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Review: Cannabis Smoke Exposure "Distinctly Different" From Tobacco

Little Rock, AR: Cannabis smoke is "distinctly different from tobacco" and its exposure is not linked to an elevated risk of either lung cancer or chronic obstructive pulmonary disease (COPD), according to a literature review published in the journal Medical Clinics of North America.

Researchers affiliated with the University of Arkansas for Medical Sciences reviewed data assessing the potential impact of cannabis smoke exposure on pulmonary health. They reported that marijuana smoking is associated with an increased risk of bronchitis, but that it is likely not responsible for lung disease, small airway injury, COPD, or lung cancer.

"[T]he data on marijuana contrast starkly with the consistent demonstration of injury from tobacco," authors concluded. "Any possible toxicity of marijuana pales in comparison."

The review's findings are consistent with those of numerous other studies determining that the long-term respiratory effects of cannabis differ from those associated with traditional smoking, and that those who exclusively smoke cannabis possess a reduced level of exposure to harmful toxicants and carcinogens than do those who smoke tobacco cigarettes. Moreover, the use of vaporization technology, which heats herbal cannabis to a set temperature below the point of combustion, is associated with even further reductions in exposure to toxic gasses and has been identified as a "safe and effective" cannabis delivery device in clinical trial settings.

Full text of the study, "Marijuana and the lung: Evolving Understandings," appears in Medical Clinics of North America.

Sentencing Commission Identifies Over 6,500 Americans Eligible to Receive Pardons Under POTUS' Marijuana Directive

Washington, DC: A recent directive by the President of the United States to pardon those with low-level federal marijuana possession convictions will provide forgiveness for 6,557 citizens, according to estimates provided by the U.S. Sentencing Commission (USSC).

The USSC analysis includes federal data dating back to 1992. It found that the greatest percentage of those eligible for relief are located either in the southwest or the mid-Atlantic region of the United States.

According to the US Department of Justice, a Presidential pardon "is an expression of the President's forgiveness and ordinarily is granted in recognition of the applicant's acceptance of responsibility for the crime and established good conduct for a significant period of time after conviction or completion of sentence. It does not signify innocence. It does, however, remove civil disabilities - e.g., restrictions on the right to vote, hold state or local office, or sit on a jury - imposed because of the conviction for which pardon is sought, and should lessen the stigma arising from the conviction. It may also be helpful in obtaining licenses, bonding, or employment."

On October 6, President Joe Biden announced his intent to "pardon of all prior Federal offenses of simple possession of marijuana." The President also announced that he was encouraging Governors to take similar actions.

To date, nearly two dozen states have enacted legislation explicitly facilitating the process of having select marijuana convictions expunged, vacated, otherwise set aside, or sealed from public view. These laws have led state and local officials nationwide to expunge or seal the records of over two million people with prior cannabis convictions. In addition, the Governors of Colorado, Nevada, Illinois, and Washington have also granted an estimated 30,000 pardons to those with low-level marijuana convictions.

Since 1965, nearly 29 million Americans have been arrested for violating state or local marijuana laws, according to archived data from the FBI's Uniform Crime Report.

According to a number of recently released national polls, Americans overwhelmingly approve of the President's decision to pardon low-level marijuana offenders.

Clinical Trial: CBD Offsets THC-Induced Anxiety

Maastricht, The Netherlands: Subjects who consume cannabis containing equal amounts of THC and CBD report experiencing less anxiety than they do after consuming THC-dominant cannabis, according to trial data published in the journal Psychopharmacology.

Dutch investigators assessed perceived anxiety levels in a cohort of 26 subjects following single doses of vaporized cannabis. Subjects vaporized cannabis samples that were either high in THC (13.75 mgs), high in CBD (13.75 mgs), contained equal amounts of both CBD and THC, or that contained no cannabinoids.

