has sustained 98,000 jobs across Canada and put $15.1 billion into government coffers." (Editor's Note: An earlier version of this reporting cited the figure '151,000 jobs.' This figure was included in the initial version of the Deloitte report, but was later changed by the report's authors.)

They concluded, "From an economic perspective, it seems clear the cannabis industry has been a great success, with more to come as it continues to grow."

Authors acknowledged that a lack of diversity exists within Canada's marijuana industry, noting that few women and people of color hold executive level positions within cannabis companies. They recommended, "Governments and cannabis companies alike must take action to improve diversity, equity, and inclusion across the sector, building on and expanding existing efforts to enable more racialized Canadians and women to participate in the industry's success."

A recently released report by the Minority Cannabis Business Association similarly identifies a lack of diversity within the US cannabis industry, concluding, "[T]he barriers to entry for minority operators have continued to stifle progress to advance social equity efforts."

Full text of the report, "The Economic and Social Impact of Canada's Cannabis Sector." Is available for download.

Study: History of Marijuana Use Not Associated with Increased Heart Attack Risk

New York, NY: Cannabis smoke exposure is not positively associated with an increased risk of myocardial infarction, according to data published in the journal Cureus.

A pair of researchers with the Icahn School of Medicine at Mount Sinai in New York City assessed the association between a history of cannabis smoking and heart attack in a cohort of over 500,000 subjects from the United Kingdom.

Researchers identified an inverse association between cannabis use and incidences of myocardial infarction, and they found no correlation between marijuana consumption and heart attack severity.

"With marijuana use, MI [myocardial infarction] decreased," authors concluded. They further acknowledged: "The association of marijuana use with reduced risk of MI is not entirely in accord with current assumptions about the cardiac effects of marijuana. ... Further studies are warranted."

Studies assessing the association between cannabis use and cardiovascular health have been inconsistent, with some studies finding an increased risk of stroke and other cardiovascular diseases among marijuana consumers while others report either no risk or provide evidence of possible cardioprotection.

Full text of the study, "Marijuana and myocardial infarction in the UK Biobank cohort," appears in Cureus.

Colorado: Nearly a Third of Family Physicians Acknowledge Recommending Patients Use Medical Cannabis

Denver, CO: Nearly one-third of practicing family physicians in Colorado acknowledge issuing medical cannabis authorizations to their patients, according to survey data published in the Journal of the American Board of Family Medicine.

A pair of researchers with the University of Colorado School of Medicine surveyed members of the Colorado Academy of Family Physicians on their experiences with and attitudes toward medical cannabis.

Thirty-one percent of respondents reported that they had recommended cannabis to a patient on at least one occasion. Among them, 42 percent had issued a medical cannabis authorization within the past year. Authorizing physicians were most likely to recommend marijuana to patients suffering from chronic pain, cancer, cachexia, severe nausea, or persistent muscle spasms.

By contrast, nearly one-third of the survey's total respondents said that their practice had policies in place that formally prohibited them from issuing medical cannabis recommendations to their patients.

Overall, 57 percent of respondents agreed that "the FDA should reclassify marijuana so that it is no longer a Schedule I drug" under federal law – up from 37 percent in 2011.

According to a recent nationwide survey of US clinicians conducted by the US Centers for Disease Control and Prevention, 69 percent of respondents said they believed that cannabis possessed medical utility and more than one-in-four respondents (27 percent) acknowledged having authorized the use of cannabis for their patients.

Full text of the study, "Colorado family physicians and medical marijuana: Has recreational marijuana changed physician attitudes and behaviors," appears in theJournal of the American Board of Family Medicine.

Study: Insomnia Patients Respond Favorably to Concurrent Use of CBD and Melatonin

Modena, Italy: Patients with sleep disorders respond favorably to the co-administration of CBD and melatonin, according to data published in the Italian journal La Clinica Terapeutica.

A team of Italian researchers assessed the short-term administration of a sublingual compound consisting of 15mgs of melatonin and 2.5 mgs of plant-derived CBD in a cohort of middle-aged to older adults (ages 43 to 96) with a history of sleep disorders and anxiety. Study participants self-administered 20 drops of the compound prior to bedtime for a three-month period.

Researchers reported that CBD/melatonin co-administration was associated with reduced feelings of anxiety, pain, depression, panic, and paranoia, as well as with "good general health perceptions."

