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Analysis: Adult-Use Legalization Laws Not Linked to Increases in Violent Crime, Problematic Substance Abuse

Cambridge, MA: The enactment of state-level, adult-use marijuana legalization laws is not associated with increases in either drug treatment admissions, violent crime, or overdose deaths, according to a comprehensive analysis published by the National Bureau of Economic Research.

A team of economists reviewed nationally representative data across all 50 states and the District of Columbia to “comprehensively explore the broader impacts of RMLs [recreational marijuana laws], providing some of the first evidence on how marijuana legalization is affecting illicit drug use, heavy alcohol use, arrests for drug and non-drug offenses, and objectively-measured adverse drug-related events including drug-related overdose deaths and admissions into substance abuse treatment services.”

They determined: “We find little compelling evidence to suggest that RMLs result in increases in illicit drug use, arrests for part I [violent] offenses, drug-involved overdoses, or drug-related treatment admissions for addiction. … Our findings provide key evidence evaluating the ongoing, occasionally contentious, political debate on legalizing marijuana use, and inform whether recreational marijuana use is a โ€˜gateway’ to addiction to harder drugs and criminal behavior.”

The study’s findings are consistent with those others – such as those here and here – which have similarly reported that changes in the state-legal status of cannabis are not associated with any significant adverse effects on overall health and safety.

Full text of the study – “Is recreational marijuana a gateway to harder drug use and crime?” – is available from the National Bureau of Economic Research.

Cannabis Use Not Independently Linked to Increased Risk of Ischemic Stroke in Young Adults

Baltimore, MD: Those with a history of cannabis use do not possess an increased risk of early-onset ischemic stroke, according to the findings of a population-based case-control study published in the journal Stroke.

Researchers with the University of Maryland School of Medicine assessed the relationship between cannabis and stroke risk in a cohort of 1,564 subjects between the ages of 15 to 49. Investigators said that their study was “the largest case-control study to date” evaluating the association between marijuana and ischemic stroke risk.

They reported, “After adjusting for other risk factors, including the amount of current tobacco smoking, marijuana use was not associated with ischemic stroke, regardless of the timing of use in relationship to the stroke, including ever use, use within 30 days, and use within 24 hours.”

Authors concluded, “These analyses do not demonstrate an association between marijuana use and an increased risk of early-onset ischemic stroke.”

Results of a 2020 study published in the journal Neurology: Clinical Practice similarly reported that recent exposure to cannabis was not associated with an increased risk of hospitalization due to acute ischemic stroke.

Other studies have yielded inconsistent results with respect to the degree with which a history of cannabis use may play a role in the risk of ischemic stroke. NORML has cautioned that those patients with a history of cardiovascular disorders may be at an elevated risk of suffering from adverse events due to the use of cannabis.

Full text of the study, “Marijuana use and the risk of early ischemic stroke: The stroke prevention in young adults study,” appears in Stroke.

Medical Cannabis Patients Show Sustained Improvements in Cognitive Performance

Belmont, MA: The use of cannabis products, particularly CBD-dominant products, is associated with sustained improvements in cognitive performance, according to longitudinal data published in the Journal of the International Neuropsychological Society.

A team of Harvard investigators assessed executive function in a cohort of medical cannabis patients prior to their use of marijuana and then again at three months, six months, and at twelve months. Patients enrolled in the study possessed little-to-no prior experience with cannabis.

Researchers reported that subjects showed improved cognitive performance within three months of treatment and that these improvements were sustained throughout the 12-month trial period. Improvements in executive function were correlated with clinical improvements in patients’ mood, anxiety, and sleep. The use of CBD-dominant products was most closely associated with participants’ changes in mood and anxiety.

Authors concluded: “In a 12-month longitudinal, observational study, patients using MC [medical cannabis] for various medical conditions exhibited improved executive function and stable verbal learning and memory within the context of improvements on measures of mood, anxiety, and sleep relative to baseline. [I]mprovement of clinical state over time was significantly associated with increased CBD exposure. … Future investigations examining the impact of individual cannabinoids and age of onset of use are warranted to clarify the implications of MC use. Ultimately, for MC patients, it is imperative to understand the relationship between these variables in order to maximize the therapeutic potential of cannabis while minimizing potential risk and harms.”

A 2020 study published in the journal AIDS Care also reported that HIV patients with a history of cannabis use exhibited better neurocognitive performance than similarly matched patients with no history of consumption.

Full text of the study, “An observational, longitudinal study of cognition in medical cannabis patients over the course of 12-months of treatment: Preliminary results,” appears in the Journal of the International Neuropsychological Society.