Investigators reported that THC-dominant and THC/CBD equivalent samples significantly increased participants' self-rated state of anxiety compared to placebo, but subjects reported less anxiety after consuming the latter. Specifically, they reported, "Combined treatment of THC and CBD delayed the onset of ... anxiety, reduced its magnitude and shortened its duration compared to inhalation of THC alone."

The study's findings are consistent with those of prior studies documenting CBD's anxiolytic effects, and determining that subjects who consume cannabis flowers containing equal ratios of THC and CBD are less likely to report experiencing adverse effects, such as feelings of paranoia.

Authors concluded: "The present study showed that cannabis containing equivalent concentrations of THC and CBD induces less self-rated ... anxiety compared to THC-only cannabis in healthy volunteers. ... The THC/CBD combination might be more favorable in clinical settings, and it may be a reasonable public health strategy to encourage cannabis breeds containing THC/CBD mixtures where recreational use of cannabis is now legal."

Full text of the study, "Cannabis containing equivalent concentrations of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) induces less state anxiety than THC-dominant cannabis," appears in Psychopharmacology.

Survey: Caregivers Report That CBD Improves Symptoms of Fragile X Syndrome

New York, NY: The use of CBD products provides symptom relief to pediatric patients with Fragile X Syndrome (FXS), according to survey responses provided by their parents and caregivers. FXS is a genetic disorder that results in developmental disorders and behavioral problems (e.g., failure to make eye contact, hyperactivity, anxiety, trouble paying attention, etc.)

Investigators affiliated with the Icahn School of Medicine at Mount Sinai, New York and with the National Fragile X Foundation in McLean, Virginia surveyed the parents and caregivers of individuals with FXS who were receiving or had received CBD.

The majority of respondents reported CBD to be either very effective or somewhat effective at improving the following FSX symptoms: anxiety (80 percent), hypersensitivity (74 percent), irritability (73 percent), attention problems (60 percent), aggression (60 percent), and sleep disorders (53 percent).

"Overall, caregivers generally reported that CBD made a significant and positive difference to individuals' symptoms," authors concluded. "Most parents reported that side effects were not experienced, and any that were reported were generally mild or very mild. ... Placebo-controlled clinical trials regarding CBD as a treatment for FXS are essential to better understanding the efficacy and safety of CBD in FXS."

In a pair of pilot studies, CBD administration was associated with quality of life improvements and reductions in patients' anxiety, compulsive behavior, and irritability.

Full text of the study, "Parent and caregiver perspectives toward cannabidiol as a treatment for Fragile X Syndrome," appears in Genes.

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Study: Long-Term Use of Cannabis Extracts Safe and Effective in Dementia Patients

Geneva, Switzerland: The administration of plant-derived extracts containing a two-to-one ratio of CBD to THC is associated with behavioral improvements and few adverse side effects in dementia patients, according to data published in the journal Frontiers in Aging Neuroscience.

A team of Swiss researchers assessed the long-term safety and efficacy of the adjunctive use of cannabis extracts in a cohort of dementia patients (mean age: 81 years). Participants received an average of 12.4 mgs of THC and 24.8 mgs of CBD per day for up to 13 months.

Investigators reported "marked improvements" in patients' symptoms over the course of the trial, including reduced agitation. They reported "no problems related to the treatment and limited adverse drug reactions."

They concluded, "A long-term THC/CBD (1:2) medication can be administered safely and with overall positive clinical improvement to poly medicated older adults with severe dementia and associated problems."

The study's results are similar to those recently reported in a placebo-controlled trial which determined that the sublingual administration of CBD-dominant plant extracts reduced agitation and improved sleep in dementia patients.

Full text of the study, "Cannabinoids for behavioral symptoms in severe dementia: Safety and feasibility in a long-term pilot observational study in nineteen patients," appears in Frontiers in Aging Neuroscience.

Survey: IBD Patients Report Fewer ER Visits Following Initiation of Medical Cannabis

Bronx, NY: Patients with inflammatory bowel disease (IBD) report symptom mitigation and fewer emergency room visits following the use of cannabis products, according to data published in the Journal of Clinical Gastroenterology.

