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Analysis: Trauma Patients with a History of Marijuana Use Possess Decreased Risk of In-Hospital Mortality

Los Angeles, CA: Trauma patients who test positive for the presence of cannabis upon their admission to the hospital possess a decreased risk of death as compared to controls, according to data published in the journal The American Surgeon.

Researchers with the University of California, Los Angeles compared in-hospital mortality outcomes in a cohort of over 141,000 trauma patients. Consistent with other data, they reported that patients with a history of cannabis use (as documented by a positive drug screen upon admission) were less likely to die while hospitalized than were patients with similar injuries but no evidence of recent marijuana exposure.

They concluded: "On multivariable analysis, the associated risk of mortality was lower (OR = .79) for pMS [patients with a positive marijuana screen] compared to nDS patients [those testing negative for all drugs and alcohol]. ... These findings require corroboration with future prospective clinical study and basic science evaluation to ascertain the exact pathophysiologic basis and thereby target potential interventions."

Prior observational studies have similarly reported that marijuana use is associated with a decreased risk of in-hospital mortality among patients suffering from congestive heart failure, cancer, COPD, pancreatitis, HIV, burn-related injuries, traumatic brain injuries, and various other types of severe trauma.

Full text of the study, "Marijuana use associated with decreased mortality in trauma patients," appears in The American Surgeon.

Congress: House Members Advance SAFE Banking Act as Part of America COMPETES Act

Washington, DC: The US House of Representatives has advanced legislation, The America COMPETES Act of 2022, which includes the provisions of the Secure and Fair Enforcement (SAFE) Banking Act.

Friday's vote marks the sixth time that members of the House have advanced the SAFE Banking Act to the Senate either as an amendment or as a stand-alone piece of legislation. The SAFE Banking Act language, which was offered as an amendment by the bill's sponsor, Rep. Ed Perlmutter (D-CO), allows banks and other financial institutions to work with state-licensed cannabis-related businesses – something they are currently discouraged from doing.

A recent survey by Whitney Economics of 396 licensed cannabis companies reported that over 70 percent of respondents cited a "lack of access to banking or investment capital" as the top challenge they face.

"It is imperative for the interests of public safety, transparency, and the economic viability of small cannabis businesses that this legislation is approved as soon as possible," said NORML Political Director Morgan Fox. "The fact that the people's chamber has approved this measure in various forms multiple times is a clear indicator of where voters stand on this issue. Continued inaction by the Senate on this popular bipartisan reform puts workers and customers at risk of violence, makes it harder for regulators to accurately track cannabis revenue, and perpetuates the high costs and lack of access to capital that are increasingly widening the gap between large and small businesses in the cannabis space when it comes to their chances to succeed. The Senate should ensure this provision remains in the final version of this funding package and approve it swiftly."

Fox added: "The SAFE Banking Act is only the first step toward making sure that state-legal marijuana markets operate safely, efficiently, and fairly. But unfortunately, the sad reality is that those who own or patronize these currently unbanked businesses are still nonetheless recognized as criminals in the eyes of the federal government and by federal law. This situation can only be rectified by removing marijuana from the list of controlled substances, and there are several pending legislative vehicles before Congress that can accomplish this goal. In the meantime, the passage of the SAFE Banking Act is a step in the right direction that will directly improve many people's lives."

The America COMPETES Act now advances to the Senate for consideration. In the past, Senate leadership has either refused to move SAFE Banking as a stand-alone bill or it has permitted the SAFE Banking language to be removed as an amendment from other legislation in conference committee – a scenario that most recently occurred in December.

Study: Inhaled Cannabis Significantly Lowers IOP for Several Hours

Irvine, CA: Inhaling cannabis significantly reduces intraocular pressure (IOP) in healthy subjects for approximately four hours, according to data published in the journal Frontiers in Medicine.

An international team of researchers from the United States and Italy assessed the association between THC plasma levels and IOP in a cohort of healthy adults following the self-administration of cannabis cigarettes containing either six percent or 13 percent THC.

Consistent with prior research, marijuana inhalation resulted in a temporary reduction in IOP. IOP reduction was most significant 60 minutes after smoking but remained below subjects' normal baseline for up to four hours. THC/plasma concentrations of 20ng/ml, but not above this level, were most strongly correlated with decreases in IOP.

"The results of this study indicate that in healthy adult subjects, inhaled THC significantly lowers IOP, and that this effect correlates with plasma THC levels," authors reported. "IOP reduction occurred soon after inhalation and was reduced by as much as 16 percent. ... Furthermore, increasing plasma levels up to a concentration of 20 ng/ml was strongly correlated with increasing reduction in IOP. THC plasma levels >20 ng/ml were not correlated with further reduction in IOP."

Scientists have long documented that THC inhalation reduces intraocular pressure. According to recently published survey data, over one-third of glaucoma patients have discussed their medical use of cannabis with their oncologists. (Glaucoma is typically caused by abnormally high pressure within the eye.) Nevertheless, the American Glaucoma Society has not endorsed the use of cannabis as a treatment for glaucoma. By contrast, virtually all state-specific medical access laws specify glaucoma as a qualifying medical condition.

