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Review: Cannabinoids Are an “Adequate Potential Treatment Option” for Fibromyalgia Patients

Fairfield, CA: Human trials indicate that the use of either whole-plant cannabis or cannabinoids can improve various symptoms in patients with fibromyalgia (FM) and that they possess an adequate safety profile for use in treatment, according to the findings of a literature review published in the journal Cureus.

Investigators affiliated with the California Institute of Behavioral Neurosciences and Psychology reviewed 22 scientific papers specific to the use of either cannabis or synthetic cannabinoids in FM patients.

Authors concluded: “[T]he data suggest that the use of cannabinoids and cannabis carries limited side effects in the treatment of FM, and they can also improve some common and debilitating symptoms associated with FM, thus making them an adequate potential treatment option, when other treatment lines have been exhausted.”

Cannabis use is frequently reported by patients with fibromyalgia, and the results of several human trials indicate that cannabinoids provide therapeutic relief to patients with fibromyalgia. Most recently, observational trial data published in February reported that the long-term use of various types of cannabis preparations was associated with significant improvements in pain and other symptoms in patients with refractory fibromyalgia.

Full text of the study, “A systematic review of fibromyalgia and recent advancements in treatment: Is medicinal cannabis a new hope?” appears in Cureus.

Top Federal Drug Official Acknowledges that Adult-Use Marijuana Legalization Hasn’t Led to Jumps in Adolescent Use

Washington, DC: The enactment of statewide laws regulating the adult-use cannabis market has not led to an increase in the percentage of young people experimenting with the plant, according to comments made recently by Nora Volkow, Director of the US National Institute on Drug Abuse.

Speaking on a podcast hosted by Ethan Nadelmann, the former Director of the Drug Policy Alliance, Volkow admitted that she had initially expressed concerns that legalization would lead to an increase in the prevalence of adolescents consuming cannabis. Thus far, however, she said, “Overall, it hasn’t.”

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

During the interview, Volkow also acknowledged that legalization has been associated with “better outcomes” in various states, and that federal laws and regulations on the cannabis plant have “hindered” scientists’ ability to research it – particularly with respect to the plant’s therapeutic efficacy.

An audio archive of the Nadelmann/Volkow interview is available online.

Commentary: Herbal Cannabis Vaporization Safer Alternative to Smoking

Toronto, Canada: Vaporizing herbal cannabis reduces consumers’ exposure to combustion-related toxins and provides a safer alternative to marijuana smoking, according to a commentary published in the Canadian Journal of Public Health.

A team of researchers with the University of Toronto’s School of Public Health opined, “Cannabis vaporizer use can reduce the emission of carbon monoxide, chronic respiratory symptoms, and exposure to several toxins while producing similar subjective effects and blood THC concentration compared with smoking cannabis, holding potential for harm reduction among habitual cannabis smokers.”

Vaporizing devices heat cannabis to the point where cannabinoid vapors form, but below the point of combustion. The results of human clinical trials assessing this technology have concluded that vaporizing herbal cannabis is a “safe and effective” cannabinoid delivery mode that does not result in exposure to combustion gases. Researchers have also reported that vaporization results in higher plasma concentrations of THC compared to those associated with smoking cannabis.

Full text of the commentary, “Are vaporizers a lower risk alternative to smoking cannabis?” appears in the Canadian Journal of Public Health.

Case Report: Cannabis Tincture Associated with Tic Reduction in Tourette Syndrome Patient

Erfurt, Germany: The administration of the proprietary cannabis tincture Nabiximols (a/k/a Sativex) is associated with a “dramatic decrease” in tic-related symptoms in a patient with Tourette Syndrome (TS), according to a case report published in the journal Tremor and Other Hyperkinetic Movements.

A pair of German researchers documented the treatment of a 25-year-old male TS patient with Nabiximols. The patient had previously reported consuming whole-plant cannabis to manage his TS symptoms. Symptoms had returned after he ceased using the plant.