Investigators affiliated with the Albert Einstein College of Medicine in New York City surveyed a cohort of 236 IBD patients registered in the state's medical cannabis access program.

Respondents "reported fewer emergency room visits in the 12 months after versus before MC [medical cannabis] use and less impact of symptoms on daily life." Subjects in the study were most likely to consume THC-dominant products via vaporization. Minor adverse effects, specifically drowsiness, were reported among a minority (4.2 percent) of subjects.

Authors concluded: "MC users with IBD perceive symptom benefits and report decreased emergency room visits without serious adverse effects. Further studies are needed to confirm these results with objective measures of healthcare utilization and disease activity."

Observational trials have previously documented that cannabis use is associated with "decreased inpatient health care utilization" in patients with irritable bowel syndrome and with fewer disease-related hospitalizations in patients with Crohn's. In a randomized placebo-controlled trial involving 21 patients with refractory Chron's disease, nearly half achieved disease remission following their use of herbal cannabis.

Full text of the study, "Medical cannabis use patterns and adverse effects in inflammatory bowel disease," appears in the Journal of Clinical Gastroenterology.

Study: Oro-Buccal Cannabis Spray Provides Relief in Cancer Patients with Refractory Pain

New South Wales, Australia: Terminal cancer patients with refractory pain respond favorably to a proprietary cannabis spray containing equal ratios of plant-derived THC and CBD, according to data published in the journal PLOS One.

A team of Australian investigators assessed the safety and efficacy of a novel water-soluble oro-buccal nanoparticle spray containing 2.5 mgs of THC and 2.5 mgs of CBD in a cohort of patients with advanced cancer and intractable pain.

Researchers reported that cannabis dosing was associated with improvements in pain relief among all patients, with those patients suffering from bone metastasis experiencing the greatest levels of relief. No serious adverse events were reported, though some patients did experience drowsiness following treatment.

Patients also reported improvements in appetite and emotional well-being.

"This study demonstrated that the administration of the investigative cannabis-based medicine was generally safe and tolerated in a short-term exposure in a cohort of patients with advanced incurable cancers with controlled pain or intractable pain despite opioid treatment," authors concluded. "There was a reduction in pain overall for the study cohort of 12 percent by the end of the treatment phase. ... [This] cannabis-based medicine ... is of significant clinical interest given that this formulation was a self-titrated medicine, that showed preliminary analgesic efficacy in a subgroup of patients."

Full text of the study, "Pilot clinical and pharmacokinetic study of delat-9-tetrahydrocannabinol/cannabidiol nanoparticle oro-buccal spray in patients with advanced cancer experiencing uncontrolled pain," appears in PLOS One.

Oklahoma: Voters to Decide Marijuana Legalization Measure in March Election

Oklahoma City, OK: Voters will decide on a citizens' initiated measure legalizing the adult-use marijuana market in a special election to be held in March.

Republican Gov. Kevin Stitt issued the executive proclamation calling for the special election on Tuesday, March 7, 2023.

State Question 820, sponsored by the group Oklahomans for Sensible Marijuana Laws, permit 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.

In July, advocates for SQ 820 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 this year's printed ballots.

"After all the delays caused by the new signature count process, we are excited to finally be going to the ballot on March 7, 2023, so that Oklahomans can experience the benefits of SQ820 without further delay," Michelle Tilley, campaign director for OSLM / Yes on 820, told the website Marijuana Moment. "Republicans, Libertarians, Democrats and independents alike are excited to stop wasting law enforcement resources and start reaping the hundreds of millions of dollars in financial benefits that come with legalizing, regulating and taxing recreational marijuana for adults in Oklahoma."

Voters in five states - Arkansas, Maryland, Missouri, North Dakota, and South Dakota - will be deciding on similar adult use legalization measures in November.

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