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Study: Aerosolized Cannabis Significantly Reduces Pain Levels, Improves Quality of Life in Neuropathy Patients

Haifa, Israel: The administration of aerosolized cannabis via a novel inhaler is associated with long-term pain reductions in patients with neuropathy and other chronic conditions, according to data published in the journal Pain Reports.

Israeli investigators assessed the efficacy of cannabis delivered via a novel metered selective dose inhaler (The Syqe Inhaler) in a cohort of chronic pain patients. The mean daily stable dose used by patients in the study was 1.5 mg of aerosolized delta-9-THC.

Use of the inhaler over a period of several months was associated with reduced pain scores and improvements in patients' quality of life. Some patients reported mild side-effects (typically dizziness and sleepiness) at the onset of the study, but few participants continued to report these effects throughout the duration of the trial.

Authors concluded: "Medical cannabis treatment with the Syqe Inhaler demonstrated overall long-term pain reduction[s], quality of life improvement[s], and opioid-sparing effect[s] in a cohort of patients with chronic pain, using just a fraction of the amount of MC [medical cannabis] compared with other modes of delivery by inhalation. These outcomes were accompanied by a lower rate of AEs [adverse events] and almost no AE reports during a long-term steady-state follow-up. Additional follow-up in a larger population is warranted to corroborate our findings."

According to recently compiled survey data, nearly one in three chronic pain patients report using cannabis for treatment management. Among patients in US states where medical cannabis access is permitted, over 60 percent are qualified to use it to treat pain.

Full text of the study, "Long-term effectiveness and safety of medical cannabis administered through the metered-dose Syqe Inhaler," appears in Pain Reports.

Randomized Controlled Trial: Topical CBD Treatment Provides Relief in Arthritis Patients

Charlottesville, VA: The administration of a topical formula containing hemp-derived CBD is associated with significant improvements in patients with thumb basal joint arthritis, according to randomized clinical trial data published in the Journal of Hand Surgery.

Researchers with the University of Virginia School of Medicine assessed the twice-daily application of 1 ml of topical CBD (6.2 mg/ml) with shea butter versus placebo in 18 patients with symptomatic thumb basal joint arthritis.

Investigators reported, "Cannabidiol treatment resulted in improvements from baseline among patient-reported outcome measures, including Visual Analog Scale pain; Disabilities of the Arm, Shoulder, and Hand; and Single Assessment Numeric Evaluation scores, compared to the control arm during the study period."

They concluded, "In this single-center, randomized controlled trial, topical CBD treatment demonstrated significant improvements in thumb basal joint arthritis-related pain and disability without adverse events."

The results contrast those of a 2021 Danish study reporting that the oral administration of synthetic CBD did not mitigate pain in patients with hand osteoarthritis.

Canadian survey data published earlier this month in the journal Clinical and Experimental Rheumatology reported that one in five patients with arthritis acknowledge using cannabis therapeutically.

Full text of the study, "A randomized controlled trial of topical cannabidiol for the treatment of thumb basal joint arthritis," appears in the Journal of Hand Surgery.

Analysis: Cannabis Use Inversely Associated with Obesity in Hep C Patients

Paris, France: Cannabis use is inversely associated with obesity in patients with chronic hepatitis C virus (HCV) infection, according to data published in the Journal of Cannabis Research.

A team of French researchers assessed the relationship between lifetime cannabis use and obesity in a cohort of over 6,300 HCV patients.

Authors reported, "[F]ormer and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. â€Ļ To our knowledge, this is the first time that such associations have been highlighted for HCV-infected patients."

The study's findings are consistent with those of analyses of other cohorts – such as those here, here, and here – reporting that marijuana use is typically associated with lower BMI and with lower rates of obesity.

Full text of the study, "Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: Results from the ANRS C022 Hepather cohort," is available in the Journal of Cannabis Research.

Study: Regular Cannabis Consumers Perform Better Than Occasional Users on Distracted Driving Tasks

Aurora, CO: Those with a history of frequent cannabis use exhibit only minor changes in driving performance shortly following marijuana smoking, according to driving simulator data published in the journal Traffic Injury Prevention.