Full text of the study, "The relationship between plasma tetrahydrocannabinol levels and intraocular pressure in healthy adult subjects," appears in Frontiers in Medicine.

Senate Majority Leader Provides Timeline for Introduction of Long-Awaited Marijuana Descheduling Legislation

Washington, DC: US Senate Majority Leader Chuck Schumer announced at a press conference on Friday that he intends to formally introduce the Cannabis Administration and Opportunity Act (CAOA) in April. The forthcoming legislation, which was released in draft form last July, repeals federal marijuana prohibition by removing cannabis from the US Controlled Substances Act.

Speaking at the event, Sen. Schumer said: "In the coming weeks, we're ramping up our outreach and we expect to introduce final legislation. Our goal is to do it in April. Then we begin the nationwide push, spearheaded by New York, to get the federal law done. As the majority leader, I can set priorities. This is a priority for me."

NORML's Political Director Morgan Fox responded: "We are enthusiastic that the Senator is moving forward on his promise to prioritize cannabis policy reform in the 117th Congress. It is our hope that the official introduction of CAOA jumpstarts hearings and debates in the Upper Chamber - debates that are long overdue."

In past months, Senate leadership has received criticism for both the slow rollout of the CAOA and for failing to support efforts to enact more incremental federal legislation, such as The SAFE Banking Act, which has been passed multiple times by the US House of Representatives.

NORML was among numerous groups that submitted comments in response to the CAOA draft.
Specifically, NORML called for:

- Strengthening civic protections, including record relief, to provide justice to those previously wronged by federal marijuana criminalization;

- Revising outdated employment policies regarding non-scientific testing for trace metabolic elements of THC;

- Ensuring that small and local businesses can compete both with larger corporations and the unregulated market by reducing regulatory and tax burdens;

- Narrowing the scope of the proposed excise tax to exempt medical cannabis consumer markets;

- Balancing the roles of the FDA, TTB (Alcohol and Tobacco Tax and Trade Bureau), ATF, and antitrust regulators in a manner that is consistent with other adult-use substances, such as alcohol or tobacco, to ensure non-disruption of currently operational state programs and promoting increased local ownership in the future iterations of the marketplace.

The entirety of NORML's comments are available online.

As initially drafted, the Cannabis Administration and Opportunity Act directs the US Attorney General to remove marijuana from the federal Controlled Substances Act - thereby allowing states to either maintain or establish their own cannabis regulatory policies free from undue federal interference. Under this scheme, state governments – if they choose to do so – can continue to impose criminal penalties for marijuana possession offenses. However, states would not be permitted to prohibit the interstate commerce of legal cannabis products transported through their borders.

The proposal also mandates for the expungement of the records of anyone convicted of a federal, non-violent marijuana offense. The expungements must take place within one year of the law's enactment.

The Act also forbids federal officials from taking discriminatory actions against those who legally use cannabis. It prohibits "individuals from being denied any federal public benefit ... on the basis of [the] use or possession of cannabis." It also, for the first time, permits physicians associated with the US Department of Veterans Affairs to make recommendations to their patients to access medical cannabis.

The proposal transfers primary agency jurisdiction over cannabis regulation from the US Drug Enforcement Administration to the Food and Drug Administration and to the Alcohol and Tobacco Tax and Trade Bureau in a manner similar to the ways in which these agencies already oversee alcohol and tobacco products. A federal excise tax of 10 percent would be imposed within the first year of the law's enactment. Medical cannabis access programs, which are operational in the majority of US states, would not be disrupted under this federal plan.

The proposed Senate plan is competing against two other House bills, The MORE Act and The States Reform Act, both of which also seek to deschedule cannabis at the federal level. The MORE Act previously was advanced by the US House of Representative in the 116th Congress and is expected to be taken up again by House lawmakers in the coming weeks.

Analysis: Interest in Delta-8 Products Far Greater in States Without Legal Cannabis Access

Atlanta, GA: Internet users residing in states without legal cannabis access are more than three times as likely to search online for the availability of delta-8 THC products as are those in jurisdictions where marijuana is legal, according to data published in the American Journal of Public Health.

Emory University investigators assessed state-level Google Trends data from February to May 2021. Consistent with prior research, they reported that "states where recreational cannabis is illegal had higher relative queries [specific to delta-8 THC] than did states with legalized recreational cannabis."

Although delta-8 THC occurs organically in the cannabis plant, it is only produced in nominal quantities. By contrast, the elevated quantities of delta-8 THC found in grey market products are the result of a chemical synthesis during which manufacturers convert hemp-derived CBD to delta-8 THC. Manufacturers engaged in synthesizing delta-8 THC are not regulated and often use potentially dangerous household products to facilitate this process. Lab analyses of unregulated delta-8 products have consistently found them to contain lower levels of the compound then advertised on the products' labels. Some products have also been found to possess heavy metal contaminants and unlabeled cutting agents.

In October, NORML issued a report on delta-8 THC and other novel, synthetically derived cannabinoids that cautioned consumers to avoid these unregulated products because they are untested and may contain impurities.

Full text of the study, "Popularity of delta-8 THC on the Internet across the United States, 2021," appears in the American Journal of Public Health.