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Federal: Language Facilitating Medical Cannabis Access for Veterans Included in Senate, House Versions of Military Spending Bill
Washington, DC: Members of the US Senate and the House of Representatives have approved amendments allowing physicians affiliated with the Department of Veterans Affairs to recommend medical cannabis to qualified patients in jurisdictions that regulate its use.
Federal regulations currently preclude physicians associated with the Veterans Affairs Department from filling out the paperwork necessary to issue a state-authorized medical marijuana recommendation. The pending language amends these rules so that no federal funds may be used to prohibit physicians from engaging in the medical marijuana authorization process.
The new provisions are included in the House and Senate versions of a much broader legislative package, the Military Construction, Veterans Affairs, and Related Agencies Appropriations Act. However, because the two chambers have approved differing versions of the Act, members must still reconcile the language of the two bills. That process typically takes place in a conference committee.
In prior years, lawmakers have removed similar cannabis reform language from the Military Construction bill during the conference committee process.
Lawmakers are anticipated to take further action on the Act shortly after reconvening from their August recess.
Study: Medical Cannabis Associated With Health-Related Quality of Life Improvements, Reduced Opioid Use Among Patients With Substance Use Disorders
London, United Kingdom: Patients diagnosed with substance use disorders (SUD) report improved sleep quality, reduced anxiety, and decreased opioid use following the sustained use of medical cannabis products, according to observational data published in the journal European Addiction Research.
British investigators assessed the use of cannabis-based medicinal products (CBMPs) in SUD patients enrolled in the UK Medical Cannabis Registry. (British health care providers may prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) More than half (53 percent) of the participants suffered from an opioid use disorder. Patients’ outcomes were assessed at one, three, and six months.
“[T]herapy with CBMPs in patients with SUDs was associated with improvements in [patients’] anxiety, sleep quality and HRQoL [health-related quality of life] at 1, 3 and 6 months,” investigators reported. “Additionally, treatment with CBMPs was associated with a reduction in the median daily OME [oral morphine equivalent] from baseline to 6 months with no severe or life-threatening adverse events reported. These findings are in line with similar studies and broader data from the UK Medical Cannabis Registry for other conditions.”
The study’s authors concluded: “In the context of SUD, CBMPs may … play a role in the maintenance therapy of opiate-dependent individuals with co-morbid anxiety and sleep disorders or symptoms. … CBMPs may also play a role during tapering of opioid doses during maintenance therapy due to the prevalence of anxiety and sleep disruption in individuals experiencing withdrawal from medications. … Although capturing a 6-month follow-up is valuable, longitudinal data to see if PROMs [patient-reported outcome measures] would stay the same, improve further or instead decline would also prove useful in strengthening the evidence base for CBMPs in the treatment of substance use disorders.”
Survey data have previously reported that a significant percentage of patients undergoing opioid maintenance therapy acknowledge consuming cannabis to ease withdrawal symptoms and drug cravings.
Other observational studies assessing the use of cannabis products among those enrolled in the UK Medical Cannabis Registry have reported them to be effective for patients diagnosed with treatment-resistant epilepsy, cancer-related pain, anxiety, fibromyalgia, inflammatory bowel disease, hypermobility disorders, depression, migraine, multiple sclerosis, osteoarthritis, and inflammatory arthritis, among other conditions.
Full text of the study, “UK Medical Cannabis Registry: A clinical analysis of patients with substance use disorder,” appears in the European Addiction Research.
Study: Patients Engage in Compensatory Driving Behaviors Following Ingestion of THC Extracts
Queensland, Australia: Patients who consume oral doses of THC drive at slower speeds and engage in other compensatory behaviors, according to driving simulator data published in the journal Psychopharmacology.
Australian researchers assessed subjects’ simulated driving performance prior to and 90 minutes after their ad libitum consumption of prescribed THC oil extracts. (Australian physicians may prescribe cannabis products to patients unresponsive to conventional prescription treatments.) On average, study subjects consumed 11 mg of THC prior to driving.
Similar to the results of prior studies, subjects engaged in compensatory driving behaviors – such as driving at slower speeds and increasing the distance between their vehicle and the vehicles in front of them – following THC dosing. Few other changes in participants’ baseline performance were identified, leading investigators to presume that patients likely become tolerant to THC’s potential effects on cognitive and psychomotor performance.
“Our results align with a growing body of evidence demonstrating that chronic THC use can mitigate the acute effects of the substance on driving performance and driving-related cognitive functions,” researchers reported.
The study’s authors concluded: “Taken together, our findings suggest that … medicinal cannabis users may … be more inclined to compensate for cannabis impairment through alterations in speed and following distance. … Future research is needed to further investigate the effects of THC on these driving-related skills and behaviors using a wider range of doses and administration methods, with populations of varying tolerance levels.”
The study’s findings are consistent with those of several others, determining that daily cannabis consumers, and patients especially, exhibit tolerance to many of cannabis’ psychomotor-influencing effects. According to the findings of a literature review published in the Journal of the German Medical Association, “Patients who take cannabinoids at a constant dosage over an extensive period of time often develop tolerance to the impairment of psychomotor performance, so that they can drive vehicles safely.”
Full text of the study, “The effects of orally ingested delta-9-tetrahydrocannabinol on drivers’ hazard perception and risk-taking behaviors: A within-subjects study of medicinal cannabis users,” appears in Psychopharmacology.
Analysis: Cannabis Use Not Associated with Elevated Risk of Kidney Disease
Baltimore, MD: Adults with a history of cannabis use do not possess an elevated risk of kidney disease at midlife, according to longitudinal data published in the journal Cannabis and Cannabinoid Research.
A team of investigators affiliated with Johns Hopkins University School of Medicine in Baltimore and Tulane University in New Orleans assessed the relationship between cannabis use and kidney function. Study participants included current cannabis consumers and non-users. Participants were assessed at baseline and again nearly a decade later.
“Compared with those with no history of cannabis use, participants with current regular cannabis use were not at higher risk of incident CKD [chronic kidney disease] (OR: 0.79), rapid kidney function decline (OR: 0.80) or incident albuminuria [the presence of albumin in urine, a symptom of kidney disease (OR: 0.84) after adjustment for [confounders],” researcher reported.
The study’s authors concluded, “[T]here was no independent association between cannabis use and adverse kidney outcomes over time.”
Full text of the study, “Evaluating the association of cannabis use and longitudinal kidney outcome,” appears in Cannabis and Cannabinoid Research.
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