Following at least twice-daily treatment with Nabiximols, the patient experienced a “marked tic reduction … without experiencing relevant side effects.” The acute effects of the drug lasted about four hours.

Authors concluded: “Based on our case, and in line with previous reports, we propose that buccal Nabiximols might be an effective addition to โ€˜acute’ or โ€˜as required’ tic treatment under specialist guidance, especially for predictable situations in the short term when severely disabling or stigmatizing tics are anticipated.”

Sativex is a whole-plant cannabis tincture containing nearly equal ratios of THC and CBD. It is available via prescription in numerous nations, but not in the United States, and it is primarily utilized for the treatment of multiple sclerosis.

Several small studies and case-reports have documented the efficacy of either inhaled cannabis or oral THC in mitigating symptoms in TS patients. In a recent survey of TS patients with experience using either herbal cannabis or oral cannabinoids, those who expressed a preference between the two products said that inhaled cannabis provided superior therapeutic benefits.

Full text of the study, “Tic reduction in adult onset Gilles De La Tourette syndrome using as required Nabiximols spray,” appears in Tremor and Other Hyperkinetic Movements.

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Proximity to Marijuana Retailers Doesn’t Influence Young People’s Intention to Use Cannabis

Santa Monica, CA: Young adults who live near state-licensed marijuana retailers are no more likely to express an intention to use either cannabis or tobacco than those who do not, according to data published in The Journal of Cannabis Research.

Researchers with the RAND Corporation and with the University of Southern California assessed the relationship between the density of marijuana retailers and subjects’ intentions to use either cannabis or tobacco in a cohort of young adults (ages 18 to 23) living in Los Angeles county.

Authors reported, “Living near more outlets of any type was not significantly associated with intentions to use in the full sample, adjusting for individual- and neighborhood-level characteristics.”

They concluded: “This is the first study to simultaneously examine the density of both MCDs [medical cannabis dispensaries] and RCRs [recreational cannabis retailers] around young adults’ homes and associations with future intentions to use cannabis, including the co-use of cannabis with tobacco/nicotine. Our results suggest that young adults who lived in an area with a greater density of any type of outlet were not significantly more likely to report stronger intentions to use cannabis, e-cigarettes, or cannabis mixed with tobacco/nicotine in the future.”

Their findings are consistent with those of prior studies similarly concluding that the prevalence of cannabis retailers is not positively associated with increases in either marijuana use or access among younger people.

Full text of the study, “Density of medical and recreational cannabis outlets: racial/ethnic differences in the association with young adult intentions to use cannabis, e-cigarettes, and cannabis mixed with tobacco/nicotine,” appears in The Journal of Cannabis Research.

Canada: No Uptick in Trauma Patients Testing Positive for Cannabis Post-Legalization

London, Canada: The enactment of adult-use marijuana legalization is not associated with any immediate uptick in the percentage of trauma patients testing positive for past cannabis exposure, according to data published in the Canadian Journal of Surgery.

A team of researchers with Western University in London, Ontario evaluated adults admitted into a leading Canadian trauma center in the three months immediately prior to and immediately following legalization. Subjects were screened for the presence of cannabis metabolites upon admission. Most patients were admitted to the trauma unit following motor vehicle collisions.

Investigators reported: “We found that the rate of positive cannabinoid screen results among patients with trauma referred directly to our trauma service was similar in the 3 months before and [in] the 3 months after the legalization of recreational cannabis in Canada. … In the subgroup of patients whose mechanism of trauma was a motor vehicle collision, there was no difference in the rate of positive toxicology screen results or positive cannabinoid screen results between the two periods.”

They concluded, “These preliminary single-center data showing no increased rates of cannabis use in patients with trauma after legalization are reassuring.”

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

Full text of the study, “Drug use in Canadian patients with trauma after cannabis legalization,” appears in the Canadian Journal of Surgery.