They concluded, "These data suggest that the formula CBD-melatonin could be competitive with the classic hypnotic synthetic drugs; the antioxidant activity of melatonin offers a further benefit to the brain network, restoring the biological clock functions, while CBD, reducing chronic pain perception, helps to complete the neuromuscular relaxation and to relieve anxiety fulfilling a very balanced sensation of well-being during the sleep."

Clinical trials have previously shown that the administration of either oral cannabinoid products or plant-derived cannabis extracts is associated with improvements in sleep in patients with insomnia. Observational studies also have shown that subjects who use herbal cannabis prior to bedtime report significant improvements in perceived insomnia levels and severity.

Full text of the study, "Insomnia treatment: A new multi-tasking natural compound based on melatonin and cannabis extracts," appears in La Clinica Terapeutica.

Analysis: Opioid Recovery Subreddit Users Frequently Report Using Cannabis for Treating Withdrawal Symptoms

San Francisco, CA: Participants in the opioid recovery subreddit online social platform frequently report consuming cannabis as an option for managing symptoms of opioid withdrawal, according to data published in the journal PLoS One.

Investigators affiliated with the University of California, San Francisco and with the Johns Hopkins Bloomberg School of Public Health in Baltimore analyzed all online posts mentioning cannabis in the subgroup over a four-year period.

Researchers reported, "The most frequent phrases from the recovery subreddit referred to time without using opioids and the possibility of using cannabis a
s a 'treatment.' ... The most common motivations for using cannabis were to manage opioid withdrawal symptoms in the recovery subreddit, often in conjunction with anti-anxiety and GI-distress 'comfort meds.'"

They concluded: "A primary finding of this study is that posters reported that the potential of cannabis to address OUD [opioid use disorder] or reduce opioid use may derive from the use of cannabis to manage acute and persistent opioid withdrawal symptoms. ... Future research is warranted with more structured assessments that examines the role of cannabis and cannabinoids in addressing both somatic and affective symptoms of opioid withdrawal."

A 2015 placebo-controlled study reported that the administration of oral THC reduced opioid withdrawal severity among participants in an in-patient detoxification program. More recently, a 2020 study published in the Journal of Substance Abuse Treatment reported that a majority of patients experiencing opioid withdrawal turn to cannabis to effectively manage various symptoms, including anxiety, tremors, and trouble sleeping. A 2020 review article published in the journal Cannabis and Cannabinoid Research concluded: "The evidence summarized in this article demonstrates the potential cannabis has to ease opioid withdrawal symptoms, reduce opioid consumption, ameliorate opioid cravings, prevent opioid relapse, improve OUD treatment retention, and reduce overdose deaths. ... The compelling nature of these data and the relative safety profile of cannabis warrant further exploration of cannabis as an adjunct or alternative treatment for OUD."

Full text of the study, "Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums," appears in PLoS One.

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by russellropeMedia, News February 15, 2022February 15, 2022No Comments

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Analysis: Trauma Patients with a History of Marijuana Use Possess Decreased Risk of In-Hospital Mortality

Los Angeles, CA: Trauma patients who test positive for the presence of cannabis upon their admission to the hospital possess a decreased risk of death as compared to controls, according to data published in the journal The American Surgeon.

Researchers with the University of California, Los Angeles compared in-hospital mortality outcomes in a cohort of over 141,000 trauma patients. Consistent with other data, they reported that patients with a history of cannabis use (as documented by a positive drug screen upon admission) were less likely to die while hospitalized than were patients with similar injuries but no evidence of recent marijuana exposure.

They concluded: "On multivariable analysis, the associated risk of mortality was lower (OR = .79) for pMS [patients with a positive marijuana screen] compared to nDS patients [those testing negative for all drugs and alcohol]. ... These findings require corroboration with future prospective clinical study and basic science evaluation to ascertain the exact pathophysiologic basis and thereby target potential interventions."

Prior observational studies have similarly reported that marijuana use is associated with a decreased risk of in-hospital mortality among patients suffering from congestive heart failure, cancer, COPD, pancreatitis, HIV, burn-related injuries, traumatic brain injuries, and various other types of severe trauma.

Full text of the study, "Marijuana use associated with decreased mortality in trauma patients," appears in The American Surgeon.

Congress: House Members Advance SAFE Banking Act as Part of America COMPETES Act

Washington, DC: The US House of Representatives has advanced legislation, The America COMPETES Act of 2022, which includes the provisions of the Secure and Fair Enforcement (SAFE) Banking Act.