Enactment of Adult-Use Marijuana Legalization Associated with Immediate, But Temporary Reductions in Opioid-Related Emergency Room Visits

Boston, MA: The enactment of adult-use marijuana legalization laws is associated with immediate reductions in opioid-related emergency department (ED) visitation rates among men, according to data published in the journal Health Economics.

A team of investigators from the Harvard Pilgrim Health Care Institute and the University of Pittsburgh assessed the relationship between marijuana legalization and opioid-related ED visitation rates in 29 states over a six-year period (2011-2017). Four of those states enacted adult-use access during the study period, and researchers compared trends in these legal states with trends in the remaining 25 states.

Authors reported that ED visit rates fell nearly eight percent among males (ages 24 to 44) during the first six-months following the enactment of legalization laws. However, these reductions dissipated in the months that followed and were no longer significant within one year.

“Our results indicate that RCLs [recreational marijuana laws] may only affect a temporary reduction in opioid-related ED visits,” they concluded. “While cannabis liberalization may offer some help in curbing the opioid crisis, our results suggest that it is not a panacea.”

The study’s lead investigators added: “We can’t definitively conclude from the data why these laws are associated with a temporary downturn in opioid-related emergency department visits but, based on our findings and previous literature, we suspect that people who use opioids for pain relief are substituting with cannabis, at least temporarily. … [T]his is good news for state policymakers. States can fight the opioid epidemic by expanding access to opioid use disorder treatment and by decreasing opioid use with recreational cannabis laws. These policies aren’t mutually exclusive; rather, they’re both a step in the right direction.”

Full text of the study, “Recreational cannabis laws and opioid-related emergency department visit rates,” appears in Health Economics.

Study: Experienced Cannabis Consumers Self-Titrate Higher Potency Products

Pullman, WA: Subjects consuming high-potency cannabis concentrates perform similarly on measurements of cognitive performance as do those inhaling lower-potency cannabis flowers, according to data published in the journal Scientific Reports.

A team of investigators affiliated with Washington State University assessed the impact of high-potency concentrates (above 60 percent THC) and lower potency flower (around 20 percent THC) on cognitive performance in a group of experienced marijuana consumers. Users’ performance was measured against that of 20 sober participants.

Researchers reported that cannabis consumers scored similar to controls on a number of measurements, including on tasks involving decision-making and prospective memory.

Cannabis users did not perform as well as controls on tests involving verbal recall and false memories. However, subjects consuming high-potency THC products performed no worse on those tests than did those subjects who ingested less potent products. Researchers attributed this latter result to the fact that those participants who consumed concentrates ingested significantly lesser quantities – thereby achieving similar levels of intoxication as did those who consumed lower potency flower.

Authors concluded: “[P]articipants randomly assigned to use a cannabis concentrate self-titrated after significantly fewer puffs yet reported comparable levels of intoxication and demonstrated equivalent levels of impairment as those who inhaled the flower products. [While] there has been concern and speculation that extremely high-potency cannabis concentrates will magnify harms, … [these] results failed to support our hypothesis that concentrates would exacerbate cognitive impairments.”

The authors’ conclusions are consistent with those of prior experimental studies showing that subjects exposed to higher-potency cannabis tend to self-titrate their intake accordingly.

The study’s findings come at a time when some state lawmakers are calling for the imposition of arbitrary caps on the percentage of THC available in certain retail cannabis products. Those opining in favor of these restrictions have claimed that there are greater adverse effects associated with the use of higher potency products. NORML has pushed back against the imposition of THC caps – arguing that proponents’ concerns are not evidence-based and that banning the sale of more potent products will only serve to expand the growth of the illicit marijuana market.

Full text of the study, “Acute effects of high-potency cannabis flower and cannabis concentrates on everyday life memory and decision making,” appears in Scientific Reports.

Animal Data: CBD Administration Mitigates Symptoms of Nicotine Withdrawal

San Diego, CA: The administration of cannabidiol reduces nicotine withdrawal symptoms in animals, according to preclinical data published in the journal Psychopharmacology.

Researchers with the University of California, San Diego assessed the use of CBD or placebo in nicotine-dependent rats during periods of acute and protracted abstinence.

Investigators reported that CBD dosing “prevented” rats from exhibiting various signs of nicotine withdrawal. These findings “suggest that using CBD as a strategy to alleviate withdrawal symptoms upon nicotine cessation may be beneficial,” they concluded.

Separate animal models have demonstrated the ability of CBD to reduce cravings for alcohol and cocaine, while human studies have reported associations between CBD intake and reduced desires for alcohol, cocaine, heroin, tobacco, and cannabis.

Full text of the study, “Cannabidiol reduces withdrawal symptoms in nicotine-dependent rats,” appears in Psychopharmacology.

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