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Analysis: Adult-Use Legalization Associated with Less Alcohol Abuse, No Increase in Psychosis

Minneapolis, MN: Residents of states where cannabis is legal do not possess elevated rates of psychosis, and they are also less likely to exhibit symptoms of alcohol abuse, according to longitudinal data published in the journal Psychological Medicine.

A team of researchers affiliated with the University of Minnesota and the University of Colorado assessed the relationship between adult-use cannabis legalization and psychosocial functioning in a cohort of 240 pairs of identical twins. One twin resided in a jurisdiction where adult-use cannabis sales were legally permitted, while the other lived in a state where marijuana was criminally prohibited.

Investigators reported that legalization was associated with a slight uptick in the frequency with which subjects reported consuming cannabis - a finding consistent with prior studies. However, they also reported that those in legalization states were less likely to engage in behaviors associated with problematic alcohol use. That finding is consistent with prior data indicating the use of cannabis is associated with a decrease in the amount of alcohol consumed by individuals seeking alcohol treatment.

Authors further reported that legalization was not positively correlated with increased incidences of psychosis, substance abuse disorder, or other adverse outcomes.

They concluded: "Recreational cannabis legalization causes increases in mean cannabis frequency and residents of recreational states have fewer recent symptoms of AUD [alcohol use disorder]. Broadly speaking, our co-twin control and differential vulnerability results suggest that the impacts of recreational cannabis legalization on psychiatric and psychosocial outcomes are otherwise minimal. … Both sets of results are reassuring with respect to public health concerns around recreational cannabis legalization."

Although the use of cannabis and other controlled substances tends to be more common among those with psychotic illnesses, studies indicate that lifetime incidences of marijuana-induced psychosis are relatively rare among those who do not already have a prior diagnosis of a psychiatric disease. According to one recently published study, fewer than one-half of one percent of cannabis consumers had ever reported experiencing psychotic symptoms requiring medical intervention - a percentage that is lower than the rate associated with alcohol.

Full text of the study, "Recreational cannabis legalization has had limited effects on a wide range of adult psychiatric and psychosocial outcomes," appears in Psychological Medicine.

Study: Cannabis Use Associated with Improvements in Patients with Inflammatory Bowel Disease

London, United Kingdom: The daily administration of cannabis products is associated with symptom improvements in patients with inflammatory bowel disease, according to observational trial data published in the journal Expert Review of Gastroenterology & Hepatology.

British investigators assessed the safety and efficacy of cannabis products in 76 patients diagnosed with either Crohn's disease or ulcerative colitis. The study subjects were participants in the UK Medical Cannabis Registry and each of them possessed a doctor's authorization to consume cannabis. Study participants consumed either cannabis extracts, THC-dominant flowers, or both for a period of three months.

Authors reported: "Initiation of CBMPs [cannabis-based medicinal products] was associated with an improvement in HRQoL [health-related quality of life] in the short term, with statistically significant improvements in IBD-specific and general HRQoL outcomes at 1 and 3 months after initiating treatment. Participants who previously consumed cannabis had greater improvements in HRQoL and fewer adverse events compared to naïve individuals. These findings highlight the potential utility of CBMPs as an adjunctive therapeutic option in the short term, especially in patients who continue to experience debilitating symptoms despite maximal medical therapy."

Longitudinal data from Israel has similarly reported that the long-term use of whole-plant cannabis is associated with both symptom improvement and the reduced use of prescription medications in patients with treatment-resistant inflammatory bowel disease.

Subjects enrolled in the UK Medical Cannabis Registry with either post-traumatic stress or depression have also demonstrated symptomatic improvements following cannabis therapy.

Full text of the study, "The effect of medical cannabis on inflammatory bowel disease: Analysis from the UK Medical Cannabis Registry," appears in Expert Review of Gastroenterology & Hepatology.