Friday's vote marks the sixth time that members of the House have advanced the SAFE Banking Act to the Senate either as an amendment or as a stand-alone piece of legislation. The SAFE Banking Act language, which was offered as an amendment by the bill's sponsor, Rep. Ed Perlmutter (D-CO), allows banks and other financial institutions to work with state-licensed cannabis-related businesses – something they are currently discouraged from doing.

A recent survey by Whitney Economics of 396 licensed cannabis companies reported that over 70 percent of respondents cited a "lack of access to banking or investment capital" as the top challenge they face.

"It is imperative for the interests of public safety, transparency, and the economic viability of small cannabis businesses that this legislation is approved as soon as possible," said NORML Political Director Morgan Fox. "The fact that the people's chamber has approved this measure in various forms multiple times is a clear indicator of where voters stand on this issue. Continued inaction by the Senate on this popular bipartisan reform puts workers and customers at risk of violence, makes it harder for regulators to accurately track cannabis revenue, and perpetuates the high costs and lack of access to capital that are increasingly widening the gap between large and small businesses in the cannabis space when it comes to their chances to succeed. The Senate should ensure this provision remains in the final version of this funding package and approve it swiftly."

Fox added: "The SAFE Banking Act is only the first step toward making sure that state-legal marijuana markets operate safely, efficiently, and fairly. But unfortunately, the sad reality is that those who own or patronize these currently unbanked businesses are still nonetheless recognized as criminals in the eyes of the federal government and by federal law. This situation can only be rectified by removing marijuana from the list of controlled substances, and there are several pending legislative vehicles before Congress that can accomplish this goal. In the meantime, the passage of the SAFE Banking Act is a step in the right direction that will directly improve many people's lives."

The America COMPETES Act now advances to the Senate for consideration. In the past, Senate leadership has either refused to move SAFE Banking as a stand-alone bill or it has permitted the SAFE Banking language to be removed as an amendment from other legislation in conference committee – a scenario that most recently occurred in December.

Study: Inhaled Cannabis Significantly Lowers IOP for Several Hours

Irvine, CA: Inhaling cannabis significantly reduces intraocular pressure (IOP) in healthy subjects for approximately four hours, according to data published in the journal Frontiers in Medicine.

An international team of researchers from the United States and Italy assessed the association between THC plasma levels and IOP in a cohort of healthy adults following the self-administration of cannabis cigarettes containing either six percent or 13 percent THC.

Consistent with prior research, marijuana inhalation resulted in a temporary reduction in IOP. IOP reduction was most significant 60 minutes after smoking but remained below subjects' normal baseline for up to four hours. THC/plasma concentrations of 20ng/ml, but not above this level, were most strongly correlated with decreases in IOP.

"The results of this study indicate that in healthy adult subjects, inhaled THC significantly lowers IOP, and that this effect correlates with plasma THC levels," authors reported. "IOP reduction occurred soon after inhalation and was reduced by as much as 16 percent. ... Furthermore, increasing plasma levels up to a concentration of 20 ng/ml was strongly correlated with increasing reduction in IOP. THC plasma levels >20 ng/ml were not correlated with further reduction in IOP."

Scientists have long documented that THC inhalation reduces intraocular pressure. According to recently published survey data, over one-third of glaucoma patients have discussed their medical use of cannabis with their oncologists. (Glaucoma is typically caused by abnormally high pressure within the eye.) Nevertheless, the American Glaucoma Society has not endorsed the use of cannabis as a treatment for glaucoma. By contrast, virtually all state-specific medical access laws specify glaucoma as a qualifying medical condition.

Full text of the study, "The relationship between plasma tetrahydrocannabinol levels and intraocular pressure in healthy adult subjects," appears in Frontiers in Medicine.

Senate Majority Leader Provides Timeline for Introduction of Long-Awaited Marijuana Descheduling Legislation

Washington, DC: US Senate Majority Leader Chuck Schumer announced at a press conference on Friday that he intends to formally introduce the Cannabis Administration and Opportunity Act (CAOA) in April. The forthcoming legislation, which was released in draft form last July, repeals federal marijuana prohibition by removing cannabis from the US Controlled Substances Act.

