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NORML Responds to Studies Identifying Link Between COVID and Cannabis Use Disorder Diagnosis

Cleveland, OH: Fully vaccinated persons with a clinical diagnosis of cannabis use disorder (CUD) possess a greater risk of COVID breakthrough infections than do to similar controls, according to data published in the journal World Psychiatry.

Researchers with the US National Institutes of Health and Case Western Reserve University in Cleveland evaluated whether those with a diagnosis of a substance abuse disorder (SUD) were at increased risk of breakthrough COVID infections in a cohort of 579,372 fully vaccinated individuals. Subjects’ substance abuse status was based on the ICD (International Classification of Diseases)-10 diagnosis code of “mental and behavioral disorders due to psychoactive substance use.” Subjects in the study designated with SUD tended to be older and possessed overall poorer health than did controls. Just over 2,000 persons in the cohort met the criteria for cannabis use disorder.

Overall, authors reported that those with a SUD diagnosis were more likely to suffer from breakthrough COVID infections as well as from poorer COVID outcomes (e.g., hospitalization and death). This risk was no longer significant for most SUD subjects once authors adjusted for confounding variables. By contrast, cannabis use disorder subjects continued to possess an elevated risk of infection compared to controls (HR=1.55), even after investigators adjusted for confounders.

Authors reported: “Patients with cannabis use disorder, who were younger and had less comorbidities than the other SUD subtypes, had higher risk for breakthrough infection even after they were matched for adverse socioeconomic determinants of health and comorbid medical conditions with non-SUD patients (HR=1.55). This may indicate that additional variables, such as behavioral factors or adverse effects of cannabis on pulmonary and immune function, could contribute to the higher risk for breakthrough infection in this group.”

Within the SUD population, the risk of breakthrough infections was highest for those who had “recent medical encounters for the SUD diagnosis.”

Commenting on the paper’s findings, NORML’s Deputy Director Paul Armentano said that study “raises more questions than it answers,” but he also cautioned that its findings should not yet be extrapolated to the cannabis consuming population at large. “Those subjects with this clinical diagnosis represent a very small and distinct subset of the cannabis consuming community and it is possible that they may possess certain behavioral traits or characteristics that place them at higher risk,” he said. “Arguably tens of thousands of cannabis consumers who did not have this diagnosis were also included in this cohort of over half a million people and they were classified as controls (subjects without a substance abuse disorder). Therefore, we have no idea from these findings what elevated risks, if any, these non-classified consumers – who comprise the overwhelming majority of marijuana users – possess.”

A separate data analysis assessing the link between those diagnosed with CUD and severe COVID-19 outcomes suggests that the two may be correlated because of shared genetic vulnerabilities rather than because of any cause-and-effect relationship. Researchers reported: “Problematic cannabis use and vulnerability to serious COVID-19 complications share genetic underpinnings that are unique from common correlates. While CUD may plausibly contribute to severe COVID-19 presentations, causal inference models yield no evidence of putative causation.”

Throughout the COVID-19 pandemic, NORML has issued guidance with respect to how cannabis consumers may be able to mitigate their risks of either COVID exposure and/or adverse health outcomes due to the disease.

Full text of the study, “Increased risk for COVID-19 breakthrough infection in fully vaccinated patients with substance abuse disorders in the United States between December 2020 and August 2021,” appears in World Psychiatry. Full text of the study, “Genetic liability to cannabis use disorder and COVID-19 hospitalization,” appears in Biological Psychiatry Global Open Science.

Survey: More Than One in Five US Caregivers Report Providing CBD to Treat Autistic Symptoms

New York, NY: Parents and caregivers are increasingly turning to CBD products to mitigate autism symptoms in children, according to survey data compiled by Autism Parenting Magazine.

Editors provided survey questions to more than 160,000 worldwide e-mail subscribers. Among US respondents, 22 percent affirmed having provided CBD to a child on the autism spectrum. Seventy-two percent of all respondents were parents while the remaining 28 percent were caregivers.

The majority of respondents reported using products marketed as hemp-derived CBD (which are advertised to possess less than 0.3 percent THC). Only about 14 percent of respondents reported providing CBD extracts that possessed more significant amounts of THC.

Respondents said that they were most likely to administer CBD products to treat symptoms of anxiety, “challenging behavior,” pain, or to improve sleep. Eighty-three percent of those surveyed said that they would recommend the use of CBD products to other parents caring for autistic children.

A recently published review of nine clinical trials assessing the use cannabinoids in autism patients identified beneficial changes in symptoms following cannabinoid therapy, including “decreased bouts of self-mutilation and anger, hyperactivity, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, perseverance, aggressiveness, and depression [and] improvement in sensory sensitivity, cognition, attention, social interaction, and language.” Researchers concluded, “Cannabis and cannabinoids have very promising effects in the treatment of autistic symptoms and can be used in the future as an important therapeutic alternative.”

NBA Suspending Marijuana Testing for 2021/2022 Season

New York, NY: For the second season in a row, the National Basketball Association has announced that it will suspend the practice of randomly testing players for marijuana.

A spokesperson for the league announced last week that it will “extend the suspension of random testing for marijuana for the 2021-22 season and focus our random testing program on performance-enhancing products and drugs of abuse.”

Commenting on the policy, NORML’s Political Director Justin Strekal said: “The NBA, like a number of sports leagues, has wisely recognized that it is inappropriate to subject players to drug detection testing for their off-the-court use of cannabis. Their actions are part of a growing trend, and we anticipate that their decision will propel other organizations and companies to make similar changes to their drug screening policies.”

Recently, both the NFL and MLB have amended their drug testing policies so that use of the substance is no longer an offense resulting in a suspension. Last month, the World Anti-Doping Agency (WADA) announced that it would be reviewing its marijuana-related drug testing guidelines for international athletic competitors.

A literature review published in September in the journal Sports Medicine reported that athletes do not perform better under the influence of either cannabis or THC, but that the use of marijuana and/or CBD may aid in their recovery following competition.

Also last month, the nation’s second largest private employer – Amazon.com – announced that it had dropped pre-employment screening for marijuana and that it was reinstating eligibility for former applicants who were denied consideration under its former policies.

Since 2015, cannabis-related testing in the workplace has fallen over five percent, with jurisdictions where marijuana use is legal for adults experiencing a more significant decline.

Several states – Nevada, New Jersey, New York, and Montana – now limit employers’ ability to pre-screen certain job applicants for past marijuana use, as do a growing number of municipalities, including Atlanta, Philadelphia, and Washington, DC.

Study: No Link Between Cannabis Exposure and Acute Kidney Disease in High Risk Patients

Memphis, TN: A history of cannabis use is not associated with acute kidney injury (AKI), according to data published in the journal Cannabis and Cannabinoid Research.

Investigators affiliated with the University of Tennessee and various other academic institutions assessed whether those with a cannabis use history were more likely to suffer from AKI as compared to non-users in a nationally representative cohort of 102,477 US veterans transitioning to dialysis.

Researchers reported that those subjects with past cannabis exposure possessed slightly lower odds of AKI (OR 0.85) than did those with no exposure.

They concluded: “In this observational study examining patients with advanced CKD (chronic kidney disease), cannabis use was not associated with AKI risk. Additional studies are needed to characterize the impact of cannabis use on risk of kidney disease and injury.”

Full text of the study, “Cannabis risk and risk of acute kidney injury in patients with advanced chronic kidney disease transitioning to dialysis,” appears in Cannabis and Cannabinoid Research.

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