Marijuana Legalization Laws Not Associated with Self-Reported Increases in Drugged Driving Behavior

Baltimore, MD: Cannabis consumers in states where the substance is legal for either medical or adult-use purposes are less likely to report having operated a motor vehicle while under its influence, according to data compiled in a recently published report by the group Cannabis Public Policy Consulting.

Investigators surveyed consumers from 25 states. Consistent with prior studies, authors reported that respondents residing in jurisdictions where cannabis is illegal are more likely to report driving under the influence than those in states where the substance is legally regulated.

"Those living in illicit states reported a significantly greater number of days driving under the influence of cannabis (DUIC) than those living in medical states and those living in adult use states," authors concluded. "The difference ... represents tens of millions of instances of DUIC each year across the United States."

Prior surveys of cannabis consumers have reported similar findings. A study conducted last year by investigators affiliated with the Research Triangle Institute reported: "Current cannabis users in recreational and medical-only cannabis states were significantly less likely to report driving within three hours of getting high in the past 30 days, compared to current users living in states without legal cannabis."

A 2021 study similarly determined that incidences of self-reported drugged driving behavior do not rise post-legalization. Rather, authors reported, "[M]arijuana users in states that legalized RM [recreational marijuana] self-reported driving after marijuana use less than their counterparts (who resided in states where adult-use cannabis remained illegal). They were also less likely to find such behavior [driving after ingesting cannabis] acceptable."

A 2020 study by researchers with the University of Nevada at Reno and with the Johns Hopkins Bloomberg School of Public Health also concluded that those "from states with legal recreational cannabis sales had significantly lower prevalence of driving after cannabis use and higher prevalence of protective attitudes compared to those from states without legal recreational sales."

Full text of the report, "Cannabis Legalization & Public Health Outcomes," is available online.

Study: Medical Cannabis Use Associated with Sustained Improvements in Pain, Anxiety, and Mood

Montreal, Canada: Canadian patients authorized to use medical cannabis products report sustained improvements in their health-related quality of life, according to longitudinal data published in the journal Cannabis and Cannabinoid Research.

A team of investigators affiliated with McGill University in Montreal assessed the safety and efficacy of medical cannabis products in a cohort of 2,991 patients. Subjects in the study consumed cannabis flower, extracts, or other related products for one year.

Consistent with other studies, researchers reported: "All patient-reported outcomes showed a statistically significant improvement at 3 months, which was maintained or further improved (for pain interference, tiredness, and well-being) over the remainder of the 12-month follow-up. Results also revealed clinically significant improvements in pain interference and tiredness, anxiety, and well-being from baseline." Few patients reported experiencing any serious adverse events as a result of their cannabis intake.

Authors concluded, "MC [medical cannabis] directed by physicians appears to be safe and effective within 3 months of initiation for a variety of medical indications."

Data published late last week in the journal JAMA Network Open reported that nearly one in four pain patients residing in states where medical cannabis access is legal self-identify as marijuana consumers.

Full text of the study, "The Quebec Cannabis Registry: Investigating the safety and effectiveness of medical cannabis," appears inCannabis and Cannabinoid Research.

Case Report: THC Tincture Effective at Reducing Dementia-Related Agitation

New Orleans, LA: The administration of plant-derived THC is associated with reductions in agitation and other behavioral issues in a patient with dementia, according to a case report published in the Journal of Palliative Medicine.

Researchers affiliated with Tulane University's School of Medicine and the University of Texas reported on the use of a THC-dominant tincture in an 85-year-old dementia patient. The subject exhibited worsening aggression over time and had been unresponsive to antipsychotic medicines.

Authors reported that the "patient's behavior rapidly improved" following THC treatment. These improvements were so significant that he was eventually discharged from in-patient treatment to home care.

The findings are consistent with those of a number of studies reporting that the use of plant-derived THC and CBD are safe and effective at alleviating dementia-related symptoms, including agitation, irritability, improved cognition, and sleep.

Full text of the study, "A case-report of treatment-resistant agitation in dementia with Lewy Bodies: Medical marijuana as an alternative to antipsychotics," appears in the Journal of Palliative Care.