Speaking at the event, Sen. Schumer said: "In the coming weeks, we're ramping up our outreach and we expect to introduce final legislation. Our goal is to do it in April. Then we begin the nationwide push, spearheaded by New York, to get the federal law done. As the majority leader, I can set priorities. This is a priority for me."

NORML's Political Director Morgan Fox responded: "We are enthusiastic that the Senator is moving forward on his promise to prioritize cannabis policy reform in the 117th Congress. It is our hope that the official introduction of CAOA jumpstarts hearings and debates in the Upper Chamber - debates that are long overdue."

In past months, Senate leadership has received criticism for both the slow rollout of the CAOA and for failing to support efforts to enact more incremental federal legislation, such as The SAFE Banking Act, which has been passed multiple times by the US House of Representatives.

NORML was among numerous groups that submitted comments in response to the CAOA draft.
Specifically, NORML called for:

- Strengthening civic protections, including record relief, to provide justice to those previously wronged by federal marijuana criminalization;

- Revising outdated employment policies regarding non-scientific testing for trace metabolic elements of THC;

- Ensuring that small and local businesses can compete both with larger corporations and the unregulated market by reducing regulatory and tax burdens;

- Narrowing the scope of the proposed excise tax to exempt medical cannabis consumer markets;

- Balancing the roles of the FDA, TTB (Alcohol and Tobacco Tax and Trade Bureau), ATF, and antitrust regulators in a manner that is consistent with other adult-use substances, such as alcohol or tobacco, to ensure non-disruption of currently operational state programs and promoting increased local ownership in the future iterations of the marketplace.

The entirety of NORML's comments are available online.

As initially drafted, the Cannabis Administration and Opportunity Act directs the US Attorney General to remove marijuana from the federal Controlled Substances Act - thereby allowing states to either maintain or establish their own cannabis regulatory policies free from undue federal interference. Under this scheme, state governments – if they choose to do so – can continue to impose criminal penalties for marijuana possession offenses. However, states would not be permitted to prohibit the interstate commerce of legal cannabis products transported through their borders.

The proposal also mandates for the expungement of the records of anyone convicted of a federal, non-violent marijuana offense. The expungements must take place within one year of the law's enactment.

The Act also forbids federal officials from taking discriminatory actions against those who legally use cannabis. It prohibits "individuals from being denied any federal public benefit ... on the basis of [the] use or possession of cannabis." It also, for the first time, permits physicians associated with the US Department of Veterans Affairs to make recommendations to their patients to access medical cannabis.

The proposal transfers primary agency jurisdiction over cannabis regulation from the US Drug Enforcement Administration to the Food and Drug Administration and to the Alcohol and Tobacco Tax and Trade Bureau in a manner similar to the ways in which these agencies already oversee alcohol and tobacco products. A federal excise tax of 10 percent would be imposed within the first year of the law's enactment. Medical cannabis access programs, which are operational in the majority of US states, would not be disrupted under this federal plan.

The proposed Senate plan is competing against two other House bills, The MORE Act and The States Reform Act, both of which also seek to deschedule cannabis at the federal level. The MORE Act previously was advanced by the US House of Representative in the 116th Congress and is expected to be taken up again by House lawmakers in the coming weeks.

Analysis: Interest in Delta-8 Products Far Greater in States Without Legal Cannabis Access

Atlanta, GA: Internet users residing in states without legal cannabis access are more than three times as likely to search online for the availability of delta-8 THC products as are those in jurisdictions where marijuana is legal, according to data published in the American Journal of Public Health.

Emory University investigators assessed state-level Google Trends data from February to May 2021. Consistent with prior research, they reported that "states where recreational cannabis is illegal had higher relative queries [specific to delta-8 THC] than did states with legalized recreational cannabis."

Although delta-8 THC occurs organically in the cannabis plant, it is only produced in nominal quantities. By contrast, the elevated quantities of delta-8 THC found in grey market products are the result of a chemical synthesis during which manufacturers convert hemp-derived CBD to delta-8 THC. Manufacturers engaged in synthesizing delta-8 THC are not regulated and often use potentially dangerous household products to facilitate this process. Lab analyses of unregulated delta-8 products have consistently found them to contain lower levels of the compound then advertised on the products' labels. Some products have also been found to possess heavy metal contaminants and unlabeled cutting agents.

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

Full text of the study, "Popularity of delta-8 THC on the Internet across the United States, 2021," appears in the American Journal of Public Health.