Investigators with the University of Colorado, Anschutz Medical Campus and the University of Iowa assessed driving simulated performance in a cohort of frequent and infrequent cannabis consumers. Participants provided their own cannabis, which contained between 15 and 30 percent THC. Following cannabis smoking ad-libitum, subjects completed a series of distracted driving scenarios.

Authors reported: "Those with a pattern of occasional use were significantly more likely to experience a lane departure during distraction periods after acute cannabis use relative to baseline, while those with daily use did not exhibit a similar increase." Consistent with other studies, researchers further acknowledged, "Participants with a pattern of daily use decreased their speed, which may be interpreted as a drug effect or as a compensatory strategy."

Separate studies have previously reported that repeated cannabis exposure is associated with either partial or even full tolerance in particular domains, including cognitive and psychomotor performance.

The study's authors concluded: "The results provide evidence that a pattern of occasional use was associated with performing worse after acute cannabis smoking as it relates to lane departures. Those with a pattern of occasional use also behave differently with respect accelerator position, and there was a trend that those with a pattern of daily use decreased the speed. This would be consistent with the hypothesis of tolerance, with individuals with daily use being somewhat less affected by or better able to mitigate the effects of acute cannabis smoking. This may indicate that those who use daily may perceive a potential adverse impact of acute cannabis use on driving performance and may attempt to compensate by slowing down to have more time to react to changes in the roadway. Further research is needed to understand the effects during longer and more complex secondary tasks."

Though not a primary focus of the study, investigators did assess subjects' baseline THC/blood levels upon their admission to the lab. Consistent with prior research, those subjects who reported daily cannabis use tested positive for THC in their blood (mean THC blood level: 5ng/ml) despite having abstained from marijuana for at least the past 12 hours.

NORML has long advocated against the imposition of THC blood thresholds as predictors of impairment, and per se traffic safety limits in particular, because they are not consistently correlated with changes in subjects' performance and because residual THC levels may linger in blood for several hours or even days post-abstinence. Alternatively, NORML has called for the expanded use of performance-based tests, like DRUID.

Full text of the study, "Influence of cannabis use history on the impact of cannabis smoking on simulated driving performance during a distraction task," appears in Traffic Injury Prevention.

Analysis: Medical Cannabis Access Positively Correlated with Traffic Safety

Philadelphia, PA: The enactment of medical cannabis access laws is associated with reductions in auto insurance premiums and improvements in overall traffic safety, according to data published in the journal Health Economics.

A team of economists associated with Temple University in Philadelphia, the University of Arkansas, Little Rock and Eastern Kentucky University assessed the relationship between legalized medical cannabis access (via licensed dispensaries) and auto insurance premiums between the years 2014 and 2019.

Researchers reported that medical access was associated with a decrease in auto premiums. "We estimate that legalizing medical cannabis reduces annual auto insurance premiums by $22 per household, a reduction of 1.7 percent for the average household," they wrote. "The effect is stronger in areas directly exposed to a dispensary, suggesting increased access to cannabis drives the results. In addition, we find relatively large declines in premiums in areas with relatively high drunk driving rates prior to medical cannabis legalization. This latter result is consistent with substitutability across substances that is argued in the literature."

They concluded: "While this [$22] reduction may be inconsequential to an individual policy-holder, the aggregate effects are economically meaningful. For just the policyholders in our switching states, we estimate a combined annual reduction in premiums of $500 million. Extending our results to other states, we find that medical cannabis legalization has reduced auto insurance premiums by $1.5 billion in all states that have currently legalized, with the potential to reduce premiums by an additional $900 million if the remaining states were to legalize. Because auto insurance premiums are directly tied to property damage and health outcomes, we find evidence of a positive social impact of medical cannabis on auto safety."

The study's findings are consistent with those of prior analyses similarly reporting a decrease in traffic fatalities following the implementation of medical cannabis access, including reductions in motor vehicle accidents involving drivers under the influence of alcohol and opioids.

Full text of the study, "Medical cannabis and automobile accidents: Evidence from auto insurance," appears in Health Economics.

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