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Study: Cannabis Mitigates Symptoms in Patients with Treatment-Resistant Post-Traumatic Stress

Tel Aviv, Israel: The use of cannabis prior to bedtime is associated with improved sleep in patients with treatment-resistant post-traumatic stress (PTS), according to data published in the journal Frontiers in Psychiatry.

Israeli researchers evaluated cannabis use in a cohort of 14 subjects with combat-related traumatic stress. Subjects had previously tried various conventional treatments without success. All of the patients were naïve to cannabis prior to enrolling in the study. Study participants consumed cannabis in the evenings in an outpatient setting for a period of at least six-months.

Investigators reported: "After treatment with cannabis, total sleep score, subjective sleep quality, and sleep duration significantly improved. ... Total PTSD symptom score and its subdomains (intrusiveness, avoidance, and alertness) showed [also] improvement." By contrast, cannabis treatment was not associated with reducing patients' frequency of nightmares.

None of the patients reported any side-effects from cannabis, nor did any elect to cease using cannabis prior to the end of the study period.

"To the best of our knowledge, this is the first published study examining long-term cannabis efficacy in chronic combat treatment-resistant PTSD patients," authors concluded. "The study's findings show an overall improvement in sleep quality and duration, as well as a decrease in PTSD symptoms. ... Future research should clarify the long-term effects of cannabis on different groups of patients suffering from PTSD."

Israelis suffering from post-traumatic stress have been legally able to access cannabis since 2014. Currently, about 10 percent of all Israelis authorized to access medical cannabis use it to treat symptoms of PTS.

Other studies have similarly reported improvements in sleep duration and in insomnia in patients with and without PTS. The enactment of adult-use marijuana legalization has also been correlated with a decrease in the sale of over-the-counter sleep aid medications.

Full text of the study, "Medical cannabis treatment for treatment-resistant combat PTSD," appears in Frontiers in Psychiatry.

Analysis: Cannabis Products Mitigate Need for Other Prescription Medications in Chronic Pain Patients

Saarbrücken, Germany: The use of cannabis-based medicinal products is associated with significant decreases in pain and prescription drug use among patients suffering from chronic pain, according to data published in the German science journal Schmerz.

A team of German researchers assessed the efficacy of cannabis-based medicines in a cohort of 187 pain patients.

Over 88 percent of patients reported experiencing either significant or moderate improvements in their overall condition following the initiation of cannabis therapy. Participating physicians reported that 61 percent of the study's participants achieved "substantial pain relief," 66 percent achieved better sleep, and 34 percent achieved improvements in their mental well-being.

Among those subjects who were taking prescription medications at the onset of the study, 65 percent ceased their use of opioids, 60 percent stopped using antidepressants, and 58 percent ceased their use of anticonvulsants -- a finding that is consistent with numerous other studies.

Authors concluded: "CbMs [cannabis-based medicines] can contribute to a clinically relevant reduction in pain, sleep problems and muscle tension and can improve daily functioning in carefully selected and supervised patients with chronic pain. CbM can contribute to the reduction or complete cessation of other pain medications (antidepressants, anticonvulsants, opioids)."

Data published earlier this month in the journal JAMA Network Open reports that nearly one in four pain patients residing in states where medical cannabis access is legal self-identify as marijuana consumers.

Numerous placebo-controlled trials document the ability of either inhaled or vaporized herbal cannabis to significantly mitigate pain in various patient populations, including those suffering from HIV, diabetes, spinal cord injury, or with severe treatment-resistant neuropathy (nerve pain). These positive results have been replicated in clinical trials utilizing relatively low doses of cannabis as well as in trials using plant-derived cannabis extracts.

A 2017 report by the National Academy of Sciences, Engineering, and Medicine concluded that "conclusive or substantial evidence" exists for cannabis' efficacy in patients suffering from chronic pain, stating, "Patients who [are] treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms."

Full text of the study, "Benefits and harms of cannabis-based medicines from the viewpoints of patients with chronic pain and their physicians: A cohort study in three pain centers of the German federal state of Saarland," appears in Schmerz.

Study: Cannabis Use Associated with Symptom Improvements in Patients with Headache Disorders

London, United Kingdom: The use of cannabis products is associated with symptomatic improvements in patients with headache disorders, according to observational trail data published in the journal Expert Review of Neurotherapeutics.