Daily Cannabis Use Associated with Reduced Neuroinflammation in HIV Patients

San Diego, CA: HIV+ patients who consume cannabis on a daily basis possess lower levels of neuroinflammation as compared to non-users, according to data published in the Journal of the International Neuropsychological Society.

Investigators with the University of California, San Diego evaluated the relationship between cannabis use and CNS (central nervous system) inflammation in a cohort of patients with and without HIV.

Researchers reported that HIV+ subjects who consumed cannabis daily possessed lower levels of chronic inflammation than did HIV+ subjects who abstained from marijuana. Further, users’ results were similar to those of HIV- subjects with no history of cannabis use.

Daily consumers also achieved better on measurements of cognitive performance than did those HIV+ patients with no history of regular use โ€“ a finding that is consistent with prior analyses of HIV+ patients.

Authors concluded, “Taken together, findings are consistent with the notion that cannabinoids may modulate inflammatory processes in PWH [patients with HIV], specifically in the CNS, and suggest a link between lower CNS inflammation and better neurocognitive function. … Future studies in PWH are needed to investigate potential distinct effects of specific cannabinoids, and adult medicinal use, on brain structure and function.”

Full text of the study, “Daily cannabis use is associated with lower CNS inflammation in people with HIV,” appears in the Journal of the International Neuropsychological Society.

Study: Cannabis Use Not Linked to Motivation Loss

Miami, FL: Marijuana use by teens is not independently associated with an increased risk of so-called โ€˜Amotivational syndrome,” according to longitudinal data published in the Journal of the International Neuropsychological Society.

A team of researchers affiliated with Florida International University assessed the association between cannabis use and motivation in a cohort of 401 adolescents (ages 14 to 17) over two years.

Authors reported that adolescents’ cannabis use was not associated with any significant changes in motivation, apathy, or engagement after investigators controlled for subjects’ use of alcohol and tobacco, among other potential confounders (such as age, sex, and depression).

They reported, “[D]espite significant increases in levels of cannabis use in our sample, change in cannabis use did not predict changes in motivation, which suggests that cannabis use may not lead to reductions in motivation over time.”

The study’s authors concluded: “Our findings do not support a relationship between cannabis use and reductions in motivation over time in a sample of adolescents at risk for escalation in cannabis use. … The current study contributes to the extant literature by examining these associations longitudinally in a large sample of adolescent cannabis users while controlling for important and often overlooked confounds, including sex and depression. … Future studies should continue to examine these associations longitudinally to determine whether heavier levels of cannabis use lead to reductions in motivation, and whether these reductions may be responsible for poorer educational and later life outcomes.”

Full text of the study, “Evidence lacking for cannabis users slacking: A longitudinal analysis of escalating cannabis use and motivation among adolescents,” appears in the Journal of the International Neuropsychological Society.

Analysis: Tax Increases on Cigarettes Don’t Influence Youth Marijuana Use

Bozeman, MT: Tax measures enacted to increase the costs of cigarettes do not inadvertently influence more young people to switch to marijuana, according to data published in the National Tax Journal.

A trio of economists assessed whether increased taxes on cigarettes influenced young adults to gravitate toward marijuana instead.

They reported, “The spillover effect of cigarette taxes on youth marijuana use has been the subject of intense public debate. Opponents of cigarette taxes warn that tax hikes will cause youths to substitute toward marijuana. … We find little evidence to suggest that teen marijuana use is sensitive to changes in the state cigarette tax.”

Authors also analyzed the effect of medical and recreational marijuana legalization laws upon youth cigarette and cannabis use. Consistent with prior studies, they reported, “We find that both state MMLs [medical marijuana laws] and RMLs [recreational marijuana laws] are associated with decreases in teen marijuana consumption, consistent with the hypothesis that selling to minors becomes a relatively risky proposition for licensed marijuana dispensaries.”

Full text of the study, “Cigarette taxes and teen marijuana use,” is available from the National Tax Journal.

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