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Study: Cannabis Products Improve Health-Related Quality of Life in Patients with Chronic Illnesses

London, United Kingdom: Patients’ consumption of medical cannabis products is well-tolerated and is associated with significant improvements in their health-related quality of life, according to observational data published in the journal Expert Review of Clinical Pharmacology.

British investigators assessed the safety and efficacy of cannabis-derived products in 2,833 patients enrolled in the UK Medical Cannabis Registry. All of the participants possessed a doctor’s authorization to access cannabis products. (Since 2018, specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.)

Patients enrolled in the registry suffered from a variety of disorders, including chronic pain, anxiety, post-traumatic stress, depression, migraine, inflammatory bowel disease, and other afflictions. 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, six, and twelve months.

Authors reported that the majority of patients experienced sustained improvements following cannabis therapy. Adverse events associated with cannabis were typically mild, with the most frequently reported side-effects being dry mouth and fatigue.

They concluded: “This observational study suggests that initiating treatment with CBMPs [cannabis-based medicinal products] is associated with an improvement in general HRQoL [health-related quality of life], as well as sleep- and anxiety-specific symptoms up to 12 months in patients with chronic illness. … Most patients tolerated the treatment well, however, the risk of AEs [adverse events] should be considered before initiating CBMPs. In particular, female and cannabis-naïve patients are at increased likelihood of experiencing adverse events. These findings may help to inform current clinical practice, but most importantly, highlights the need for further clinical trials to determine causality and generate guidelines to optimize therapy with CBMPs.”

Full text of the study, “An observational study of safety and clinical outcome measures across patient groups in the United Kingdom Medical Cannabis Registry,” appears in Expert Review of Clinical Pharmacology.

Justice Department Appealing Federal Ruling That Struck Down Gun Ban for Cannabis Consumers

Washington, DC: The Justice Department is appealing a ruling issued by a federal judge last month that struck down a longstanding federal law prohibiting marijuana users from possessing firearms.

In early February, a federal judge for the US District Court for the Western District of Oklahoma determined that the 1968 law was unconstitutional. The judge determined: “[T]he mere use of marijuana carries none of the characteristics that the Nation’s history and tradition of firearms regulation supports. The use of marijuana — which can be bought legally (under state law) at more than 2,000 ordinary store fronts in Oklahoma — is not in and of itself a violent, forceful, or threatening act. It is not a ‘crime of violence.’ Nor does it involve ‘the actual use or threatened use of force.’”

On Friday, the Justice Department announced that it was appealing the ruling in the U.S. Court of Appeals for the Tenth Circuit.

In 2016, a three-judge panel of the Ninth Circuit Court of Appeals upheld the federal government’s interpretation of the law. Justices opined that the ban “furthers the Government’s interest in preventing gun violence” because marijuana users “are more likely to be involved in violent crimes.”

The case is United States of America v. James Michael Harrison.

Adult-Use Marijuana Legalization Legislation Advances in Three States

Washington, DC: Legislation legalizing the possession of marijuana by those age 21 and older continues to advance in three states.

Lawmakers in Hawaii advanced Senate Bill 669 on Tuesday by a vote of 22 to 3. The bill legalizes marijuana use, production, and retail sales for adults. It now awaits action in the House, where it faces an uncertain future. Specifically, House Speaker Scott Saiki has expressed reluctance to move the bill this year, instead calling for the issue to be further assessed in a summer study session.

In Delaware, House members voted 28 to 13 in support of HB 1, which removes criminal and civil penalties for adults who possess personal use quantities of cannabis. Complimentary legislation (HB 2) providing regulations for the adult-use cannabis retail market is pending in the chamber. Last year legislation similar to SB 1 was passed by lawmakers, but vetoed by Democratic Gov. John Carney, who opined, “I do not believe that promoting or expanding the use of recreational marijuana is in the best interests of the state of Delaware, especially our young people.”

Finally, in Minnesota, a pair of bills (HF 100 | SB 73) legalizing the adult-use cannabis market have passed multiple committees and are anticipated to receive floor votes in the coming weeks. The bills have the support of Democratic Gov. Tim Walz, who publicly predicted that the state would pass legalization by May.

Analysis: Black and Hispanic Patients Disproportionately Screened for Perinatal Cannabis Use

Boston, MA: Patients selected to undergo marijuana-specific drug screening during the labor and delivery process are disproportionately Hispanic or African American and they are also likely to be on subsidized health insurance plans, according to data published in the journal Hospital Pediatrics.

Researchers affiliated with Harvard Medical School assessed characteristics of 1,924 patients who underwent peripartum toxicology testing between 2016 and 2020 at five birthing hospitals in Massachusetts.

Consistent with prior studies, those singled out for testing were disproportionately Black or Hispanic and many were publicly insured. Specifically, Hispanic patients were twice as likely to be mandated to undergo testing and Black patients were four times as likely to be ordered to do so. Those on public health care plans were more than twice as likely to be tested for past cannabis exposure.

However, doctors seldom took any follow up action or made changes to patients’ clinical management after they tested positive for cannabis.

The study’s authors concluded, “Toxicology testing of patients for a sole indication of cannabis use, without other risk factors, may be of limited utility in elucidating other substance use and may exacerbate existing disparities in perinatal outcomes.”

Data assessing the relationship between in utero cannabis exposure and various neonatal outcomes, such as birth weight, is inconsistent. However, longitudinal data indicates that cannabis exposure is rarely independently linked with adverse neurodevelopmental consequences, finding, “Although there is a theoretical potential for cannabis to interfere with neurodevelopment, human data drawn from four prospective cohorts have not identified any long-term or long lasting meaningful differences between children exposed in utero to cannabis and those not.”

Nonetheless, in some states, such as in Oklahoma and Alabama, mothers have been arrested and criminally prosecuted for the use of cannabis during their pregnancy. In total, 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and three consider it grounds for civil commitment, according to data provided by the Guttmacher Policy Review.

Full text of the study, “Limited utility of toxicology testing at delivery for perinatal cannabis use,” appears in Hospital Pediatrics.