British investigators assessed the safety and efficacy of cannabis-derived products in 97 patients diagnosed with migraine and other headache disorders. Study subjects were participants in the UK Medical Cannabis Registry, and each of them possessed a doctor's authorization to access cannabis. Study participants consumed cannabis by either vaporizing marijuana flowers or by ingesting plant-derived extracts containing both THC and CBD. Researchers assessed subjects' symptoms compared to baseline at one, three, and six-months.

Cannabis therapy was associated with sustained improvements in pain, anxiety, sleep, and other health-related outcomes. Fewer than one-in-five patients reported experiencing any adverse events from cannabis. Most events were perceived to be mild.

"[While] these results provide promise with respect to the changes in health-related quality of life experienced by those with primary headache disorders, there is a still a requirement for further RCTs [randomized placebo-controlled trials] to be conducted to understand the true efficacy of CBMPs [cannabis-based medicinal products] for this indication," authors concluded. "However, whilst these are awaited, the present study outcomes with respect to safety and efficacy, provides useful insights to inform current clinical practice."

According to a systematic review of the literature published in December, the inhalation of cannabis flowers is generally effective and well-tolerated among patients with migraine. Authors of the review concluded: "[M]edical marijuana has a significant clinical response by reducing the length and frequency of migraines. No severe adverse effects were noted. Due to its effectiveness and convenience, medical marijuana therapy may be helpful for patients suffering from migraines."

Patients enrolled in the UK Medical Cannabis Registry with diagnoses of post-traumatic stress, depression, refractory epilepsy, and inflammatory bowel disease have also demonstrated symptomatic improvements following cannabis therapy.

Full text of the study, "UK Cannabis Registry: Assessment of clinical outcomes in patients with headache disorders," appears in Expert Review of Neurotherapeutics.

Oklahoma: Voters to Decide on Adult-Use Legalization Initiative Next Month

Oklahoma City, OK: Oklahomans will decide on March 7 whether to approve a citizens' initiated measure (State Question 820) legalizing the adult-use marijuana market.

State Question 820 permits adults to legally possess and home-cultivate personal use qualities of cannabis while also establishing a licensed, retail marketplace. Those with past marijuana convictions, or those who are currently incarcerated for certain cannabis-related crimes, would be able to petition the courts for either record expungement or re-sentencing consideration.

According to a just published economic analysis, excise taxes from retail cannabis sales in Oklahoma could yield $434 million in new tax revenue over four years.

Advocates for SQ 820 in July turned in nearly twice the total of signatures necessary to qualify the initiative for the 2022 ballot. However, the Secretary of State's office took an excessive amount of time to ultimately verify proponents' signatures. Opponents of the measure then filed a series of questionable legal challenges litigating various facets of the campaign, including challenges to the initiative's summary language. Although justices ultimately dismissed those challenges, they did so after time had elapsed for state officials to include SQ 820 on that year's printed ballots.

In October, Republican Gov. Kevin Stitt issued the executive proclamation calling for a special election to be held on Tuesday, March 7, 2023. State Question 820 will be the only item on the ballot.

Oklahomans who are not yet registered to vote have until Friday, February 10, to do so. Residents can check their voters registration status or register to vote online via the Oklahoma State Election Board's OK Voter Portal.

The deadline for voters to request an absentee ballot is Monday, February 20th. Early voting begins on Thursday, March 2nd. Polling location information is available from the OK Voter Portal.

Oklahomans previously voted in a special election in 2018 to legalize the cultivation and dispensing of marijuana for medical purposes.

Additional campaign information is available from Yes on 820.

Hawaii: Analysis Projects Adult-Use Cannabis Sales Could Create 3000+ New Jobs, Raise Over $80 Million in Annual Tax Revenue

Honolulu, Hawaii: Licensing Hawaiian businesses to engage in cultivating and selling cannabis to adults will create thousands of jobs and raise tens of millions of dollars in new tax revenue, according to an economic assessment provided by the Hawai'i Cannabis Industry Association.

Authors of the report estimated that legalization will create 3,375 new jobs and will yield nearly $82 million in annual tax revenue.

Several bills are pending in the state legislature to legalize the adult-use cannabis market. Newly elected Governor, Democrat Josh Green pledged as a candidate that he would sign legalization legislation if such a bill was advanced by the legislature.

Although the dispensing of medical cannabis has been legal in Hawaii since 2000, criminal penalties remain in place for the adult possession of more than three grams of marijuana.

Full text of the analysis, "HICIA 2023 Adult Use Market and Tax Projection Report," is available from the Hawai'i Cannabis Industry Association.