Study: Cannabis Products Associated with Improved Quality of Life, Reduced Opioid Use Among Chronic Pain Patients
London, United Kingdom: Chronic pain patients who use cannabis products for six months report improvements in their health-related quality of life and decreases in their daily opioid consumption, according to observational data published in the journal Expert Review of Neurotherapeutics.
British investigators assessed the safety and efficacy of plant-derived cannabis products (either oils, flower, or a combination of both) in over 700 chronic pain patients enrolled in the UK Medical Cannabis Registry. All of the participants possessed a doctor’s authorization to access cannabis products. (Since 2018, specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Authors assessed the efficacy of cannabis at one, three, and six months.
Consistent with prior studies, investigators reported: “Treatment with oil-based
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, dried flowers, or a combination of both CBMPs [cannabis-based medicinal products] are associated with statistically significant improvements in pain relief and sleep quality after six months in chronic pain patients. Additionally, patients prescribed oils or both types of CBMPs experienced reduced anxiety and an improvement in their ability to perform daily activities. Patients prescribed a combination of both CBMPs recorded improvements in their self-care and mobility abilities. Collectively, this evidence signals that [the] initiation of CBMP treatment is associated with improved HRQoL [health-related quality of life].”
Researchers also acknowledged that patients significantly reduced their daily intake of prescription opioids -- a finding that is consistent with dozens of other studies.
“In summary, these results suggest that both [cannabis] oils and dried flowers are associated with long-term improved HRQoL in chronic pain patients,” they concluded.
Prior studies assessing the use of cannabis products in patients enrolled in the UK registry have similarly reported them to be safe and effective for patients suffering from anxiety, post-traumatic stress, depression, migraine, inflammatory bowel disease, and other afflictions.
Data published earlier this year in the journal JAMA Network Open reported that nearly one in four pain patients who reside in states where medical cannabis access is legal self-identify as marijuana consumers.
Full text of the study, “Clinical outcome data of chronic pain patients treated with cannabis-based oils and dried flower from the UK medical cannabis registry,” appears in Expert Review of Neurotherapeutics.
Study: Patients with a History of Cannabis Use Consume Fewer Prescription Opioids Following Wrist Surgery
Aurora, CO: Patients with a history of cannabis use consume fewer prescription opioids following surgical treatment for distal radius fractures (a/k/a bone wrist fractures), according to case-control data published in the International Open Access Journal of the American Society for Plastic Surgeons.
Researchers affiliated with the University of Colorado, Anschutz Medical Center compared the demand for opioids among cannabis consumers (cases) and non-users (controls) following wrist surgery.
They reported, “[T]here was a significant reduction in average MME [morphine milligram equivalents] for the case population’s initial opioid prescription compared with the control population.”
The findings are consistent with those of numerous other studies documenting that patients frequently use cannabis for pain mitigation, and that many patients either reduce or eliminate their consumption of opioids and other medications following the initiation of cannabis therapy.
The study’s authors concluded: “Patients with a diagnosis of cannabis use filled a significantly reduced volume of opioids, measured as MME per prescription, in their first opioid prescription after [surgery] compared to their control counterparts.”
In clinical trials, the co-administration of either smoked cannabis or oral cannabinoids has been documented to augment the pain-relieving effects of opioids. In one study, vaporized herbal cannabis was demonstrated to enhance the pain-relieving activity of morphine and oxycodone in chronic pain subjects, thereby allowing “for opioid treatment at lower doses with fewer side effects.” Another study reported similarly enhanced analgesic efficacy when low doses of oral THC were combined with hydromorphone (aka Dilaudid). Authors reported, “These data … are indicative of [the] possible opioid-sparing effects” of cannabinoids. These synergistic effects have also been documented in settings where subjects were provided with only sub-therapeutic doses of cannabis and opioids.
Full text of the study, “Patterns of opioid demand after operative treatment of distal radius fractures,” appears in the International Open Access Journal of the American Society for Plastic Surgeons. Additional information is available from the NORML Fact Sheet, ‘Relationship Between Marijuana and Opioids.’
NBA to Cease Drug Testing Players for Cannabis
New York, NY: The NBA and the Players Association have reportedly settled upon a new collective bargaining agreement that amends the league’s cannabis-related policies.
The new agreement codifies changes first implemented on a temporary basis in 2020 limiting the ability of league officials to randomly screen players for cannabis and to punish those who test positive.
The changes are similar to those implemented by Major League Baseball, which also dropped cannabis from its banned substances list. Both the NFL and the NHL continue to drug test some players for cannabis use, but they no longer impose suspensions for those who test positive for it. Last year, the NCAA also relaxed its marijuana testing regulations.
It has also been reported that the new NBA agreement will permit players to provide paid endorsements for certain cannabis products. However, full details of the new collective bargaining agreement have not yet been made public.
New Mexico: Governor Signs Expungement Verification Bill into Law
Santa Fe, NM: Democratic Gov. Michelle Lujan Grisham has signed legislation, House Bill 314, into law facilitating a process whereby those with past cannabis convictions can verify that their criminal records have been expunged.
The Governor previously signed legislation in 2021 providing for the automatic review and expungement of the records of those convicted of certain low-level marijuana offenses. The new law permits persons charged with offenses eligible for automatic expungement to “verify whether automatic expungement has occurred, and [to] request expedited automatic expungement if eligible charges have not yet been expunged.”
The new law also allows persons convicted of multiple offenses to request to have their cannabis-specific convictions expunged.
To date, 24 states and the District of Columbia have enacted laws providing explicit pathways to either expunge (or otherwise set aside) the records of those with low-level marijuana convictions. According to publicly available data compiled by NORML, state and local officials have issued over 100,000 pardons and more than 1.7 million marijuana-related expungements since 2018.
Montana: Lawmakers Pass Legislation Permitting Police to Administer Saliva Tests to Suspected Drugged Drivers
Helena, MT: House and Senate lawmakers have advanced legislation, Senate Bill 13, amending the state’s implied consent law so that police may administer oral fluid tests to motorists suspected of being under the influence of drugs. The bill now awaits action from Republican Gov. Greg Gianforte.
The legislation stipulates, “A person who operates or is in actual physical control of a vehicle ... is considered to have given consent to a test or tests of the person’s blood or breath for the purpose of determining any measured amount or detected presence of alcohol, or blood or oral fluid for the purpose of determining any measured amount or detected presence of drugs in the person’s body.”
The bill’s sponsor said that the results of oral fluid screens will be used for purposes of establishing probable cause only; a positive test result would be not viewed as prima facie evidence of impairment.
Saliva testing can typically identify residual traces of THC for up to 48 hours following marijuana inhalation, a period of time beyond the window of cannabis-related impairment. However, this detection window is shorter than that associated with urine tests, which can detect the presence of the inert metabolite carboxy-THC for several weeks post-abstinence, or blood tests, which can detect the residual levels of THC for over a week in the blood of more habitual consumers.
Montana is among a handful of states that imposes criminal penalties for those who operate a motor vehicle with a detectable level of THC above 5ng/ml in their blood. NORML has long opposed the imposition of THC per se thresholds for cannabinoids in traffic safety legislation, opining, “The sole presence of THC and/or its metabolites in blood, particularly at low levels, is an inconsistent and largely inappropriate indicator of psychomotor impairment in cannabis consuming subjects.”
In 2021, lawmakers in Indiana and Nevada repealed their per se traffic safety limits for the presence of THC in blood.
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